CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities
Net income	$ 1,238	$ 930
Adjustments to reconcile net income to net cash provided by operating activities:
Loss on investment securities, net	60	76
Equity in net losses	17	4
Stock-based compensation	38	43
Depreciation	200	181
Amortization	18	24
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:
Receivables	(1,433)	(1,360)
Other assets	(907)	(628)
Benefits payable	754	1,089
Other liabilities	(238)	(103)
Unearned revenues	6,934	34
Other	6	12
Net cash provided by operating activities	6,687	302
Cash flows from investing activities
Acquisitions, net of cash and cash equivalents acquired	(73)	(74)
Purchases of property and equipment, net	(223)	(295)
Purchases of investment securities	(1,313)	(2,161)
Proceeds from maturities of investment securities	267	588
Proceeds from sales of investment securities	50	1,294
Net cash used in investing activities	(1,292)	(648)
Cash flows from financing activities
Receipts from contract deposits, net	2,997	2,475
Proceeds from issuance of senior notes, net	1,215	744
Repayments of senior notes	(60)	0
Repayments from issuance of commercial paper, net	(177)	(265)
Repayment of term loan	(500)	0
Debt issue costs	(4)	(1)
Change in book overdraft	108	(9)
Common stock repurchases	(94)	(1,024)
Dividends paid	(100)	(91)
Other	(106)	(13)
Net cash provided by financing activities	3,279	1,816
Increase in cash and cash equivalents	8,674	1,470
Cash and cash equivalents at beginning of period	5,061	3,394
Cash and cash equivalents at end of period	13,735	4,864
Supplemental cash flow disclosures:
Interest payments	97	67
Income tax payments (refund), net	6	(20)
Details of businesses acquired in purchase transactions:
Fair value of assets acquired, net of cash and cash equivalents acquired	73	84
Less: Fair value of liabilities assumed	(5)	(10)
Less: Noncontrolling interests acquired	5	0
Cash paid for acquired businesses, net of cash and cash equivalents acquired	$ 73	$ 74