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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities:    
Cash receipts from customers $ 235,395 $ 209,104
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (138,785) (122,129)
Insurance benefits paid (51,434) (46,965)
Cash paid to other suppliers and employees (22,368) (21,840)
Interest and investment income received 327 582
Interest paid (1,936) (2,095)
Income taxes paid (3,070) (2,397)
Net cash provided by operating activities 18,129 14,260
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 5,535 5,559
Purchases of investments (6,439) (7,417)
Purchases of property and equipment (2,039) (1,923)
Acquisitions (net of cash acquired) (131) (135)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,808 and $0) (1,928) 0
Other 74 95
Net cash used in investing activities (4,928) (3,821)
Cash flows from financing activities:    
Proceeds from issuance of long-term debt 0 987
Repayments of long-term debt (4,195) (7,823)
Repurchase of common stock (2,000) 0
Dividends paid (2,188) (1,965)
Proceeds from exercise of stock options 510 440
Payments for taxes related to net share settlement of equity awards (337) (161)
Other (119) 80
Net cash used in financing activities (8,329) (8,442)
Net increase in cash, cash equivalents and restricted cash 4,872 1,997
Cash, cash equivalents and restricted cash at the beginning of the period 12,691 11,043
Cash, cash equivalents and restricted cash at the end of the period 17,563 13,040
Reconciliation of net income to net cash provided by operating activities:    
Net income (loss) 1,865 6,602
Adjustments required to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 3,198 3,397
Loss on assets held for sale 2,521 0
Goodwill impairment 0 431
Stock-based compensation 341 346
Gain on sale of subsidiary (225) 0
Loss on early extinguishment of debt 0 363
Deferred income taxes and other noncash items (2,250) (645)
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (2,009) (3,504)
Inventories (415) 1,097
Other assets (311) (88)
Accounts payable and pharmacy claims and discounts payable 3,350 3,973
Health care costs payable and other insurance liabilities 4,687 348
Other liabilities 7,377 1,940
Net cash provided by operating activities $ 18,129 $ 14,260