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