| 01 | California Department of Health Care Servicesof $92.8B total | $92.8B | $80.6B | +15% | same |
| 02 | NYS Department of Healthof $59B total | $59B | $47B | +26% | ▲ 1 |
| 03 | Health & Human SVC Commn TXof $52.9B total | $52.9B | $50.5B | +5% | ▼ 1 |
| 04 | UnitedHealth Groupof $52.8B total | $37.4B | $29.9B | +25% | ▲ 3 |
| 05 | PA Department of Human Servicesof $37.1B total | $37.1B | $36.6B | +1% | ▼ 1 |
| 06 | Department of Social Services Californiaof $27.1B total | $27.1B | $21.8B | +24% | ▲ 5 |
| 07 | Ohio Department of Medicaidof $25B total | $25B | — | — | — |
| 08 | Florida Agency for Health Care Administrationof $24.9B total | $24.9B | $19.5B | +28% | ▲ 5 |
| 09 | Michigan Department of Health and Human Servicesof $24.2B total | $24.2B | $24.7B | −2% | ▲ 1 |
| 10 | North Carolina Department of Health & Human Servicesof $21.8B total | $21.8B | $25.2B | −14% | ▼ 1 |
| 11 | New Jersey Department of Human Servicesof $20B total | $20B | $18.4B | +8% | ▲ 3 |
| 12 | The Commonwealth of Massachusettsof $18.9B total | $18.9B | $17.6B | +7% | ▲ 6 |
| 13 | Illinois Department of Healthcare & Family Servicesof $18B total | $18B | $18.1B | −1% | ▲ 3 |
| 14 | Arizona Health Care Cost Containment Systemof $18B total | $18B | $14.9B | +21% | ▲ 11 |
| 15 | Department of Social & Health Servicesof $17.4B total | $17.4B | $15.8B | +10% | ▲ 7 |
| 16 | Indiana Family and Social Servof $15.7B total | $15.7B | $14.9B | +6% | ▲ 8 |
| 17 | Health Services Kentucky Cabinet forof $14.8B total | $14.8B | $18.2B | −19% | ▼ 2 |
| 18 | Metropolitan Transportation Authorityof $14.6B total | $14.6B | $2.9B | +397% | ▲ 133 |
| 19 | New York State Office of Temporary & Disability Assistanceof $14.2B total | $14.2B | $13.4B | +6% | ▲ 8 |
| 20 | Minnesota Department of Human Servicesof $13.8B total | $13.8B | $12.3B | +12% | ▲ 10 |
| 21 | Department of Education Californiaof $13.3B total | $13.3B | $30.3B | −56% | ▼ 15 |
| 22 | Department of Social Services Missoof $13.1B total | $13.1B | $12.2B | +8% | ▲ 9 |
| 23 | VA Department of Medical Assistance Serviceof $12.4B total | $12.4B | $11.1B | +12% | ▲ 9 |
| 24 | Georgia Department of Community Healthof $11.7B total | $11.7B | $9.5B | +23% | ▲ 17 |
| 25 | State of Wisconsin Department of Health Servicesof $11.6B total | $11.6B | $11B | +5% | ▲ 8 |
| 26 | Lousiana Department of Healthof $11.4B total | $11.4B | $12.6B | −9% | ▲ 2 |
| 27 | Oregon Health Authority-Public Healthof $10.8B total | $10.8B | $11B | −2% | ▲ 7 |
| 28 | Finance & Administration Tennessee Deparof $9.4B total | $9.4B | $9.4B | +1% | ▲ 14 |
| 29 | New Mexico Health Care Authorityof $9.4B total | $9.4B | $7.9B | +18% | ▲ 19 |
| 30 | International Bank for Reconstruction and Developmentof $9.1B total | $9.1B | $205.8M | — | ▲ 760 |
| 31 | New York State Division of Homeland Security & Emergency Servicesof $9.1B total | $9.1B | $2B | +361% | ▲ 152 |
| 32 | State of Colorado - Dept of Health Care Policy & Financingof $8.7B total | $8.7B | $7.1B | +22% | ▲ 27 |
| 33 | Mckesson Corporationof $8.4B total | $8.4B | $7.7B | +9% | ▲ 18 |
| 34 | Department of Social Services Connecticutof $8.4B total | $8.4B | $7.8B | +7% | ▲ 16 |
| 35 | Department of Health Human Servicesof $8.1B total | $8.1B | $7.2B | +14% | ▲ 23 |
| 36 | Florida Department of Children and Familiesof $7.7B total | $7.7B | $10.9B | −29% | ▼ 1 |
| 37 | Illinois Department of Human Serviceof $7.7B total | $7.7B | $10.5B | −27% | same |
| 38 | Arkansas Department of Human Servicesof $7.3B total | $7.3B | $6.3B | +17% | ▲ 26 |
| 39 | Ohio Department of Job & Family Servicesof $6.9B total | $6.9B | $30.9B | −78% | ▼ 34 |
| 40 | National Railroad Passenger Corporationof $6.6B total | $6.6B | $4.7B | +41% | ▲ 44 |
| 41 | Oklahoma Health Care Authorityof $6.6B total | $6.6B | $4.8B | +38% | ▲ 41 |
| 42 | IA Department of Human Servicesof $6.3B total | $6.3B | $6.2B | +1% | ▲ 24 |
| 43 | Department of Human Servicesof $6.3B total | $6.3B | $5.3B | +19% | ▲ 28 |
| 44 | West Virginia Department of Health and Human Resourcesof $6.2B total | $6.2B | $6.4B | −3% | ▲ 19 |
| 45 | Alabama Medicaid Agencyof $6.2B total | $6.2B | $5.8B | +7% | ▲ 24 |
| 46 | Department of Transportation Californiaof $5.8B total | $5.8B | $3.7B | +55% | ▲ 67 |
| 47 | Texas Department of Transportationof $5.8B total | $5.8B | $5.4B | +7% | ▲ 23 |
| 48 | Mississippi Division of Medicaidof $5.6B total | $5.6B | $5B | +13% | ▲ 29 |
| 49 | Florida Department of Educationof $5.4B total | $5.4B | $14.2B | −62% | ▼ 23 |
| 50 | New York State Education Departmentof $4.9B total | $4.9B | $17.1B | −71% | ▼ 30 |
| 51 | United Nations World Food Programmeof $4.7B total | $4.7B | $3B | +54% | ▲ 97 |
| 52 | West Virginia Department of Health and Human Resourcesof $4.6B total | $4.6B | $4.1B | +11% | ▲ 45 |
| 53 | Nevada Department of Health & Human Servicesof $4.5B total | $4.5B | $4.8B | −7% | ▲ 27 |
| 54 | Nevada Department of Human Servicesof $4.4B total | $4.4B | $3.6B | +22% | ▲ 68 |
| 55 | Texas Department of Agricultureof $4.2B total | $4.2B | $2.8B | +51% | ▲ 100 |
| 56 | Miscellaneous Foreign Awardeesof $4.7B total | $4.1B | $4.9B | −17% | ▲ 23 |
| 57 | Utah Department of Health and Human Servicesof $4.1B total | $4.1B | $3.6B | +12% | ▲ 62 |
| 58 | The Global Fund to Fight Aids, Tuberculosis and Malaria (the Global Fund)of $4.1B total | $4.1B | $1.5B | +172% | ▲ 167 |
| 59 | Science Applications International Corporationof $4B total | $4B | $3.5B | +15% | ▲ 67 |
| 60 | Maine Department of Health and Human Servicesof $3.9B total | $3.9B | $3.7B | +6% | ▲ 54 |
| 61 | TX Education Agencyof $3.8B total | $3.8B | $21.8B | −82% | ▼ 49 |
| 62 | Government of District of Columbiaof $3.8B total | $3.8B | $4.1B | −8% | ▲ 38 |
| 63 | Michigan Department of Educationof $3.7B total | $3.7B | $7.9B | −53% | ▼ 14 |
| 64 | Governor's Authorized Representativeof $3.7B total | $3.7B | $6.9B | −46% | ▼ 4 |
| 65 | Nebraska Department of Health & Human Servicesof $3.6B total | $3.6B | $3.8B | −6% | ▲ 43 |
| 66 | New Jersey Transit Corporationof $3.6B total | $3.6B | $1.1B | +223% | ▲ 200 |
| 67 | Virginia Department of Social Servicesof $3.5B total | $3.5B | $4.3B | −18% | ▲ 26 |
| 68 | New York City Housing Authorityof $3.5B total | $3.5B | $3.2B | +8% | ▲ 70 |
| 69 | Kansas Department of Health & Environmentof $3.5B total | $3.5B | $3.6B | −3% | ▲ 54 |
| 70 | Texas Division of Emergency Managementof $3.4B total | $3.4B | $10B | −66% | ▼ 31 |
| 71 | Department of Human Services Hawaiiof $3.4B total | $3.4B | $3.6B | −6% | ▲ 49 |
| 72 | Homeland Security & Emergencyof $3.3B total | $3.3B | $6.5B | −50% | ▼ 11 |
| 73 | Maryland Department of Human Servicesof $3.3B total | $3.3B | $3.6B | −9% | ▲ 48 |
| 74 | Louisiana Department of Children and Family Servicesof $3.3B total | $3.3B | $3.4B | −5% | ▲ 53 |
| 75 | Idaho Department of Health & Welfareof $3.2B total | $3.2B | $3.7B | −12% | ▲ 40 |
| 76 | Department of Human Resources Alabamaof $3.1B total | $3.1B | $3.8B | −16% | ▲ 36 |
| 77 | Arizona Department of Economic Securityof $3.1B total | $3.1B | $6.4B | −52% | ▼ 15 |
| 78 | State of Rhode Island Department of Administrationof $3.1B total | $3.1B | $2.7B | +12% | ▲ 79 |
| 79 | Office of Emergency Servicesof $3B total | $3B | $4.5B | −33% | ▲ 6 |
| 80 | Oklahoma Dept of Human Servicesof $3B total | $3B | $3.2B | −6% | ▲ 61 |
| 81 | Puerto Rico Department of Healthof $3B total | $3B | $3.1B | −4% | ▲ 62 |
| 82 | Administracion DE Desarrollo Socioeconomico DE LA Familiaof $2.8B total | $2.8B | $4.3B | −35% | ▲ 10 |
| 83 | Georgia Dept of Educationof $2.8B total | $2.8B | $8.2B | −66% | ▼ 36 |
| 84 | State of Florida Department of Transportationof $2.8B total | $2.8B | $2.5B | +11% | ▲ 81 |
| 85 | Tennessee Department of Human Servicesof $2.7B total | $2.7B | $5.1B | −46% | ▼ 11 |
| 86 | Department of Transportation New Yorkof $2.7B total | $2.7B | $1.9B | +46% | ▲ 108 |
| 87 | Pennsylvania Dept of Educationof $2.7B total | $2.7B | $2B | +38% | ▲ 95 |
| 88 | Illinois State Board of Educationof $2.7B total | $2.7B | $9.6B | −72% | ▼ 48 |
| 89 | State of Alaska Department of Healthof $2.7B total | $2.7B | $2.4B | +12% | ▲ 83 |
| 90 | Ohio Department of Educationof $2.7B total | $2.7B | $8.3B | −68% | ▼ 44 |
| 91 | Pennsylvania Department of Transportationof $2.7B total | $2.7B | $2.4B | +12% | ▲ 82 |
| 92 | Commonwealth of Virginia State Board of Educationof $2.6B total | $2.6B | $4.5B | −42% | ▼ 5 |
| 93 | Department of Human Services Coloradoof $2.6B total | $2.6B | $3.3B | −22% | ▲ 42 |
| 94 | Oregon Department of Human Servicesof $2.5B total | $2.5B | $2.5B | +2% | ▲ 73 |
| 95 | Arizona Department of Educationof $2.5B total | $2.5B | $4.2B | −41% | same |
| 96 | Illinois Department of Transportationof $2.4B total | $2.4B | $1.8B | +31% | ▲ 102 |
| 97 | State of Montana Department of Health and Human Servicesof $2.3B total | $2.3B | $2.4B | −6% | ▲ 73 |
| 98 | New Hampshire Department of Health & Human Servicesof $2.2B total | $2.2B | $2.5B | −10% | ▲ 68 |
| 99 | V2X, Inc.of $2.2B total | $2.2B | $2.4B | −7% | ▲ 75 |
| 100 | Haut Commissariat Des Nations Unies Pour Les Refugiersof $2.2B total | $2.2B | $1.9B | +14% | ▲ 88 |