XML 29 R7.htm IDEA: XBRL DOCUMENT v3.24.0.1Close
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash flows from operating activities:      
Cash receipts from customers $ 345,464 $ 313,662 $ 284,219
Cash paid for inventory, prescriptions dispensed and health services rendered (208,848) (189,766) (165,783)
Insurance benefits paid (84,097) (69,728) (63,598)
Cash paid to other suppliers and employees (34,735) (32,662) (31,652)
Interest and investment income received 1,584 1,026 743
Interest paid (2,418) (2,239) (2,469)
Income taxes paid (3,524) (4,116) (3,195)
Net cash provided by operating activities 13,426 16,177 18,265 Close
Cash flows from investing activities:      
Proceeds from sales and maturities of investments 7,729 6,729 7,246
Purchases of investments (9,043) (7,746) (9,963)
Purchases of property and equipment (3,031) (2,727) (2,520)
Acquisitions (net of cash and restricted cash acquired) (16,612) (139) (146)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,854 in 2022) 0 (1,249) 0
Other 68 85 122
Net cash used in investing activities (20,889) (5,047) (5,261) Close
Cash flows from financing activities:      
Commercial paper borrowings (repayments), net 200 0 0
Proceeds from issuance of short-term loan 5,000 0 0
Repayment of short-term loan (5,000) 0 0
Proceeds from issuance of long-term debt 10,898 0 987
Repayments of long-term debt (3,166) (4,211) (10,254)
Repurchase of common stock (2,012) (3,500) 0
Dividends paid (3,132) (2,907) (2,625)
Proceeds from exercise of stock options 277 551 549
Payments for taxes related to net share settlement of equity awards (181) (370) (168)
Other (201) (79) 155
Net cash provided by (used in) financing activities 2,683 (10,516) (11,356) Close
Net increase (decrease) in cash, cash equivalents and restricted cash (4,780) 614 1,648 Close
Cash, cash equivalents and restricted cash at the beginning of the period 13,305 12,691 11,043
Cash, cash equivalents and restricted cash at the end of the period 8,525 13,305 12,691
Reconciliation of net income to net cash provided by operating activities:      
Net income 8,368 4,327 7,989
Adjustments required to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 4,366 4,224 4,486
Loss on assets held for sale 349 2,533 0
Store impairments 0 0 1,358
Goodwill impairment 0 0 431
Stock-based compensation 588 447 484
Gain on sale of subsidiaries 0 (475) 0
Loss on early extinguishment of debt 0 0 452
Deferred income taxes (676) (2,029) (402)
Other noncash items 416 332 (390)
Change in operating assets and liabilities, net of effects from acquisitions:      
Accounts receivable, net (6,260) (2,971) (2,703)
Inventories 1,233 (1,435) 735
Other assets (510) (491) (30)
Accounts payable and pharmacy claims and discounts payable 3,618 4,260 2,898
Health care costs payable and other insurance liabilities 394 992 101
Other liabilities 1,540 6,463 2,856
Net cash provided by operating activities $ 13,426 $ 16,177 $ 18,265