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| | |
 | Issue Date FY: 2016 ( Subtotal = $16,706,366 ) |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20161-T21 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 1 - T21 | 0 | 1 | CMS | 10/7/2015 | $1,980,793 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20162 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 2 - T19 | 0 | 1 | CMS | 1/1/2016 | $72,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20161 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2015 | $340,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20161 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2015 | $10,770,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20161 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 1 - T19 | 1 | 1 | CMS | 10/1/2015 | $72,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20163 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 3 - T19 | 0 | 1 | CMS | 4/1/2016 | $98,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20164 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 4 - T19 | 0 | 1 | CMS | 7/1/2016 | $2,950,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20164 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 4 - T19 | 1 | 1 | CMS | 7/1/2016 | $46,000 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20162-T21 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 2 - T21 | 0 | 1 | CMS | 2/10/2016 | $154,686 |
| | 2016 | 2016 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20162-T21 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 2 - T21 | 1 | 1 | CMS | 3/24/2016 | $388,521 |
| | 2016 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20162 | Medicaid entitlement for Amer. Samoa - FY 2016 Quarter 2 - T19 | 1 | 1 | CMS | 3/30/2016 | -$165,634 |
|
| Issue Date FY: 2015 ( Subtotal = $15,463,629 ) |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20151-T21 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 1 - T21 | 0 | 1 | CMS | 10/22/2014 | $1,267,648 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20151 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 1 - T19 | 1 | 1 | CMS | 12/4/2014 | $3,000,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20151 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 1 - T19 | 2 | 1 | CMS | 11/13/2014 | $68,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20151 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2014 | $340,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20151 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2014 | $10,560,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20153 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 3 - T19 | 0 | 1 | CMS | 4/1/2015 | $91,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20153 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 3 - T19 | 1 | 1 | CMS | 6/25/2015 | -$49,019 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20152 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 2 - T19 | 1 | 1 | CMS | 4/23/2015 | $2,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 0 | 1 | CMS | 7/1/2015 | $55,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 6 | 1 | CMS | 7/1/2015 | $55,000 |
| | 2015 | 2015 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20152 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 2 - T19 | 0 | 1 | CMS | 1/1/2015 | $74,000 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 2 | 1 | CMS | 8/31/2015 | $65 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 5 | 1 | CMS | 8/20/2015 | -$25,000 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 4 | 1 | CMS | 8/20/2015 | $25,000 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 9 | 1 | CMS | 8/20/2015 | $25,000 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 3 | 1 | CMS | 8/31/2015 | -$65 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 8 | 1 | CMS | 8/31/2015 | -$65 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 7 | 1 | CMS | 8/31/2015 | $65 |
| | 2015 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20154 | Medicaid entitlement for Amer. Samoa - FY 2015 Quarter 4 - T19 | 10 | 1 | CMS | 8/20/2015 | -$25,000 |
|
| Issue Date FY: 2014 ( Subtotal = $12,077,589 ) |
| | 2014 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20141 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2013 | $10,300,000 |
| | 2014 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20141 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 1 - T19 | 0 | 1 | CMS | 10/1/2013 | $340,000 |
| | 2014 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20141 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 1 - T19 | 1 | 1 | CMS | 10/1/2013 | $271,800 |
| | 2014 | 2014 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20141-T21 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 1 - T21 | 0 | 1 | CMS | 10/1/2013 | $1,383,737 |
| | 2014 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20144 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 4 - T19 | 1 | 1 | CMS | 9/29/2014 | -$67,773 |
| | 2014 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20144 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 4 - T19 | 0 | 1 | CMS | 9/29/2014 | $67,773 |
| | 2014 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20142 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 2 - T19 | 1 | 1 | CMS | 3/28/2014 | $37,000 |
| | 2014 | 2012 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20142 | Medicaid entitlement for Amer. Samoa - FY 2014 Quarter 2 - T19 | 0 | 1 | CMS | 3/28/2014 | -$254,948 |
|
| Issue Date FY: 2013 ( Subtotal = $15,564,889 ) |
| | 2013 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20131 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 1 - T19 | 0 | 1 | CMS | 10/1/2012 | $9,900,000 |
| | 2013 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | | | USA | AS20132-T21 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 2 - T21 | 0 | 1 | CMS | 1/1/2013 | $207,889 |
| | 2013 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20133 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 3 - T19 | 0 | 1 | CMS | 4/1/2013 | $5,000,000 |
| | 2013 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20134 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 4 - T19 | 0 | 1 | CMS | 9/25/2013 | $117,000 |
| | 2013 | 2013 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | 96799 | AMERICAN SAMOA | USA | AS20131 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 1 - T19 | 0 | 1 | CMS | 10/1/2012 | $340,000 |
| | 2013 | 2012 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | | | USA | AS20131 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 1 - T19 | 2 | 1 | CMS | 12/12/2012 | -$173,000 |
| | 2013 | 2012 | LBJ TROPICAL MED/MEDICAID | LBJ TROPICAL MEDICAL CENTER | PAGO PAGO | AS | | | USA | AS20131 | MEDICAID ENTITLEMENT FOR AMER. SAMOA - FY 2013 QUARTER 1 - T19 | 1 | 1 | CMS | 12/12/2012 | $173,000 |
|
| Issue Date FY: 2012 ( Subtotal = $14,884,265 ) (Continued on the next page) |
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