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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Cash flows from operating activities:    
Cash receipts from customers $ 120,808 $ 87,977
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (70,567) (70,763)
Insurance benefits paid (25,992) (1,737)
Cash paid to other suppliers and employees (14,497) (8,471)
Interest and investment income received 512 194
Interest paid (1,502) (560)
Income taxes paid (1,476) (1,351)
Net cash provided by operating activities 7,286 5,289
Cash flows from investing activities:    
Purchases of investments 3,786 37
Purchases of investments (4,062) (53)
Purchases of property and equipment (1,289) (912)
Acquisitions (net of cash acquired) (250) (556)
Proceeds from sale of subsidiary 0 725
Other 14 7
Net cash used in investing activities (1,801) (752)
Cash flows from financing activities:    
Net repayments of short-term debt (275) (1,276)
Proceeds from issuance of long-term debt 0 39,376
Repayments of long-term debt (1,899) (1)
Derivative settlements 0 446
Dividends paid (1,306) (1,018)
Proceeds from exercise of stock options 111 130
Payments for taxes related to net share settlement of equity awards (80) (37)
Other 7 0
Net cash provided by (used in) financing activities (3,442) 37,620
Net increase in cash, cash equivalents and restricted cash 2,043 42,157
Cash, cash equivalents and restricted cash at the beginning of the period 4,295 1,900
Cash, cash equivalents and restricted cash at the end of the period 6,338 44,057
Reconciliation of net income (loss) to net cash provided by operating activities:    
Net income (loss) 3,358 (1,565)
Adjustments required to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 2,183 1,291
Goodwill impairment 0 3,921
Deferred income taxes and other noncash items 226 110
Deferred income taxes and other noncash items (42) 252
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (681) (1,059)
Inventories 939 369
Other assets (314) (174)
Accounts payable and pharmacy claims and discounts payable 917 1,045
Health care costs payable and other insurance liabilities 496 224
Reconciliation of net income (loss) to net cash provided by operating activities: 204 875
Net cash provided by operating activities $ 7,286 $ 5,289