| Mark Twain Association for Mental Health INC | Health Care and Social Assistance | $1,636,585 | $1,645,768 | 149 | N/A |  Research |
| Hannibal-Lagrange University | Educational Services | $1,300,325 | $1,307,838 | 250 | N/A | Research |
| Golden Eagle Distributing Co. | Wholesale Trade | $1,173,415 | $1,186,518 | 15 | <$5M | Research |
| Gilstrap Restaurants Ltd | Accommodation and Food Services | $1,056,700 | $1,071,259 | 192 | $34.1M | Research |
| Hannibal Lagrange University | Educational Services | $1,054,355 | $1,058,895 | 298 | N/A | Research |
| Hannibal Carbide Tool, INC | Manufacturing | $894,335 | $901,390 | 87 | $22.8M | Research |
| Independent's Service Company | Manufacturing | $708,200 | $714,593 | 70 | $69.4M | Research |
| Ehrhardt's Jefferson City LLC | Accommodation and Food Services | $695,334 | $698,386 | 80 | $25.0M | Research |
| Ehrhardts' Macon LLC | Accommodation and Food Services | $607,796 | $610,886 | 78 | $24.4M | Research |
| Tom Boland Ford, INC | Retail Trade | $509,518 | $513,537 | 44 | $11.1M | Research |
| Ehrhardts Jefferson City LLC | Accommodation and Food Services | $496,700 | $501,019 | 80 | $25.0M | Research |
| Advance/hannibal Regional Hospital, LLC | Health Care and Social Assistance | $495,100 | $500,120 | 38 | $10.3M | Research |
| Mcdonald Service Enterprises LLC | Administrative and Support and Waste Management | $493,500 | $498,874 | 60 | $11.4M | Research |
| Ehrhardt Hospitality LLC | Accommodation and Food Services | $474,505 | $476,468 | 57 | $17.8M | Research |
| Meco Engineering Company INC | Professional, Scientific, and Technical Services | $466,902 | $468,783 | 35 | <$5M | Research |
| Fiddlestiks Food and Spirits Company | Accommodation and Food Services | $463,992 | $466,595 | 91 | $16.2M | Research |
| Meco Engineering Company INC | Professional, Scientific, and Technical Services | $452,687 | $455,227 | 35 | <$5M | Research |
| Midwest Orthopedic Specialists, INC | Health Care and Social Assistance | $436,700 | $439,799 | 27 | $8.5M | Research |
| Ehrhardts' Macon, LLC | Accommodation and Food Services | $434,140 | $437,408 | 93 | $29.1M | Research |
| P&d Electric, INC | Construction | $392,800 | $395,211 | 24 | $7.9M | Research |
| Turning Point Recovery Centers | Health Care and Social Assistance | $391,328 | $394,078 | 42 | N/A | Research |
| Wade Stables PC | Professional, Scientific, and Technical Services | $388,525 | $390,748 | 37 | $11.8M | Research |
| Turning Point Recovery Centers | Health Care and Social Assistance | $370,200 | $373,030 | 54 | N/A | Research |
| Hannibal Sandy's LLC | Accommodation and Food Services | $354,865 | $356,639 | 71 | $22.2M | Research |
| Hannibal Dental Group LLC | Health Care and Social Assistance | $347,315 | $349,165 | 28 | $6.5M | Research |