| 1 | Health Care Services, California Department of | $112.5B | 14.6% |
| 2 | Nys Department of Health | $76.5B | 9.9% |
| 3 | Health & Human Svc Commn tx | $33.8B | 4.4% |
| 4 | pa Department of Human Services | $32.3B | 4.2% |
| 5 | North Carolina Department of Health & Human Services | $28.5B | 3.7% |
| 6 | Ohio Department of Medicaid | $27.7B | 3.6% |
| 7 | Florida Agency For Health Care Administration | $22.8B | 3.0% |
| 8 | Illinois Department of Healthcare & Family Services | $21.8B | 2.8% |
| 9 | Michigan Department of Health And Human Services | $21.7B | 2.8% |
| 10 | Human Services, New Jersey Department of | $18.4B | 2.4% |
| 11 | va Department of Medical Assistance Service | $17.2B | 2.2% |
| 12 | Health Services Kentucky Cabinet For | $17.1B | 2.2% |
| 13 | The Commonwealth of Massachusetts | $16.8B | 2.2% |
| 14 | Indiana Family And Social Serv | $16.7B | 2.2% |
| 15 | Arizona Health Care Cost Containment System | $16.4B | 2.1% |
| 16 | National Railroad Passenger Corporation | $15.2B | 2.0% |
| 17 | Lousiana Department of Health | $14.6B | 1.9% |
| 18 | Department of Social & Health Services | $14.0B | 1.8% |
| 19 | Oregon Health Authority | $13.9B | 1.8% |
| 20 | Minnesota Department of Human Services | $13.1B | 1.7% |
| 21 | Department of Social Services Misso | $13.0B | 1.7% |
| 22 | Georgia Department of Community Health | $13.0B | 1.7% |
| 23 | Finance & Administration Tennessee Depar | $11.9B | 1.6% |
| 24 | Maryland Department of Health | $11.8B | 1.5% |
| 25 | State of Colorado - Dept of Health Care Policy & Financing | $10.0B | 1.3% |
| 26 | State of Wisconsin Department of Health Services | $9.8B | 1.3% |
| 27 | Government of The Virgin Islands | $9.7B | 1.3% |
| 28 | Department of Social Services California | $9.5B | 1.2% |
| 29 | Department of Human Services New Mexico | $8.6B | 1.1% |
| 30 | Oklahoma Health Care Authority | $7.9B | 1.0% |
| 31 | Department of Social Services Connecticut | $7.8B | 1.0% |
| 32 | Department of Health Human Services | $7.7B | 1.0% |
| 33 | Department of Education California | $7.5B | 1.0% |
| 34 | ia Department of Human Services | $7.5B | 1.0% |
| 35 | Human Services, Arkansas Department of | $7.2B | 0.9% |
| 36 | Alabama Medicaid Agency | $6.6B | 0.9% |
| 37 | Department of Transportation California | $6.3B | 0.8% |
| 38 | Nevada Department of Health & Human Services | $6.1B | 0.8% |
| 39 | Office of Emergency Services | $6.1B | 0.8% |
| 40 | Mississippi Division of Medicaid | $6.0B | 0.8% |
| 41 | Texas Department of Transportation | $6.0B | 0.8% |
| 42 | Health And Human Resources, West Virginia Department of | $4.7B | 0.6% |
| 43 | New York State Education Department | $4.6B | 0.6% |
| 44 | Kansas Department of Health & Environment | $4.6B | 0.6% |
| 45 | State of Florida Division of Emergency Management | $4.4B | 0.6% |
| 46 | New York State Office of Temporary & Disability Assistance | $4.2B | 0.5% |
| 47 | Health And Human Services, Maine Department of | $4.0B | 0.5% |
| 48 | tx Education Agency | $3.9B | 0.5% |
| 49 | Nebraska Department of Health & Human Services | $3.9B | 0.5% |
| 50 | Puerto Rico Department of Health | $3.7B | 0.5% |