| Seton Family of Doctors | St Louis | E30 Health Care | $201M | 8 |
| First Community Credit Union | Chesterfield | — | $200.6M | 16 |
| ST VINCENT ANDERSON REGIONAL HOSPITAL INC | St Louis | E22 Health Care | $197.3M | 19 |
| COLUMBIA ST MARY'S INC | St Louis | E21 Health Care | $196.2M | 22 |
| ST FRANCIS HEALTHCARE SYSTEMS | Cape Girardeau | E20Z Health Care | $195.7M | 5 |
| Saint Thomas Health | St Louis | E21Z Health Care | $193.9M | 19 |
| MICHAEL AND NOEMI NEIDORFF FAMILY | Clayton | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $184.5M | 0 |
| ST ANTHONY SHAWNEE HOSPITAL INC | St Louis | E22 Health Care | $181.7M | 21 |
| Maryville University - St Louis | St Louis | B430 Education | $180.5M | 8 |
| HORIZON HOUSING FOUNDATION | Saint Louis | L20 Housing & Shelter | $179.7M | 0 |
| PREFERRED FAMILY HEALTHCARE INC | Kirksville | F20Z Mental Health & Crisis Intervention | $177.1M | 16 |
| UNIVERSITY HEALTH PHYSICIANS | Kansas City | E200 Health Care | $175.8M | 16 |
| St Joseph Hospital & Health Center Inc | St Louis | E220 Health Care | $173.8M | 18 |
| EWING MARION KAUFFMAN FOUNDATION | Kansas City | B82 Education | $173.8M | 14 |
| Webster University | St Louis | B430 Education | $170.8M | 11 |
| MISSOURI DELTA MEDICAL CENTER | Sikeston | E22 Health Care | $160.6M | 9 |
| Alvin Goldfarb Foundation | Saint Louis | — | $159M | 1 |
| Together Credit Union | Saint Louis | — | $158.8M | 27 |
| Ameren Active Employee Healthcare Trust | Saint Louis | — | $154.4M | 1 |
| St Vincent's Medical Center-Clay County Inc | St Louis | — | $153.8M | 20 |
| St John Health System Inc | St Louis | E210 Health Care | $151.6M | 7 |
| COX HEALTH SYSTEMS INSURANCE COMPANY | Springfield | E31 Health Care | $150.8M | 9 |
| Cuivre River Electric Cooperative Inc | Troy | — | $150.3M | 22 |
| Dell Children's Medical Group | St Louis | E24 Health Care | $150.1M | 10 |
| ASCENSION MICHIGAN | St Louis | P750 Human Services | $148.4M | 16 |
| Ascension Texas | St Louis | E22 Health Care | $147.9M | 4 |
| HARVESTERS - THE COMMUNITY FOOD NETWORK | Kansas City | K300 Food, Agriculture & Nutrition | $143.7M | 9 |
| Presence Healthcare Services | St Louis | E320 Health Care | $142.4M | 5 |
| CITIZENS ELECTRIC CORPORATION | Perryville | — | $142.4M | 17 |
| Enterprise Holdings Foundation | Saint Louis | — | $142.3M | 0 |
| SSM REGIONAL HEALTH SERVICES | St Louis | E220 Health Care | $142.3M | 16 |
| St Vincent's Ambulatory Care Inc | St Louis | — | $137.9M | 25 |
| LINDENWOOD EDUCATION SYSTEM | St Charles | B43 Education | $137.7M | 18 |
| Kansas City University | Kansas City | B500 Education | $136.9M | 10 |
| Jane Phillips Memorial Medical Center Inc | St Louis | E220 Health Care | $131.6M | 9 |
| Children International | Kansas City | Q330 International, Foreign Affairs & National Security | $130.2M | 14 |
| ASCENSION ST FRANCIS HOSPITAL INC | St Louis | E220 Health Care | $129.6M | 19 |
| NW Electric Power Cooperative | Cameron | — | $126.4M | 24 |
| ST MARY'S HOSPITAL CENTRALIA ILLINOIS | St Louis | E220 Health Care | $123.8M | 24 |
| ST VINCENT HEALTH INC | St Louis | E20 Health Care | $123.5M | 7 |
| The Against Malaria Foundation | Kansas City | G12 Diseases, Disorders & Medical Disciplines | $119.4M | 0 |
| OLIN CORPORATION VEBA | Clayton | — | $118.8M | 2 |
| MRIGlobal | Kansas City | U200 Science & Technology | $118M | 35 |
| St Vincent's Health System Inc | St Louis | E210 Health Care | $117.9M | 17 |
| COLLEGE OF THE OZARKS | Point Lookout | B420 Education | $115.9M | 14 |
| ROCKHURST UNIVERSITY | Kansas City | B430 Education | $115.6M | 7 |
| ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN INC | St Louis | E30 Health Care | $113.8M | 20 |
| MERCY ACO CLINICAL SERVICES | Chesterfield | E32 Health Care | $113.6M | 10 |
| MID-AMERICA TRANSPLANT SERVICES | St Louis | E65 Health Care | $108.1M | 17 |
| Northeast Missouri Electric Power Coop | Palmyra | — | $106.1M | 26 |
