Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Net income	$ 2,342.1	$ 2,711.7	$ 1,176.8
Adjustments to reconcile net income to net cash provided by operating activities:
Stock-based compensation expense	441.4	429.5	360.5
Depreciation expense	125.6	109.5	106.9
Deferred income taxes	(154.6)	277.3	167.4
Gains on equity securities	(17.1)	(311.9)	(197.6)
(Decrease) increase in fair value of contingent consideration	(3.1)	13.1	4.5
Other non-cash items, net	14.4	78.7	16.9
Changes in operating assets and liabilities:
Accounts receivable, net	(274.7)	(223.4)	(225.6)
Inventories	(92.8)	(132.0)	(64.0)
Prepaid expenses and other assets	(91.8)	(297.6)	35.4
Accounts payable	31.9	51.3	(22.8)
Accrued expenses	305.4	122.2	172.9
Other liabilities	16.8	425.1	38.0
Net cash provided by operating activities	2,643.5	3,253.5	1,569.3
Cash flows from investing activities:
Payments to acquire businesses, net of cash acquired	0.0	0.0	(1,154.2)
Purchases of available-for-sale debt securities	(528.2)	(431.4)	(537.2)
Maturities of available-for-sale debt securities	499.3	372.3	475.9
Sale of equity securities	0.0	437.6	94.9
Purchases of property and equipment	(235.0)	(259.8)	(75.4)
Investment in equity securities and notes receivable	(77.0)	(19.3)	(39.3)
Net cash (used in) provided by investing activities	(340.9)	99.4	(1,235.3)
Cash flows from financing activities:
Issuances of common stock under benefit plans	102.0	264.9	343.2
Repurchases of common stock	(1,425.4)	(539.1)	(186.0)
Payments in connection with common stock withheld for employee tax obligations	(135.9)	(200.3)	(6.0)
Payments on finance leases	(47.0)	(42.3)	(39.2)
Proceeds from finance leases	22.6	13.3	10.0
Other financing activities	5.7	(1.8)	4.8
Net cash (used in) provided by financing activities	(1,478.0)	(505.3)	126.8
Effect of changes in exchange rates on cash	(13.4)	20.6	1.6
Net increase in cash, cash equivalents and restricted cash	811.2	2,868.2	462.4
Cash, cash equivalents and restricted cash—beginning of period	5,988.9	3,120.7	2,658.3
Cash, cash equivalents and restricted cash—end of period	6,800.1	5,988.9	3,120.7
Supplemental disclosure of cash flow information:
Cash paid for interest	56.3	54.5	55.6
Cash paid for income taxes	$ 476.3	$ 191.8	$ 24.7