| 1 | Health Care Services, California Department ofof $112.5B total | $112.5B | $100.9B | +12% | same |
| 2 | NYS Department of Healthof $76.6B total | $76.6B | $72.4B | +6% | same |
| 3 | Health & Human SVC Commn TXof $40.8B total | $40.8B | $42.3B | −3% | ▲ 1 |
| 4 | PA Department of Human Servicesof $36.2B total | $36.2B | $34.4B | +5% | ▲ 1 |
| 5 | North Carolina Department of Health & Human Servicesof $31.4B total | $31.4B | $27.1B | +15% | ▲ 1 |
| 6 | Ohio Department of Medicaidof $27.7B total | $27.7B | $24.6B | +13% | ▲ 1 |
| 7 | Michigan Department of Health and Human Servicesof $24.5B total | $24.5B | $24.4B | 0% | ▲ 1 |
| 8 | Florida Agency for Health Care Administrationof $22.8B total | $22.8B | $21.6B | +6% | ▲ 4 |
| 9 | Illinois Department of Healthcare & Family Servicesof $21.9B total | $21.9B | $20.6B | +6% | ▲ 5 |
| 10 | Department of Social Services Californiaof $21.1B total | $21.1B | $21B | +1% | ▲ 3 |
| 11 | Human Services, New Jersey Department ofof $20.2B total | $20.2B | $17.7B | +14% | ▲ 5 |
| 12 | Health Services Kentucky Cabinet forof $18.2B total | $18.2B | $17.1B | +6% | ▲ 6 |
| 13 | Indiana Family and Social Servof $18B total | $18B | $16.7B | +8% | ▲ 7 |
| 14 | VA Department of Medical Assistance Serviceof $17.2B total | $17.2B | $14.8B | +16% | ▲ 8 |
| 15 | The Commonwealth of Massachusettsof $16.8B total | $16.8B | $17.4B | −3% | ▲ 2 |
| 16 | Arizona Health Care Cost Containment Systemof $16.4B total | $16.4B | $15.8B | +4% | ▲ 5 |
| 17 | Department of Social & Health Servicesof $15.8B total | $15.8B | $14.1B | +12% | ▲ 7 |
| 18 | National Railroad Passenger Corporationof $15.2B total | $15.2B | $7B | +115% | ▲ 30 |
| 19 | Lousiana Department of Healthof $14.6B total | $14.6B | $13.5B | +8% | ▲ 6 |
| 20 | Department of Social Services Missoof $14.5B total | $14.5B | $14.6B | −1% | ▲ 3 |
| 21 | Oregon Health Authority-Public Healthof $13.9B total | $13.9B | $12.4B | +12% | ▲ 6 |
| 22 | Minnesota Department of Human Servicesof $13.8B total | $13.8B | $12.7B | +9% | ▲ 4 |
| 23 | Georgia Department of Community Healthof $13B total | $13B | $11.9B | +9% | ▲ 5 |
| 24 | Finance & Administration Tennessee Deparof $11.9B total | $11.9B | $10B | +19% | ▲ 6 |
| 25 | State of Wisconsin Department of Health Servicesof $11B total | $11B | $9.6B | +15% | ▲ 6 |
| 26 | New York State Office of Temporary & Disability Assistanceof $11B total | $11B | $10.4B | +5% | ▲ 3 |
| 27 | State of Colorado - Dept of Health Care Policy & Financingof $10B total | $10B | $8.7B | +15% | ▲ 8 |
| 28 | Government of the Virgin Islandsof $9.7B total | $9.7B | $5.8B | +67% | ▲ 28 |
| 29 | New Mexico Health Care Authorityof $9.6B total | $9.6B | $8.5B | +12% | ▲ 8 |
| 30 | Department of Health Human Servicesof $8.9B total | $8.9B | $8.6B | +3% | ▲ 6 |
| 31 | Department of Social Services Connecticutof $8.6B total | $8.6B | $8.3B | +4% | ▲ 9 |
| 32 | IA Department of Human Servicesof $8B total | $8B | $7.3B | +9% | ▲ 15 |
| 33 | Oklahoma Health Care Authorityof $7.9B total | $7.9B | $7.5B | +6% | ▲ 11 |
| 34 | Florida Department of Children and Familiesof $7.6B total | $7.6B | $8.3B | −9% | ▲ 5 |
| 35 | Department of Education Californiaof $7.5B total | $7.5B | $7.4B | +2% | ▲ 11 |
| 36 | Human Services, Arkansas Department ofof $7.2B total | $7.2B | $6.2B | +16% | ▲ 15 |
| 37 | Alabama Medicaid Agencyof $6.6B total | $6.6B | $6.4B | +3% | ▲ 13 |
| 38 | Department of Transportation Californiaof $6.3B total | $6.3B | $5.5B | +15% | ▲ 20 |
| 39 | Office of Emergency Servicesof $6.2B total | $6.2B | $4.8B | +31% | ▲ 30 |
| 40 | Nevada Department of Human Servicesof $6.1B total | $6.1B | $5.1B | +21% | ▲ 24 |
| 41 | Mississippi Division of Medicaidof $6B total | $6B | $5.9B | +2% | ▲ 14 |
| 42 | Texas Department of Transportationof $6B total | $6B | $6.1B | −2% | ▲ 12 |
| 43 | Illinois Department of Human Serviceof $5.9B total | $5.9B | $6.1B | −4% | ▲ 9 |
| 44 | State of Florida Division of Emergency Managementof $5.8B total | $5.8B | $2B | +193% | ▲ 108 |
| 45 | Health and Human Resources, West Virginia Department ofof $4.7B total | $4.7B | $4.1B | +14% | ▲ 33 |
| 46 | New York State Education Departmentof $4.6B total | $4.6B | $4.6B | +1% | ▲ 27 |
| 47 | New York City Housing Authorityof $4.6B total | $4.6B | $4.1B | +13% | ▲ 33 |
| 48 | Kansas Department of Health & Environmentof $4.6B total | $4.6B | $3.7B | +25% | ▲ 40 |
| 49 | Ohio Department of Job & Family Servicesof $4.4B total | $4.4B | $5.2B | −16% | ▲ 12 |
| 50 | Health and Human Services, Maine Department ofof $4.3B total | $4.3B | $4B | +8% | ▲ 31 |
| 51 | Nebraska Department of Health & Human Servicesof $4.2B total | $4.2B | $3.7B | +16% | ▲ 38 |
| 52 | Department of Human Servicesof $4B total | $4B | $3.7B | +9% | ▲ 35 |
| 53 | Idaho Department of Health & Welfareof $4B total | $4B | $3.4B | +17% | ▲ 45 |
| 54 | TX Education Agencyof $3.9B total | $3.9B | $3.9B | +1% | ▲ 29 |
| 55 | District of Columbia, Government ofof $3.9B total | $3.9B | $3.6B | +8% | ▲ 37 |
| 56 | Utah Department of Health and Human Servicesof $3.8B total | $3.8B | $4.8B | −21% | ▲ 14 |
| 57 | Puerto Rico Department of Healthof $3.7B total | $3.7B | $4.7B | −20% | ▲ 14 |
| 58 | International Bank for Reconstruction and Developmentof $3.5B total | $3.5B | $4.2B | −17% | ▲ 18 |
| 59 | Metropolitan Transportation Authorityof $3.4B total | $3.4B | $3.4B | 0% | ▲ 38 |
| 60 | Texas Comptroller of Public Accountsof $3.4B total | $3.4B | — | — | — |
| 61 | Department of Transportation New Yorkof $3.3B total | $3.3B | $2.5B | +35% | ▲ 61 |
| 62 | Agriculture, Texas Department ofof $3.3B total | $3.3B | $3.6B | −9% | ▲ 31 |
| 63 | Florida Department of Educationof $3.2B total | $3.2B | $3.3B | −4% | ▲ 40 |
| 64 | Administracion DE Desarrollo Socioeconomico DE LA Familiaof $3.1B total | $3.1B | $2.9B | +5% | ▲ 45 |
| 65 | Department of Transitional Assistanof $3B total | $3B | $1.3B | +136% | ▲ 145 |
| 66 | Department of Human Services Hawaiiof $3B total | $3B | $3.3B | −9% | ▲ 36 |
| 67 | Wright National Flood Insurance Companyof $2.9B total | $2.9B | $323.5M | +810% | ▲ 589 |
| 68 | Pennsylvania Department of Transportationof $2.9B total | $2.9B | $3.1B | −6% | ▲ 38 |
| 69 | State of Alaska Department of Healthof $2.9B total | $2.9B | $2.6B | +10% | ▲ 50 |
| 70 | Merck Sharp & Dohme LLCof $2.9B total | $2.9B | $2.9B | 0% | ▲ 41 |
| 71 | Arizona Department of Economic Securityof $2.8B total | $2.8B | $3B | −4% | ▲ 37 |
| 72 | State of Florida Department of Transportationof $2.8B total | $2.8B | $3.2B | −11% | ▲ 32 |
| 73 | State of Rhode Island Department of Administrationof $2.7B total | $2.7B | $2.7B | +2% | ▲ 42 |
| 74 | Florida Department of Commerceof $2.6B total | $2.6B | $1.4B | +93% | ▲ 127 |
| 75 | Illinois Department of Transportationof $2.6B total | $2.6B | $2.4B | +5% | ▲ 48 |
| 76 | Pennsylvania Dept of Educationof $2.6B total | $2.6B | $2.4B | +7% | ▲ 49 |
| 77 | Tennessee Department of Human Servicesof $2.5B total | $2.5B | $2.6B | −1% | ▲ 43 |
| 78 | Illinois State Board of Educationof $2.4B total | $2.4B | $2.8B | −13% | ▲ 34 |
| 79 | Social Services, Virginia Department ofof $2.4B total | $2.4B | $2.3B | +5% | ▲ 53 |
| 80 | State of Montana Department of Health and Human Servicesof $2.3B total | $2.3B | $2.1B | +9% | ▲ 60 |
| 81 | Ohio Department of Transportationof $2.3B total | $2.3B | $2.4B | −3% | ▲ 47 |
| 82 | Health and Social Services, Delaware Dept ofof $2.3B total | $2.3B | $2.3B | 0% | ▲ 54 |
| 83 | Department of Human Resources Alabamaof $2.3B total | $2.3B | $2.1B | +8% | ▲ 61 |
| 84 | Georgia Dept of Educationof $2.2B total | $2.2B | $2.4B | −6% | ▲ 43 |
| 85 | Ohio Department of Educationof $2.2B total | $2.2B | $2.2B | 0% | ▲ 52 |
| 86 | Department of Transportation Connecticutof $2.2B total | $2.2B | $1.1B | +94% | ▲ 156 |
| 87 | New Hampshire Department of Health & Human Servicesof $2.2B total | $2.2B | $1.9B | +14% | ▲ 68 |
| 88 | Texas Workforce Commissionof $2.3B total | $2.2B | $2.3B | −4% | ▲ 47 |
| 89 | Louisiana Department of Children and Family Servicesof $2.2B total | $2.2B | $2.3B | −4% | ▲ 45 |
| 90 | Maryland Department of Human Servicesof $2.2B total | $2.2B | $2.1B | +3% | ▲ 51 |
| 91 | California Public Utilities Commissionof $2.1B total | $2.1B | — | — | — |
| 92 | Michigan Department of Labor and Economic Opportunityof $2.1B total | $2.1B | $500.4M | +321% | ▲ 381 |
| 93 | Human Services, Oklahoma Dept ofof $2.1B total | $2.1B | $2.1B | −1% | ▲ 49 |
| 94 | Oregon Department of Human Servicesof $2.1B total | $2.1B | $1.8B | +15% | ▲ 68 |
| 95 | North Carolina Department of Public Instructionof $2B total | $2B | $1.9B | +6% | ▲ 62 |
| 96 | Transportation North Carolina Departmentof $2B total | $2B | $1.5B | +37% | ▲ 93 |
| 97 | Department of Human Services Coloradoof $2B total | $2B | $2B | −2% | ▲ 50 |
| 98 | Georgia Department of Transportationof $2B total | $2B | $2.1B | −5% | ▲ 47 |
| 99 | Human Services Vermont Agency ofof $1.9B total | $1.9B | $1.9B | +1% | ▲ 57 |
| 100 | Michigan Department of Educationof $1.9B total | $1.9B | $2.3B | −18% | ▲ 30 |