| 1 | Sentara Health Plans Virginia Bch, VA | $6.5B | $1.7B |
| 2 | Inova Health Care Services Fairfax, VA | $6.4B | $8.1B |
| 3 | Sentara Hospitals Virginia Bch, VA | $4.4B | $2.7B |
| 4 | Good360 Alexandria, VA | $3.3B | $108.1M |
| 5 | Riverside Healthcare Association INC Newport News, VA | $2.5B | $1.8B |
| 6 | National Rural Utilities Cooperative Finance Corp. Dulles, VA | $2.1B | $38.3B |
| 7 | Carilion Medical Center Roanoke, VA | $2.0B | $2.2B |
| 8 | George Washington University Ashburn, VA | $1.9B | $5.1B |
| 9 | Liberty University INC Lynchburg, VA | $1.8B | $4.6B |
| 10 | Railroad Employees National Health and Welfare Plan Trust Arlington, VA | $1.8B | $597.2M |
| 11 | Nature Conservancy Arlington, VA | $1.5B | $9.5B |
| 12 | Valley Health System Winchester, VA | $1.4B | $1.8B |
| 13 | Aerospace Corporation Chantilly, VA | $1.4B | $1.3B |
| 14 | Sentara Health Virginia Bch, VA | $1.3B | $7.2B |
| 15 | Centra Health INC Lynchburg, VA | $1.2B | $1.5B |
| 16 | Old Dominion Electric Cooperative Glen Allen, VA | $1.1B | $2.2B |
| 17 | Mary Washington Healthcare Fredericksbrg, VA | $1.1B | $620.3M |
| 18 | Charities Aid Foundation America Alexandria, VA | $1.1B | $485.8M |
| 19 | University of Virginia Investment Management Company Charlottesvle, VA | $912.3M | $14.6B |
| 20 | Northern Virginia Electric Co-op Manassas, VA | $907.0M | $1.5B |
| 21 | Virginia Hospital Center Arlington Health System Alexandria, VA | $896.4M | $2.0B |
| 22 | Inova Health System Foundation Fairfax, VA | $885.9M | $9.2B |
| 23 | Delta Dental Plan of Virginia Roanoke, VA | $861.5M | $207.7M |
| 24 | National Rural Electric Cooperative Arlington, VA | $838.3M | $862.3M |
| 25 | Childrens Hospital of the Kings Daughters INC Norfolk, VA | $665.8M | $1.2B |
| 26 | University of Virginia Physicians Group Charlottesvle, VA | $656.3M | $500.6M |
| 27 | National Railway Carriers & United Trans Union Health & Welfare Plan Arlington, VA | $644.1M | $321.0M |
| 28 | Avmed INC Virginia Bch, VA | $616.6M | $444.3M |
| 29 | Noblis INC Reston, VA | $614.5M | $452.3M |
| 30 | Rappahannock Electric Cooperative Fredericksbrg, VA | $605.7M | $1.4B |
| 31 | Lifenet Health Virginia Bch, VA | $598.6M | $650.8M |
| 32 | Sentara Rmh Medical Center Virginia Bch, VA | $575.2M | $281.8M |
| 33 | Augusta Health Care INC Fishersville, VA | $559.1M | $1.2B |
| 34 | Public Broadcasting Service Arlington, VA | $558.2M | $654.6M |
| 35 | Bae Systems North America Welfare Benefit Trust Falls Church, VA | $534.2M | $33.2M |
| 36 | American Foundation for Donation and Transplantation N Chesterfld, VA | $531.8M | $114.3M |
| 37 | University of Richmond Richmond, VA | $498.3M | $3.8B |
| 38 | Cfa Institute Charlottesvle, VA | $462.9M | $912.9M |
| 39 | Sentara Princess Anne Hospital Virginia Bch, VA | $461.3M | $405.1M |
| 40 | American Institutes for Research in the Behavioral Sciences Arlington, VA | $437.2M | $1.1B |
| 41 | Stand Together Chamber of Commerce INC Arlington, VA | $432.6M | $257.3M |
| 42 | Carilion Services INC Roanoke, VA | $427.1M | $1.2B |
| 43 | Nrlca Veba Trust Alexandria, VA | $423.8M | $144.4M |
| 44 | Leidos Health and Welfare Benfits TR Reston, VA | $417.3M | $19.2M |
| 45 | Partnership for Supply Chain Management INC Arlington, VA | $415.7M | $135.7M |
| 46 | Martha Jefferson Hospital Virginia Bch, VA | $408.6M | $247.6M |
| 47 | U S Committee for Refugees and Immigrants INC Arlington, VA | $403.5M | $133.9M |
| 48 | Sentara Medical Group Virginia Bch, VA | $401.5M | $110.7M |
| 49 | UVA Prince William Medical Center Manassas, VA | $388.8M | $244.7M |
| 50 | Air Line Pilots Association International McLean, VA | $382.1M | $663.2M |