CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities
Net income	$ 2,194	$ 1,627
Adjustments to reconcile net income to net cash provided by operating activities:
Loss on investment securities, net	45	137
Equity in net losses	27	2
Stock-based compensation	89	93
Depreciation	410	369
Amortization	34	45
Impairment on property and equipment	0	140
Deferred income taxes	0	167
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:
Receivables	269	(1,733)
Other assets	(1,141)	(655)
Benefits payable	978	1,361
Other liabilities	(170)	(333)
Unearned revenues	7,092	10
Other	36	31
Net cash provided by operating activities	9,863	1,261
Cash flows from investing activities
Acquisitions, net of cash and cash equivalents acquired	(189)	(167)
Purchases of property and equipment, net	(487)	(574)
Purchases of investment securities	(2,737)	(3,239)
Proceeds from maturities of investment securities	577	947
Proceeds from sales of investment securities	811	1,363
Net cash used in investing activities	(2,025)	(1,670)
Cash flows from financing activities
Receipts from contract deposits, net	3,510	3,076
Proceeds from issuance of senior notes, net	1,215	744
Repayments of senior notes	(349)	0
Repayments from issuance of commercial paper, net	238	(418)
Repayment of term loan	(500)	0
Debt issue costs	(4)	(2)
Change in book overdraft	159	65
Common stock repurchases	(623)	(1,028)
Dividends paid	(211)	(191)
Other	(120)	(11)
Net cash provided by financing activities	3,315	2,235
Increase in cash and cash equivalents	11,153	1,826
Cash and cash equivalents at beginning of period	5,061	3,394
Cash and cash equivalents at end of period	16,214	5,220
Supplemental cash flow disclosures:
Interest payments	175	171
Income tax payments, net	681	373
Details of businesses acquired in purchase transactions:
Fair value of assets acquired, net of cash and cash equivalents acquired	346	190
Less: Fair value of liabilities assumed	(162)	(23)
Less: Noncontrolling interests acquired	5	0
Cash paid for acquired businesses, net of cash and cash equivalents acquired	$ 189	$ 167