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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Cash flows from operating activities:    
Cash receipts from customers $ 260,300 $ 235,395
Cash paid for inventory, prescriptions dispensed and health services rendered (153,051) (138,785)
Insurance benefits paid (61,658) (51,434)
Cash paid to other suppliers and employees (26,038) (22,728)
Interest and investment income received 1,174 687
Interest paid (2,049) (1,936)
Income taxes paid (2,616) (3,070)
Net cash provided by operating activities 16,062 18,129
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 5,547 5,535
Purchases of investments (6,625) (6,439)
Purchases of property and equipment (2,120) (2,039)
Acquisitions (net of cash and restricted cash acquired) (16,492) (131)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,808 in 2022) 0 (1,928)
Other 43 74
Net cash used in investing activities (19,647) (4,928)
Cash flows from financing activities:    
Proceeds from issuance of short-term loan 5,000 0
Repayment of short-term loan (5,000) 0
Proceeds from issuance of long-term debt 10,898 0
Repayments of long-term debt (2,734) (4,195)
Repurchase of common stock (2,013) (2,000)
Dividends paid (2,353) (2,188)
Proceeds from exercise of stock options 242 510
Payments for taxes related to net share settlement of equity awards (175) (337)
Other (210) (119)
Net cash provided by (used in) financing activities 3,655 (8,329)
Net increase in cash, cash equivalents and restricted cash 70 4,872
Cash, cash equivalents and restricted cash at the beginning of the period 13,305 12,691
Cash, cash equivalents and restricted cash at the end of the period 13,375 17,563
Reconciliation of net income to net cash provided by operating activities:    
Net income (loss) 6,321 1,995
Adjustments required to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 3,232 3,181
Loss on assets held for sale 349 2,521
Stock-based compensation 461 341
Gain on sale of subsidiary 0 (225)
Deferred income taxes and other noncash items (360) (2,213)
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (3,920) (2,009)
Inventories 1,305 (415)
Other assets (518) (244)
Accounts payable and pharmacy claims and discounts payable 2,466 3,350
Health care costs payable and other insurance liabilities 4,679 4,476
Other liabilities 2,047 7,371
Net cash provided by operating activities $ 16,062 $ 18,129