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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flows from operating activities:    
Cash receipts from customers $ 264,538 $ 260,300
Cash paid for inventory, prescriptions dispensed and health services rendered (145,469) (153,051)
Insurance benefits paid (80,357) (61,658)
Cash paid to other suppliers and employees (28,933) (26,038)
Interest and investment income received 1,288 1,174
Interest paid (2,391) (2,049)
Income taxes paid (1,429) (2,616)
Net cash provided by operating activities 7,247 16,062 Close
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 7,634 5,547
Purchases of investments (12,677) (6,625)
Purchases of property and equipment (2,013) (2,120)
Acquisitions (net of cash and restricted cash acquired) (85) (16,492)
Other 75 43
Net cash used in investing activities (7,066) (19,647) Close
Cash flows from financing activities:    
Commercial paper borrowings (repayments), net 600 0
Proceeds from issuance of short-term loan 0 5,000
Repayment of short-term loan 0 (5,000)
Proceeds from issuance of long-term debt 4,959 10,898
Repayments of long-term debt (1,706) (2,734)
Repurchase of common stock (3,023) (2,013)
Dividends paid (2,535) (2,353)
Proceeds from exercise of stock options 342 242
Payments for taxes related to net share settlement of equity awards (181) (175)
Other (22) (210)
Net cash provided by (used in) financing activities (1,566) 3,655 Close
Net increase (decrease) in cash, cash equivalents and restricted cash (1,385) 70 Close
Cash, cash equivalents and restricted cash at the beginning of the period 8,525 13,305
Cash, cash equivalents and restricted cash at the end of the period 7,140 13,375
Reconciliation of net income to net cash provided by operating activities:    
Net income 2,963 6,321
Adjustments required to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 3,450 3,232
Stock-based compensation 403 461
Restructuring charges (impairment of long-lived assets) 840 152
Deferred income taxes and other items (912) (163)
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (986) (3,920)
Inventories 355 1,305
Other assets (850) (518)
Accounts payable and pharmacy claims and discounts payable 2,169 2,466
Health care costs payable and other insurance liabilities 2,878 4,679
Other liabilities (3,063) 2,047
Net cash provided by operating activities $ 7,247 $ 16,062