The health sector let itself be heard in Washington in 2015, as the American Medical Association and three other organizations spent their way into the lobbying top 10, according to the Center for Responsive Politics.

The AMA spent $28.6 million on lobbying last year – tops among the health sector and third among all lobbyers. The other health sector entities among the top 10 in spending were Blue Cross/Blue Shield at $23.2 million (fourth overall), the American Hospital Association at $20.7 million (seventh), and the Pharmaceutical Research and Manufacturers of America at $18.4 million (ninth), the center reported.

That’s definitely nothing to sneeze at, but it would have taken the combined spending of all four, about $90.9 million, to surpass the U.S. Chamber of Commerce, which led all lobbyers at $84.7 million.

Total spending on lobbying for the health sector was $507 million in 2015, which was second to “miscellaneous business” (including the Chamber of Commerce) among the center’s 13 ranked sectors. Total spending on lobbying for all sectors was $3.2 billion for the year, according to the center’s calculations, which were based on data from the Senate Office of Public Records.