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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
$ in Millions
 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Cash flows from operating activities    
Net income $ 2,194 $ 1,627
Adjustments to reconcile net income to net cash provided by operating activities:    
Loss on investment securities, net 45 137
Equity in net losses 27 2
Stock-based compensation 89 93
Depreciation 410 369
Amortization 34 45
Impairment on property and equipment 0 140
Deferred income taxes 0 167
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:    
Receivables 269 (1,733)
Other assets (1,141) (655)
Benefits payable 978 1,361
Other liabilities (170) (333)
Unearned revenues 7,092 10
Other 36 31
Net cash provided by operating activities 9,863 1,261 Close
Cash flows from investing activities    
Acquisitions, net of cash and cash equivalents acquired (189) (167)
Purchases of property and equipment, net (487) (574)
Purchases of investment securities (2,737) (3,239)
Proceeds from maturities of investment securities 577 947
Proceeds from sales of investment securities 811 1,363
Net cash used in investing activities (2,025) (1,670) Close
Cash flows from financing activities    
Receipts from contract deposits, net 3,510 3,076
Proceeds from issuance of senior notes, net 1,215 744
Repayments of senior notes (349) 0
Repayments from issuance of commercial paper, net 238 (418)
Repayment of term loan (500) 0
Debt issue costs (4) (2)
Change in book overdraft 159 65
Common stock repurchases (623) (1,028)
Dividends paid (211) (191)
Other (120) (11)
Net cash provided by financing activities 3,315 2,235 Close
Increase in cash and cash equivalents 11,153 1,826 Close
Cash and cash equivalents at beginning of period 5,061 3,394
Cash and cash equivalents at end of period 16,214 5,220
Supplemental cash flow disclosures:    
Interest payments 175 171
Income tax payments, net 681 373
Details of businesses acquired in purchase transactions:    
Fair value of assets acquired, net of cash and cash equivalents acquired 346 190
Less: Fair value of liabilities assumed (162) (23)
Less: Noncontrolling interests acquired 5 0
Cash paid for acquired businesses, net of cash and cash equivalents acquired $ 189 $ 167