CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income	$ 6,717	$ 6,552	$ 5,893
Depreciation, amortization and other	4,071	3,417	3,398
Stock-based compensation expense	431	401	341
Deferred income taxes	(1,273)	(1,198)	(453)
Acquired in-process research and development	0	0	1,505
Adjustments for equity method investments	11	891	33
Loss on divestiture	0	567	0
(Gains) losses on equity securities	(1,565)	127	0
Other items, net	563	(303)	(262)
Changes in operating assets and liabilities, net of acquisitions:
Trade receivables, net	(1,015)	(746)	(429)
Inventories	491	(742)	(165)
Other assets	(564)	258	(237)
Accounts payable	(402)	154	(69)
Accrued income taxes, net	(1,031)	(647)	(854)
Long-term tax liabilities	371	229	204
Accrued sales incentives and allowance	935	846	404
Other liabilities	731	(85)	(48)
Net cash provided by operating activities	8,471	9,721	9,261
Cash flows from investing activities:
Cash paid for acquisitions, net of cash acquired	(26,989)	(3,839)	(2,529)
Purchases of marketable securities	(1)	(2,587)	(8,900)
Proceeds from sales of marketable securities	1,123	98	4,403
Proceeds from maturities of marketable securities	550	1,120	8,831
Purchases of property, plant and equipment	(1,112)	(936)	(880)
Other	225	100	(192)
Net cash (used in) provided by investing activities	(26,204)	(6,044)	733
Cash flows from financing activities:
Net proceeds from issuance of debt	27,777	6,919	4,945
Extinguishment of debt	(647)	(297)	0
Repayment of debt	(1,454)	0	(4,150)
Repurchases of common stock	0	(6,360)	(4,975)
Dividends paid	(4,556)	(4,196)	(4,013)
Other	(72)	(103)	(78)
Net cash provided by (used in) financing activities	21,048	(4,037)	(8,271)
Increase (decrease) in cash and cash equivalents	3,315	(360)	1,723
Cash and cash equivalents at beginning of year	7,629	7,989	6,266
Cash and cash equivalents at end of year	$ 10,944	$ 7,629	$ 7,989