| 1 | Sentara Health Plans Virginia Bch | E | $19.0B | $6.5B | $1.7B |
| 2 | Sentara Health Virginia Bch | E | $11.1B | $1.3B | $7.2B |
| 3 | Inova Health Care Services Fairfax | E | $6.5B | $6.4B | $8.1B |
| 4 | University of Virginia Investment Management Company Charlottesvle | B | $4.9B | $912.3M | $14.6B |
| 5 | Sentara Hospitals Virginia Bch | E | $4.4B | $4.4B | $2.7B |
| 6 | Nature Conservancy Arlington | Z | $4.0B | $1.5B | $9.5B |
| 7 | Good360 Alexandria | Q | $3.3B | $3.3B | $108.1M |
| 8 | Riverside Healthcare Association INC Newport News | Z | $2.6B | $2.5B | $1.8B |
| 9 | George Washington University Ashburn | B | $2.4B | $1.9B | $5.1B |
| 10 | Liberty University INC Lynchburg | B | $2.4B | $1.8B | $4.6B |
| 11 | National Rural Electric Cooperative Arlington | Z | $2.3B | $838.3M | $862.3M |
| 12 | National Rural Utilities Cooperative Finance Corp. Dulles | Z | $2.2B | $2.1B | $38.3B |
| 13 | Carilion Medical Center Roanoke | E | $2.2B | $2.0B | $2.2B |
| 14 | Railroad Employees National Health and Welfare Plan Trust Arlington | Z | $1.8B | $1.8B | $597.2M |
| 15 | Valley Health System Winchester | Z | $1.5B | $1.4B | $1.8B |
| 16 | University of Richmond Richmond | B | $1.4B | $498.3M | $3.8B |
| 17 | Aerospace Corporation Chantilly | U | $1.4B | $1.4B | $1.3B |
| 18 | Virginia Tech Foundation INC Blacksburg | B | $1.4B | $293.8M | $3.0B |
| 19 | Charities Aid Foundation America Alexandria | T | $1.2B | $1.1B | $485.8M |
| 20 | Centra Health INC Lynchburg | E | $1.2B | $1.2B | $1.5B |
| 21 | Mary Washington Healthcare Fredericksbrg | E | $1.1B | $1.1B | $620.3M |
| 22 | Old Dominion Electric Cooperative Glen Allen | Z | $1.1B | $1.1B | $2.2B |
| 23 | National Stabilization Agreement of Sheet Metal Workers Industry TR Fd Falls Church | Z | $1.1B | $182.0M | $1.6B |
| 24 | Air Line Pilots Association International McLean | Z | $974.9M | $382.1M | $663.2M |
| 25 | Virginia Hospital Center Arlington Health System Alexandria | E | $967.6M | $896.4M | $2.0B |
| 26 | Cfa Institute Charlottesvle | Z | $922.1M | $462.9M | $912.9M |
| 27 | Childrens Hospital of the Kings Daughters INC Norfolk | E | $920.3M | $665.8M | $1.2B |
| 28 | Northern Virginia Electric Co-op Manassas | Z | $907.0M | $907.0M | $1.5B |
| 29 | Inova Health System Foundation Fairfax | E | $893.5M | $885.9M | $9.2B |
| 30 | Delta Dental Plan of Virginia Roanoke | E | $877.7M | $861.5M | $207.7M |
| 31 | American Institutes for Research in the Behavioral Sciences Arlington | V | $787.5M | $437.2M | $1.1B |
| 32 | Lifenet Health Virginia Bch | E | $768.5M | $598.6M | $650.8M |
| 33 | General Dynamics Land Systems Retiree Benefit Trust Agreement Reston | Z | $702.3M | $14.3M | $258.6M |
| 34 | Noblis INC Reston | U | $673.8M | $614.5M | $452.3M |
| 35 | University of Virginia Physicians Group Charlottesvle | E | $656.5M | $656.3M | $500.6M |
| 36 | Sentara Rmh Medical Center Virginia Bch | E | $656.1M | $575.2M | $281.8M |
| 37 | National Railway Carriers & United Trans Union Health & Welfare Plan Arlington | Y | $644.1M | $644.1M | $321.0M |
| 38 | Washington & Lee University Lexington | B | $642.3M | $284.8M | $2.6B |
| 39 | Avmed INC Virginia Bch | Z | $630.0M | $616.6M | $444.3M |
| 40 | National Association of Chain Drug Stores INC Arlington | Z | $616.2M | $364.1M | $623.2M |
| 41 | Public Broadcasting Service Arlington | A | $606.5M | $558.2M | $654.6M |
| 42 | Rappahannock Electric Cooperative Fredericksbrg | Z | $606.0M | $605.7M | $1.4B |
| 43 | Colonial Williamsburg Foundation Williamsburg | A | $574.5M | $149.4M | $1.7B |
| 44 | Augusta Health Care INC Fishersville | E | $561.4M | $559.1M | $1.2B |
| 45 | Navy Mutual Aid Association City of Arlingto | W | $560.4M | $284.9M | $3.3B |
| 46 | Bae Systems North America Welfare Benefit Trust Falls Church | Y | $534.2M | $534.2M | $33.2M |
| 47 | American Foundation for Donation and Transplantation N Chesterfld | E | $531.8M | $531.8M | $114.3M |
| 48 | Marine Toys for Tots Foundation Triangle | T | $506.2M | $0 | $202.9M |
| 49 | Sentara Princess Anne Hospital Virginia Bch | E | $461.3M | $461.3M | $405.1M |
| 50 | Virginia Federal Credit Union N Chesterfld | Z | $460.3M | $189.5M | $5.3B |