0001127602-22-026782.txt : 20221202 0001127602-22-026782.hdr.sgml : 20221202 20221202164317 ACCESSION NUMBER: 0001127602-22-026782 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221201 FILED AS OF DATE: 20221202 DATE AS OF CHANGE: 20221202 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Clark James David CENTRAL INDEX KEY: 0001757584 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-01011 FILM NUMBER: 221442579 MAIL ADDRESS: STREET 1: ONE CVS DRIVE CITY: WOONSOCKET STATE: RI ZIP: 02760 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CVS HEALTH Corp CENTRAL INDEX KEY: 0000064803 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-DRUG STORES AND PROPRIETARY STORES [5912] IRS NUMBER: 050494040 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: ONE CVS DR. CITY: WOONSOCKET STATE: RI ZIP: 02895 BUSINESS PHONE: 4017651500 MAIL ADDRESS: STREET 1: ONE CVS DR. CITY: WOONSOCKET STATE: RI ZIP: 02895 FORMER COMPANY: FORMER CONFORMED NAME: CVS CAREMARK CORP DATE OF NAME CHANGE: 20070509 FORMER COMPANY: FORMER CONFORMED NAME: CVS/CAREMARK CORP DATE OF NAME CHANGE: 20070322 FORMER COMPANY: FORMER CONFORMED NAME: CVS CORP DATE OF NAME CHANGE: 19970128 4 1 form4.xml PRIMARY DOCUMENT X0306 4 2022-12-01 0000064803 CVS HEALTH Corp CVS 0001757584 Clark James David ONE CVS DRIVE WOONSOCKET RI 02895 1 SVP, Cont & Chief Acct Officer Common Stock 2022-12-01 4 F 0 153 101.65 D 26177.2554 D Common Stock (restricted) 12824 D Stock Option 104.82 2017-04-01 2023-04-01 Common Stock 7044 7044 D Stock Option 78.05 2018-04-03 2024-04-03 Common Stock 9050 9050 D Stock Option 62.21 2019-04-01 2025-04-01 Common Stock 7513 7513 D Stock Option 54.19 2020-04-01 2029-04-01 Common Stock 24240 24240 D Stock Option 58.34 2021-04-01 2030-04-01 Common Stock 17157 17157 D Stock Option 74.30 2022-04-01 2031-04-01 Common Stock 12094 12094 D Stock Option 101.09 2023-04-01 2032-04-01 Common Stock 6756 6756 D Transaction represents the withholding of shares by the Issuer to satisfy FICA taxes arising from the reporting person being retirement eligible. Options became exercisable in four equal annual installments beginning on 4/1/2017. Options became exercisable in four equal annual installments beginning on 4/3/2018. Options became exercisable in four equal annual installments, commencing 4/1/2019. Options became exercisable in four equal annual installments, commencing 4/1/2020. The number of shares subject to the option were calculated using a 30-day average price. Options became exercisable in four equal annual installments, commencing 4/1/2021. Option becomes exercisable in four equal annual installments, commencing 4/1/2022. Option becomes exercisable in four equal installments, commencing 4/1/2023. /s/ James D. Clark 2022-12-02