| 01 | California Department of Health Care Servicesof $117.3B total | $117.3B | $112.5B | same |
| 02 | NYS Department of Healthof $75.1B total | $75.1B | $76.6B | same |
| 03 | Health & Human SVC Commn TXof $46.6B total | $46.6B | $40.8B | same |
| 04 | PA Department of Human Servicesof $39.8B total | $39.8B | $36.2B | same |
| 05 | North Carolina Department of Health & Human Servicesof $32.4B total | $32.4B | $31.4B | same |
| 06 | Ohio Department of Medicaidof $29B total | $29B | $27.7B | same |
| 07 | Florida Agency for Health Care Administrationof $27.9B total | $27.9B | $22.8B | ▲ 1 |
| 08 | Michigan Department of Health and Human Servicesof $27.7B total | $27.7B | $24.5B | ▼ 1 |
| 09 | Illinois Department of Healthcare & Family Servicesof $25.5B total | $25.5B | $21.9B | same |
| 10 | Department of Social & Health Servicesof $23B total | $23B | $15.8B | ▲ 7 |
| 11 | Department of Social Services Californiaof $22.7B total | $22.7B | $21.1B | ▼ 1 |
| 12 | New Jersey Department of Human Servicesof $22.4B total | $22.4B | $20.2B | ▼ 1 |
| 13 | Health Services Kentucky Cabinet forof $20.5B total | $20.5B | $18.2B | ▼ 1 |
| 14 | Arizona Health Care Cost Containment Systemof $18.9B total | $18.9B | $16.4B | ▲ 2 |
| 15 | The Commonwealth of Massachusettsof $17B total | $17B | $16.8B | same |
| 16 | VA Department of Medical Assistance Serviceof $16.8B total | $16.8B | $17.2B | ▼ 2 |
| 17 | Department of Social Services Missoof $16.5B total | $16.5B | $14.5B | ▲ 3 |
| 18 | Indiana Family and Social Servof $16B total | $16B | $18B | ▼ 5 |
| 19 | Oregon Health Authority-Public Healthof $16B total | $16B | $13.9B | ▲ 2 |
| 20 | Georgia Department of Community Healthof $14.9B total | $14.9B | $13B | ▲ 3 |
| 21 | Lousiana Department of Healthof $14.6B total | $14.6B | $14.6B | ▼ 2 |
| 22 | Minnesota Department of Human Servicesof $14B total | $14B | $13.8B | same |
| 23 | Maryland Department of Healthof $13.3B total | $13.3B | — | — |
| 24 | State of Wisconsin Department of Health Servicesof $12.2B total | $12.2B | $11B | ▲ 1 |
| 25 | Finance & Administration Tennessee Deparof $12.2B total | $12.2B | $11.9B | ▼ 1 |
| 26 | State of Colorado - Dept of Health Care Policy & Financingof $11.7B total | $11.7B | $10B | ▲ 1 |
| 27 | New York State Office of Temporary & Disability Assistanceof $11.1B total | $11.1B | $11B | ▼ 1 |
| 28 | New Mexico Health Care Authorityof $10.7B total | $10.7B | $9.6B | ▲ 1 |
| 29 | Department of Health Human Servicesof $9.4B total | $9.4B | $8.9B | ▲ 1 |
| 30 | Oklahoma Health Care Authorityof $8.9B total | $8.9B | $7.9B | ▲ 3 |
| 31 | National Railroad Passenger Corporationof $8.6B total | $8.6B | $15.2B | ▼ 13 |
| 32 | Department of Social Services Connecticutof $8.5B total | $8.5B | $8.6B | ▼ 1 |
| 33 | Department of Education Californiaof $7.6B total | $7.6B | $7.5B | ▲ 2 |
| 34 | Texas Office of the Governorof $7.6B total | $7.6B | $331.5M | ▲ 395 |
| 35 | IA Department of Human Servicesof $7.4B total | $7.4B | $8B | ▼ 3 |
| 36 | Arkansas Department of Human Servicesof $7.1B total | $7.1B | $7.2B | same |
| 37 | Alabama Medicaid Agencyof $6.9B total | $6.9B | $6.6B | same |
| 38 | Florida Department of Children and Familiesof $6.8B total | $6.8B | $7.6B | ▼ 4 |
| 39 | Department of Transportation Californiaof $6.5B total | $6.5B | $6.3B | ▼ 1 |
| 40 | Mississippi Division of Medicaidof $6.3B total | $6.3B | $6B | ▲ 1 |
| 41 | Texas Department of Transportationof $6.2B total | $6.2B | $6B | ▲ 1 |
| 42 | Nevada Department of Human Servicesof $6B total | $6B | $6.1B | ▼ 2 |
| 43 | Illinois Department of Human Serviceof $5.7B total | $5.7B | $5.9B | same |
| 44 | West Virginia Department of Health and Human Resourcesof $5.5B total | $5.5B | $4.7B | ▲ 1 |
| 45 | Kansas Department of Health & Environmentof $5.3B total | $5.3B | $4.6B | ▲ 3 |
| 46 | New York State Education Departmentof $5B total | $5B | $4.6B | same |
| 47 | Maine Department of Health and Human Servicesof $4.8B total | $4.8B | $4.3B | ▲ 3 |
| 48 | Ohio Department of Job & Family Servicesof $4.6B total | $4.6B | $4.4B | ▲ 1 |
| 49 | Nebraska Department of Health & Human Servicesof $4.5B total | $4.5B | $4.2B | ▲ 2 |
| 50 | Puerto Rico Department of Healthof $4.5B total | $4.5B | $3.7B | ▲ 7 |
| 51 | Transportation North Carolina Departmentof $4.5B total | $4.5B | $2B | ▲ 45 |
| 52 | New York City Housing Authorityof $4.4B total | $4.4B | $4.6B | ▼ 5 |
| 53 | TX Education Agencyof $4B total | $4B | $3.9B | ▲ 1 |
| 54 | Department of Human Servicesof $4B total | $4B | $4B | ▼ 2 |
| 55 | Utah Department of Health and Human Servicesof $3.9B total | $3.9B | $3.8B | ▲ 1 |
| 56 | Government of District of Columbiaof $3.9B total | $3.9B | $3.9B | ▼ 1 |
| 57 | Pennsylvania Department of Transportationof $3.8B total | $3.8B | $2.9B | ▲ 11 |
| 58 | Idaho Department of Health & Welfareof $3.8B total | $3.8B | $4B | ▼ 5 |
| 59 | Texas Department of Agricultureof $3.6B total | $3.6B | $3.3B | ▲ 3 |
| 60 | State of Alaska Department of Healthof $3.6B total | $3.6B | $2.9B | ▲ 9 |
| 61 | Department of Human Services Hawaiiof $3.4B total | $3.4B | $3B | ▲ 5 |
| 62 | State of Florida Department of Transportationof $3.3B total | $3.3B | $2.8B | ▲ 10 |
| 63 | Florida Department of Educationof $3.3B total | $3.3B | $3.2B | same |
| 64 | United Nations Office for the Coordination of Humanitarian Affairsof $3.2B total | $3.2B | — | — |
| 65 | Administracion DE Desarrollo Socioeconomico DE LA Familiaof $3.1B total | $3.1B | $3.1B | ▼ 1 |
| 66 | State of Rhode Island Department of Administrationof $3.1B total | $3.1B | $2.7B | ▲ 7 |
| 67 | Ohio Department of Transportationof $3B total | $3B | $2.3B | ▲ 14 |
| 68 | Metropolitan Transportation Authorityof $2.8B total | $2.8B | $3.4B | ▼ 9 |
| 69 | Department of Transitional Assistanof $2.8B total | $2.8B | $3B | ▼ 4 |
| 70 | Delaware Dept of Health and Social Servicesof $2.7B total | $2.7B | $2.3B | ▲ 12 |
| 71 | Department of Transportation New Yorkof $2.7B total | $2.7B | $3.3B | ▼ 10 |
| 72 | State of Florida Division of Emergency Managementof $2.7B total | $2.7B | $5.8B | ▼ 28 |
| 73 | Illinois State Board of Educationof $2.7B total | $2.7B | $2.4B | ▲ 5 |
| 74 | Ufcw - Northern California Employers Joint Pension Planof $2.6B total | $2.6B | — | — |
| 75 | State of Montana Department of Health and Human Servicesof $2.6B total | $2.6B | $2.3B | ▲ 5 |
| 76 | Georgia Dept of Educationof $2.6B total | $2.6B | $2.2B | ▲ 8 |
| 77 | New York State Division of Homeland Security & Emergency Servicesof $2.5B total | $2.5B | $1.4B | ▲ 54 |
| 78 | New Hampshire Department of Health & Human Servicesof $2.5B total | $2.5B | $2.2B | ▲ 9 |
| 79 | Minnesota Department of Transportationof $2.5B total | $2.5B | $1.2B | ▲ 69 |
| 80 | Tennessee Department of Human Servicesof $2.5B total | $2.5B | $2.5B | ▼ 3 |
| 81 | Virginia Department of Social Servicesof $2.5B total | $2.5B | $2.4B | ▼ 2 |
| 82 | Pennsylvania Dept of Educationof $2.4B total | $2.4B | $2.6B | ▼ 6 |
| 83 | Illinois Department of Transportationof $2.4B total | $2.4B | $2.6B | ▼ 8 |
| 84 | The Global Fund to Fight Aids, Tuberculosis and Malaria (the Global Fund)of $2.4B total | $2.4B | $1.3B | ▲ 53 |
| 85 | Oregon Department of Human Servicesof $2.4B total | $2.4B | $2.1B | ▲ 9 |
| 86 | Ohio Department of Educationof $2.3B total | $2.3B | $2.2B | ▼ 1 |
| 87 | Human Services Vermont Agency ofof $2.3B total | $2.3B | $1.9B | ▲ 12 |
| 88 | Georgia Department of Transportationof $2.2B total | $2.2B | $2B | ▲ 10 |
| 89 | Department of Human Resources Alabamaof $2.2B total | $2.2B | $2.3B | ▼ 6 |
| 90 | Department of Human Services Coloradoof $2.2B total | $2.2B | $2B | ▲ 7 |
| 91 | Texas Workforce Commissionof $2.3B total | $2.2B | $2.2B | ▼ 3 |
| 92 | Maryland Department of Human Servicesof $2.2B total | $2.2B | $2.2B | ▼ 2 |
| 93 | Arizona Department of Economic Securityof $2.2B total | $2.2B | $2.8B | ▼ 22 |
| 94 | North Carolina Department of Public Safetyof $2.1B total | $2.1B | $1.5B | ▲ 25 |
| 95 | Michigan Department of Educationof $2.1B total | $2.1B | $1.9B | ▲ 5 |
| 96 | Massachusetts Department of Transportationof $2.1B total | $2.1B | $1.3B | ▲ 44 |
| 97 | Oklahoma Dept of Human Servicesof $2B total | $2B | $2.1B | ▼ 4 |
| 98 | Florida Department of Environmental Protectionof $2B total | $2B | $255.8M | ▲ 408 |
| 99 | North Carolina Department of Public Instructionof $2B total | $2B | $2B | ▼ 4 |
| 100 | Department of Transportation Connecticutof $2B total | $2B | $2.2B | ▼ 14 |