| 01 | California Department of Health Care Servicesof $80.6B total | $80.6B | $66.8B | +21% | ▲ 1 |
| 02 | Health & Human SVC Commn TXof $50.5B total | $50.5B | $38.7B | +30% | ▲ 2 |
| 03 | NYS Department of Healthof $47B total | $47B | $51.8B | −9% | same |
| 04 | PA Department of Human Servicesof $36.6B total | $36.6B | $30.4B | +20% | ▲ 1 |
| 05 | Ohio Department of Job & Family Servicesof $30.9B total | $30.9B | $26.8B | +16% | ▲ 1 |
| 06 | Department of Education Californiaof $30.3B total | $30.3B | $10.7B | +183% | ▲ 15 |
| 07 | UnitedHealth Groupof $39.6B total | $29.9B | $101.4B | −71% | ▼ 6 |
| 08 | State of California Department of Financeof $27.6B total | $27.6B | — | — | — |
| 09 | North Carolina Department of Health & Human Servicesof $25.2B total | $25.2B | $16.9B | +49% | ▲ 2 |
| 10 | Michigan Department of Health and Human Servicesof $24.7B total | $24.7B | $20.2B | +22% | ▼ 3 |
| 11 | Department of Social Services Californiaof $21.8B total | $21.8B | $17.3B | +26% | ▼ 2 |
| 12 | TX Education Agencyof $21.8B total | $21.8B | $4.9B | +350% | ▲ 44 |
| 13 | Florida Agency for Health Care Administrationof $19.5B total | $19.5B | $18.8B | +4% | ▼ 5 |
| 14 | New Jersey Department of Human Servicesof $18.4B total | $18.4B | $14.2B | +30% | same |
| 15 | Health Services Kentucky Cabinet forof $18.2B total | $18.2B | $12.1B | +50% | ▲ 2 |
| 16 | Illinois Department of Healthcare & Family Servicesof $18.1B total | $18.1B | $14.5B | +25% | ▼ 3 |
| 17 | Texas Office of the Governorof $17.7B total | $17.7B | $8.6B | +105% | ▲ 14 |
| 18 | The Commonwealth of Massachusettsof $17.6B total | $17.6B | $14.6B | +21% | ▼ 6 |
| 19 | Texas Office of the Governorof $17.4B total | $17.4B | $8.3B | +109% | ▲ 13 |
| 20 | New York State Education Departmentof $17.1B total | $17.1B | $5.5B | +210% | ▲ 27 |
| 21 | State of New Yorkof $16.3B total | $16.3B | $5.1B | +218% | ▲ 31 |
| 22 | Department of Social & Health Servicesof $15.8B total | $15.8B | $12B | +32% | ▼ 3 |
| 23 | Puerto Rico Department of Housingof $15.1B total | $15.1B | $1.7B | +777% | ▲ 114 |
| 24 | Indiana Family and Social Servof $14.9B total | $14.9B | $12.1B | +23% | ▼ 6 |
| 25 | Arizona Health Care Cost Containment Systemof $14.9B total | $14.9B | $12.5B | +19% | ▼ 9 |
| 26 | Florida Department of Educationof $14.2B total | $14.2B | $4.1B | +249% | ▲ 34 |
| 27 | New York State Office of Temporary & Disability Assistanceof $13.4B total | $13.4B | $10B | +34% | ▼ 4 |
| 28 | Lousiana Department of Healthof $12.6B total | $12.6B | $9.5B | +32% | ▼ 1 |
| 29 | State of Florida Department of Financial Servicesof $12.5B total | $12.5B | $5.9B | +114% | ▲ 14 |
| 30 | Minnesota Department of Human Servicesof $12.3B total | $12.3B | $10.6B | +16% | ▼ 8 |
| 31 | Department of Social Services Missoof $12.2B total | $12.2B | $10.8B | +12% | ▼ 11 |
| 32 | VA Department of Medical Assistance Serviceof $11.1B total | $11.1B | $9.8B | +13% | ▼ 7 |
| 33 | State of Wisconsin Department of Health Servicesof $11B total | $11B | $8.3B | +32% | same |
| 34 | Oregon Health Authority-Public Healthof $11B total | $11B | $8.7B | +26% | ▼ 5 |
| 35 | Florida Department of Children and Familiesof $10.9B total | $10.9B | $8B | +37% | same |
| 36 | Illinois Emergency Management Agency and Office of Homeland Securityof $10.6B total | $10.6B | $3.7B | +188% | ▲ 33 |
| 37 | Illinois Department of Human Serviceof $10.5B total | $10.5B | $5.4B | +94% | ▲ 12 |
| 38 | Maryland Department of Healthof $10B total | $10B | $8.7B | +16% | ▼ 8 |
| 39 | Texas Division of Emergency Managementof $10B total | $10B | $2.7B | +277% | ▲ 55 |
| 40 | Illinois State Board of Educationof $9.6B total | $9.6B | $3.3B | +192% | ▲ 36 |
| 41 | Georgia Department of Community Healthof $9.5B total | $9.5B | $9.1B | +5% | ▼ 13 |
| 42 | Finance & Administration Tennessee Deparof $9.4B total | $9.4B | $8.1B | +16% | ▼ 8 |
| 43 | Executive Office of the Commonwealth of Pennsylvaniaof $8.9B total | $8.9B | $3.9B | +126% | ▲ 20 |
| 44 | State of Michigan Treasury Depttof $8.5B total | $8.5B | — | — | — |
| 45 | New Jersey Dept of Community Affairsof $8.5B total | $8.5B | $595.6M | — | ▲ 274 |
| 46 | Ohio Department of Educationof $8.3B total | $8.3B | $2.7B | +210% | ▲ 46 |
| 47 | Georgia Dept of Educationof $8.2B total | $8.2B | $2.5B | +234% | ▲ 55 |
| 48 | New Mexico Health Care Authorityof $7.9B total | $7.9B | $6.7B | +18% | ▼ 11 |
| 49 | Michigan Department of Educationof $7.9B total | $7.9B | $2.7B | +196% | ▲ 44 |
| 50 | Department of Social Services Connecticutof $7.8B total | $7.8B | $7B | +11% | ▼ 14 |
| 51 | Mckesson Corporationof $7.7B total | $7.7B | $6.7B | +14% | ▼ 13 |
| 52 | Governors Officeof $7.7B total | $7.7B | $3.7B | +108% | ▲ 16 |
| 53 | Executive Office State of Ohioof $7.5B total | $7.5B | $3.9B | +94% | ▲ 12 |
| 54 | Commonwealth of Pennsylvania Department of Educationof $7.4B total | $7.4B | $638M | — | ▲ 249 |
| 55 | Texas Workforce Commissionof $7.4B total | $7.3B | $5.3B | +39% | ▼ 5 |
| 56 | State of Georgiaof $7.3B total | $7.3B | $186.2M | — | ▲ 612 |
| 57 | Massachusetts Cultural Councilof $7.2B total | $7.2B | — | — | — |
| 58 | Department of Health Human Servicesof $7.2B total | $7.2B | $6.4B | +12% | ▼ 18 |
| 59 | State of Colorado - Dept of Health Care Policy & Financingof $7.1B total | $7.1B | $6.7B | +7% | ▼ 20 |
| 60 | Governor's Authorized Representativeof $6.9B total | $6.9B | $13.4B | −48% | ▼ 45 |
| 61 | Homeland Security & Emergencyof $6.5B total | $6.5B | $2.7B | +138% | ▲ 30 |
| 62 | Arizona Department of Economic Securityof $6.4B total | $6.4B | $4.1B | +58% | ▼ 1 |
| 63 | West Virginia Department of Health and Human Resourcesof $6.4B total | $6.4B | $4.7B | +35% | ▼ 6 |
| 64 | Arkansas Department of Human Servicesof $6.3B total | $6.3B | $5.7B | +11% | ▼ 19 |
| 65 | LA Dept. Of Adminof $6.3B total | $6.3B | $1.7B | +269% | ▲ 74 |
| 66 | IA Department of Human Servicesof $6.2B total | $6.2B | $5.3B | +18% | ▼ 15 |
| 67 | New York City Office of Management & Budgetof $5.9B total | $5.9B | — | — | — |
| 68 | North Carolina Department of Public Instructionof $5.9B total | $5.9B | $1.1B | +419% | ▲ 135 |
| 69 | Alabama Medicaid Agencyof $5.8B total | $5.8B | $5.5B | +5% | ▼ 21 |
| 70 | Texas Department of Transportationof $5.4B total | $5.4B | $4.3B | +25% | ▼ 12 |
| 71 | Department of Human Servicesof $5.3B total | $5.3B | $3.9B | +37% | ▼ 7 |
| 72 | Executive Office of the State of Washingtonof $5.3B total | $5.3B | — | — | — |
| 73 | Department of Housing & Community Developmentof $5.1B total | $5.1B | $459.3M | — | ▲ 293 |
| 74 | Tennessee Department of Human Servicesof $5.1B total | $5.1B | $2.6B | +97% | ▲ 23 |
| 75 | New Jersey Department of Educationof $5B total | $5B | $1.3B | +301% | ▲ 105 |
| 76 | Tennessee Department of Finance and Administrationof $5B total | $5B | $2.4B | +106% | ▲ 27 |
| 77 | Mississippi Division of Medicaidof $5B total | $5B | $5B | −1% | ▼ 23 |
| 78 | Commonwealth of Virginiaof $4.9B total | $4.9B | — | — | — |
| 79 | Miscellaneous Foreign Awardeesof $5.5B total | $4.9B | $3.7B | +31% | ▼ 12 |
| 80 | Nevada Department of Health & Human Servicesof $4.8B total | $4.8B | $3.8B | +27% | ▼ 14 |
| 81 | Department of Education Tennesseeof $4.8B total | $4.8B | $1.5B | +231% | ▲ 78 |
| 82 | Oklahoma Health Care Authorityof $4.8B total | $4.8B | $4B | +18% | ▼ 20 |
| 83 | Texas General Land Officeof $4.7B total | $4.7B | — | — | — |
| 84 | National Railroad Passenger Corporationof $4.7B total | $4.7B | $3B | +55% | ▼ 3 |
| 85 | Office of Emergency Servicesof $4.5B total | $4.5B | $3B | +53% | same |
| 86 | Executive Office of State of Arizonaof $4.5B total | $4.5B | $1.9B | +133% | ▲ 41 |
| 87 | Commonwealth of Virginia State Board of Educationof $4.5B total | $4.5B | $1.7B | +166% | ▲ 53 |
| 88 | Colorado Department of Personnel & Administrationof $4.5B total | $4.5B | $1.7B | +167% | ▲ 53 |
| 89 | Gavi Allianceof $4.4B total | $4.4B | — | — | — |
| 90 | Department of Education of Puerto Ricoof $4.3B total | $4.3B | $1.2B | +263% | ▲ 105 |
| 91 | State of Indianaof $4.3B total | $4.3B | $2.5B | +72% | ▲ 9 |
| 92 | Administracion DE Desarrollo Socioeconomico DE LA Familiaof $4.3B total | $4.3B | $2.2B | +92% | ▲ 19 |
| 93 | Virginia Department of Social Servicesof $4.3B total | $4.3B | $2.5B | +68% | ▲ 5 |
| 94 | Maryland Department of Budget and Managementof $4.2B total | $4.2B | — | — | — |
| 95 | Arizona Department of Educationof $4.2B total | $4.2B | $1.5B | +174% | ▲ 56 |
| 96 | Texas Department of Housing & Community Affairsof $4.2B total | $4.2B | $493.4M | +744% | ▲ 257 |
| 97 | West Virginia Department of Health and Human Resourcesof $4.1B total | $4.1B | $3.5B | +17% | ▼ 26 |
| 98 | South Carolina Department of Educationof $4.1B total | $4.1B | $1.1B | +266% | ▲ 109 |
| 99 | Elementary & Secondary Education Missouri Department ofof $4.1B total | $4.1B | $1.1B | +262% | ▲ 103 |
| 100 | Government of District of Columbiaof $4.1B total | $4.1B | $2.8B | +45% | ▼ 11 |