| Affinia Healthcare | St Louis | — | $52.2M | 17 |
| MERCY HOSPITAL LINCOLN | Troy | E22 Health Care | $52.1M | 13 |
| NEW MAC ELECTRIC COOPERATIVE INC | Neosho | — | $51.7M | 15 |
| WATERORG | Kansas City | Q300 International, Foreign Affairs & National Security | $51.5M | 10 |
| AMERICAN ANGUS ASSOCIATION | St Joseph | — | $51.5M | 9 |
| MISSOURI COALITION FOR COMMUNITY | Jefferson City | — | $51.1M | 7 |
| HALL FAMILY FOUNDATION | Kansas City | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $51.1M | 1 |
| THREE RIVERS ELECTRIC COOPERATIVE | Linn | — | $50.8M | 15 |
| SSMHC LIABILITY TRUST I | St Louis | Y200 Mutual & Membership Benefit | $50.4M | 3 |
| Mo-Kan Sheet Metal Workers Welfare Fund | Kansas City | — | $49.7M | 1 |
| JOHN BURROUGHS SCHOOL | St Louis | B250 Education | $49.6M | 6 |
| Ascension Michigan CMG | St Louis | E91Z Health Care | $49.2M | 6 |
| ASCENSION CARE MANAGEMENT INSURANCE HOLDINGS | St Louis | E12 Health Care | $48.9M | 14 |
| URBAN LEAGUE OF METROPOLITAN ST LOUIS | Saint Louis | — | $48.1M | 12 |
| MISSOURI COALITION FOR PRIMARY | Jefferson City | — | $48.1M | 8 |
| Ascension Medical Group Genesys | St Louis | E11 Health Care | $48.1M | 23 |
| OZARKS FOOD HARVEST INC | Springfield | K300 Food, Agriculture & Nutrition | $47.5M | 1 |
| BETHESDA LONG TERM CARE INC | St Louis | E910 Health Care | $47.2M | 12 |
| PRESENCE LIFE CONNECTIONS | St Louis | — | $46.9M | 11 |
| LOGAN UNIVERSITY INC | Chesterfield | B500 Education | $46.7M | 17 |
| PGP Charitable Fund | Kansas City | P11 Human Services | $46.4M | 0 |
| Alabama Providence Healthcare Services | St Louis | E21 Health Care | $46.1M | 12 |
| OSAGE VALLEY ELECTRIC COOPERATIVE | Butler | — | $46.1M | 16 |
| EDWARD JONES FOUNDATION | St Louis | T21 Philanthropy, Voluntarism & Grantmaking Foundations | $45.7M | 0 |
| INTERNATIONAL BROTHERHOOD OF ELECTR | St Louis | — | $45.3M | 0 |
| SAINT LOUIS SYMPHONY ORCHESTRA | St Louis | A690 Arts, Culture & Humanities | $45.2M | 9 |
| FRIENDSHIP VILLAGE OF WEST COUNTY | Chesterfield | P750 Human Services | $45.2M | 10 |
| HALLMARK EMPLOYEE BENEFIT TRUSTS COMMERCE | Kansas City | — | $45.1M | 1 |
| UNIVERSITY OF HEALTH SCIENCES AND PHARMACY IN | Saint Louis | B500 Education | $44.7M | 10 |
| ASCENSION VIA CHRISTI HEALTH INC | St Louis | E210 Health Care | $44.7M | 15 |
| BIG SPRINGS MEDICAL ASSOCIATION INC | Ellington | — | $44.2M | 9 |
| ST LOUIS CHILDREN'S HOSPITAL FOUNDATION | St Louis | E110 Health Care | $43.9M | 3 |
| WEBSTER ELECTRIC COOPERATIVE | Marshfield | — | $43M | 18 |
| Ascension Borgess Allegan Hospital | St Louis | E220 Health Care | $42.7M | 13 |
| ST LOUIS ARC INC | St Louis | P820 Human Services | $42.7M | 5 |
| Ranken Technical College | St Louis | B410 Education | $42.7M | 9 |
| IRONWORKERS ST LOUIS DISTRICT COUNCIL | Maryland Heights | — | $42.5M | 0 |
| Forest Park Forever Inc | St Louis | C500 Environment | $42.3M | 9 |
| Kansas City CARE Clinic | Kansas City | — | $41.9M | 9 |
| COMMUNITY COUNSELING CENTER | Cape Girardeau | F320 Mental Health & Crisis Intervention | $41.6M | 10 |
| CRAWFORD ELECTRIC COOPERATIVE | Bourbon | — | $41.5M | 15 |
| VOLUNTARY INTERDISTRICT CHOICE CORPORATION | Saint Louis | B120 Education | $41.1M | 1 |
| Stowers Institute for Medical Research | Kansas City | H92 Medical Research | $41M | 0 |
| ASCENSION VIA CHRISTI HEALTH PARTNERS INC | St Louis | E190 Health Care | $40.7M | 11 |
| WILLIAM JEWELL COLLEGE | Liberty | B420 Education | $40.7M | 11 |
| MISSOURI VALLEY COLLEGE | Marshall | B42Z Education | $40.2M | 9 |
| EMMAUS HOMES INC | St Charles | — | $40.1M | 9 |
| SOUTHWEST BAPTIST UNIVERSITY | Bolivar | B430 Education | $39.8M | 8 |
| GREATER KC LINC INC | Kansas City | P200 Human Services | $39.6M | 6 |
| CARROLL COUNTY MEMORIAL HOSPITAL | Carrollton | E220 Health Care | $39.6M | 8 |
