| PARENTS AS TEACHERS NATIONAL CENTER INC | St Louis | G030 Diseases, Disorders & Medical Disciplines | $20.5M | 7 |
| UNION STATION KANSAS CITY INC | Kansas City | A54 Arts, Culture & Humanities | $20.5M | 6 |
| Lewis County Rural Electric Cooperative Assoc | Lewistown | — | $20.5M | 17 |
| Saint Thomas Network | St Louis | E110 Health Care | $20.4M | 7 |
| LIFEFLIGHT EAGLE | Kansas City | E62 Health Care | $20.3M | 5 |
| PONY BIRD INC | Herculaneum | P30 Human Services | $20.3M | 7 |
| SUMMIT CHRISTIAN ACADEMY | Lees Summit | B24Z Education | $20.3M | 2 |
| C K BLANDIN RESIDUARY TRUST C/O WELLS FARGO BANK NA | Saint Louis | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $20.2M | 2 |
| ST MARYS WARRICK HOSPITAL INC | St Louis | E220 Health Care | $20.2M | 11 |
| St Vincent Salem Hospital Inc | St Louis | — | $20.1M | 15 |
| BOONE CENTER INC | St Peters | — | $20.1M | 3 |
| St Vincent Clay Hospital Inc | St Louis | E22 Health Care | $20M | 14 |
| ASCENSION RIVER DISTRICT HOSPITAL | St Louis | E20 Health Care | $19.9M | 12 |
| UNITED ASSOCIATION OF JOURNEYMEN OF THE PLUMBING & PIPEFITTING INDUSTRY L562 | Earth City | — | $19.9M | 29 |
| MISSOURI BANKERS ASSOCIATION - VOLUNTARY EMPLOYEES BENEFICIARY ASSN | Jefferson City | — | $19.8M | 0 |
| DELL CHILDREN'S FOUNDATION | St Louis | — | $19.6M | 3 |
| OPERATION BREAKTHROUGH INC | Kansas City | B20 Education | $19.5M | 7 |
| ALLIANCE CREDIT UNION | Fenton | — | $19.3M | 7 |
| Jewish Federation of St Louis | St Louis | T700 Philanthropy, Voluntarism & Grantmaking Foundations | $19.2M | 7 |
| Ralls County Electric Cooperative | New London | — | $19.2M | 16 |
| NORTH EAST COMMUNTIY ACTION CORPORATION SUBSIDIARIES | Bowling Green | — | $19.2M | 4 |
| THE MCKEAN FAMILY FOUNDATION | St Louis | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $19.1M | 0 |
| ASCENSION WISCONSIN PHARMACY INC | St Louis | E910 Health Care | $19M | 10 |
| ABILITY KC | Kansas City | — | $19M | 9 |
| BEHAVIORAL HEALTH RESPONSE INC | St Louis | F20Z Mental Health & Crisis Intervention | $19M | 2 |
| AUTOMOTIVE PETROLEUM & ALLIED INDUSTRIES EMPLOYEES WELFARE FUND | Earth City | — | $19M | 2 |
| DISABLED CITIZENS ALLIANCE FOR INDEPENDENCE INC | Viburnum | — | $18.9M | 3 |
| CLEAN FUELS ALLIANCE AMERICA | Jefferson City | — | $18.8M | 9 |
| LIFT FOR LIFE ACADEMY INC | Saint Louis | N40Z Recreation & Sports | $18.8M | 4 |
| BOILERMAKERS NATIONAL APPRENTICESHIP FUND | Kansas City | — | $18.8M | 0 |
| MISSOURI ATHLETIC CLUB | St Louis | — | $18.7M | 8 |
| ASCENSION BORGESS-LEE HOSPITAL | St Louis | E220 Health Care | $18.6M | 10 |
| WHEATON FRANCISCAN HEALTHCARE - TERRACE AT ST FRANCIS INC | St Louis | — | $18.6M | 10 |
| UNIVERSITY ACADEMY | Kansas City | B20 Education | $18.6M | 3 |
| ST LOUIS COUNTRY CLUB | Saint Louis | — | $18.4M | 7 |
| DOUGLAS COUNTY PUBLIC HEALTH SVCS GROUP INC | Ava | E30 Health Care | $18.3M | 11 |
| Heart Surgeons of Kansas City Inc | Kansas City | E21 Health Care | $18.3M | 11 |
| ST VINCENT HOSPITAL FOUNDATION INC | St Louis | E110 Health Care | $18.3M | 5 |
| CONCORDANCE | St Louis | I31Z Crime & Legal-Related | $18.2M | 9 |
| Haven of Our Lady of Peace Inc | St Louis | X200 Religion-Related | $18.2M | 5 |
| UNITED CEREBRAL PALSY HEARTLAND | Berkeley | G200 Diseases, Disorders & Medical Disciplines | $18.1M | 4 |
| EAST MISSOURI ACTION AGENCY INC | Park Hills | S800 Community Improvement & Capacity Building | $18M | 1 |
| Community Health Center of Central Missouri | Jefferson City | P80 Human Services | $17.8M | 7 |
| SOUTHEAST MISSOURI AREA AGENCY ON AGING INC | Cape Girardeau | P81Z Human Services | $17.8M | 2 |
| MBCH CHILDREN AND FAMILY MINISTRIES | Bridgeton | P70 Human Services | $17.6M | 4 |
| ALTERNATIVE COMMUNITY TRAINING INC (TAX) | Columbia | J300 Employment | $17.6M | 2 |
| PREMIER CHARTER SCHOOL | St Louis | B110 Education | $17.5M | 3 |
| HOGAN PREPARATORY ACADEMY INC | Kansas City | B20 Education | $17.5M | 3 |
| GREATER ST LOUIS INC | St Louis | S41 Community Improvement & Capacity Building | $17.5M | 8 |
| Seton Family of Pediatric Surgeons | St Louis | E30 Health Care | $17.5M | 5 |
