| 1 | Novant Health INC Winston Salem, NC | $6.5B | $14.6B |
| 2 | Duke University Health System INC Durham, NC | $5.8B | $8.6B |
| 3 | Duke University Durham, NC | $4.5B | $21.2B |
| 4 | Chancellor Masters & Scholars of the University of Oxford Cary, NC | $3.6B | $11.3B |
| 5 | North Carolina Baptist Hospital Winstonsalem, NC | $3.3B | $2.8B |
| 6 | State Chartered Credit Unions INC Raleigh, NC | $2.6B | $56.4B |
| 7 | Wakemed Raleigh, NC | $2.3B | $2.0B |
| 8 | Presbyterian Hospital Winston Salem, NC | $2.3B | $4.8B |
| 9 | Pitt County Memorial Hospital INC Greenville, NC | $2.1B | $1.7B |
| 10 | Samaritans Purse Boone, NC | $1.8B | $2.6B |
| 11 | Gothic Corporation Durham, NC | $1.8B | $8.2B |
| 12 | Rex Hospital INC Raleigh, NC | $1.7B | $1.8B |
| 13 | Wake Forest University Health Sciences Winstonsalem, NC | $1.7B | $2.2B |
| 14 | Forsyth Memorial Hospital INC Winston Salem, NC | $1.6B | $3.2B |
| 15 | Research Triangle Institute Durham, NC | $1.4B | $935.9M |
| 16 | Duke Health Integrated Practice INC Durham, NC | $1.3B | $249.1M |
| 17 | North Carolina Electric Membership Corporation Raleigh, NC | $1.3B | $2.4B |
| 18 | First Health of the Carolinas INC Pinehurst, NC | $1.2B | $1.7B |
| 19 | Educational Testing Service Charlotte, NC | $1.1B | $1.7B |
| 20 | Family Health International Durham, NC | $800.0M | $348.3M |
| 21 | Gaston Memorial Hospital INC Gastonia, NC | $790.9M | $895.1M |
| 22 | Wake Forest University Winstonsalem, NC | $764.4M | $2.8B |
| 23 | Foundation for the Carolinas Charlotte, NC | $761.4M | $3.9B |
| 24 | Atlantic Coast Conference Charlotte, NC | $711.4M | $274.0M |
| 25 | The Moses H Cone Memorial Hospital Operating Corporation Greensboro, NC | $598.6M | $2.0B |
| 26 | East Carolina Health Greenville, NC | $596.8M | $383.7M |
| 27 | North Carolina Insurance Raleigh, NC | $570.8M | $1.8B |
| 28 | Sandhills Center for Mental Health Developmental Disabilities & Subst West End, NC | $532.9M | $251.2M |
| 29 | High Point Regional Health High Point, NC | $502.9M | $487.6M |
| 30 | Gothic Hsp Corporation Durham, NC | $490.2M | $2.5B |
| 31 | High Point University High Point, NC | $489.7M | $1.2B |
| 32 | Elon University Elon, NC | $413.0M | $1.2B |
| 33 | University Health Systems of Eastern Carolina INC Greenville, NC | $401.3M | $508.4M |
| 34 | Wayne Memorial Hospital INC Goldsboro, NC | $382.1M | $515.2M |
| 35 | L C Ind INC Durham, NC | $359.2M | $237.3M |
| 36 | Group Health Program of the Natnl Telecommunications Coop Assoc Asheville, NC | $353.3M | $332.5M |
| 37 | Cumberland County Hospital System INC Fayetteville, NC | $346.9M | $1.8B |
| 38 | Vidant Medical Group LLC Greenville, NC | $336.6M | $91.2M |
| 39 | Southeastern Regional Medical Center Lumberton, NC | $334.3M | $333.9M |
| 40 | Blue Ridge Healthcare Hospitals INC Morganton, NC | $334.0M | $723.5M |
| 41 | Fletcher Hospital INC Hendersonvlle, NC | $332.2M | $330.7M |
| 42 | Nc State Investment Fund INC Raleigh, NC | $304.3M | $2.5B |
| 43 | Energyunited Electric Membership Corporation Statesville, NC | $301.1M | $620.9M |
| 44 | Scotland Memorial Hospital Incorporated Laurinburg, NC | $296.7M | $379.0M |
| 45 | Davidson College Davidson, NC | $270.0M | $1.9B |
| 46 | Ncinnovation INC Rtp, NC | $259.1M | $272.9M |
| 47 | Food Bank of Central & Eastern North Carolina INC Raleigh, NC | $247.2M | $106.4M |
| 48 | Brunswick Electric Membership Corp. Supply, NC | $237.1M | $535.2M |
| 49 | Community Care of North Carolina INC Garner, NC | $233.0M | $129.3M |
| 50 | North Carolina Joint Underwriting Association Raleigh, NC | $232.8M | $226.5M |