| | | | | | | | | | | | | | | |
| | |
 | Issue Date FY: 2022 ( Subtotal = -$109,000 ) |
| | 2022 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Medical Assistance Program | 4 | 1 | 1/18/2022 | SUPPLEMENT FOR EXPANSION | -$109,000 |
|
| Issue Date FY: 2021 ( Subtotal = $219,500 ) |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Medical Assistance Program | 0 | 1 | 12/21/2020 | NEW | $220,000 |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Medical Assistance Program | 3 | 1 | 7/1/2021 | NEW | $160,000 |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Medical Assistance Program | 2 | 1 | 7/16/2021 | SUPPLEMENT FOR EXPANSION | $59,500 |
| | 2021 | 2021 | American Samoa Medicaid Agency | 998383 Tafuna Road #306 | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | Medical Assistance Program | 1 | 1 | 4/20/2021 | SUPPLEMENT FOR EXPANSION | -$220,000 |
|
|
