v3.25.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash flows from operating activities:      
Cash receipts from customers $ 357,995 $ 345,464 $ 313,662
Cash paid for inventory, prescriptions dispensed and health services rendered (197,726) (208,848) (189,766)
Insurance benefits paid (109,464) (84,097) (69,728)
Cash paid to other suppliers and employees (38,821) (34,735) (32,662)
Interest and investment income received 1,735 1,584 1,026
Interest paid (2,909) (2,418) (2,239)
Income taxes paid (1,703) (3,524) (4,116)
Net cash provided by operating activities 9,107 13,426 16,177
Cash flows from investing activities:      
Proceeds from sales and maturities of investments 10,353 7,729 6,729
Purchases of investments (15,191) (9,043) (7,746)
Purchases of property and equipment (2,781) (3,031) (2,727)
Acquisitions (net of cash and restricted cash acquired) (95) (16,612) (139)
Proceeds from sale of subsidiaries (net of cash and restricted cash sold of $2,854 in 2022) 0 0 (1,249)
Other 101 68 85
Net cash used in investing activities (7,613) (20,889) (5,047)
Cash flows from financing activities:      
Commercial paper borrowings (repayments), net 1,919 200 0
Proceeds from issuance of short-term loan 0 5,000 0
Repayment of short-term loan 0 (5,000) 0
Proceeds from issuance of long-term debt 7,913 10,898 0
Repayments of long-term debt (4,773) (3,166) (4,211)
Repurchase of common stock (3,023) (2,012) (3,500)
Dividends paid (3,373) (3,132) (2,907)
Proceeds from exercise of stock options 361 277 551
Payments for taxes related to net share settlement of equity awards (185) (181) (370)
Other 26 (201) (79)
Net cash provided by (used in) financing activities (1,135) 2,683 (10,516)
Net increase (decrease) in cash, cash equivalents and restricted cash 359 (4,780) 614
Cash, cash equivalents and restricted cash at the beginning of the period 8,525 13,305 12,691
Cash, cash equivalents and restricted cash at the end of the period 8,884 8,525 13,305
Reconciliation of net income to net cash provided by operating activities:      
Net income 4,586 8,368 4,327
Adjustments required to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 4,597 4,366 4,224
Loss on assets held for sale 0 349 2,533
Stock-based compensation 540 588 447
Restructuring charges (impairment of long-lived assets) 840 152 0
Gain on sale of subsidiaries 0 0 (475)
Gain on early extinguishment of debt (491) 0 0
Deferred income taxes (572) (676) (2,029)
Other items (502) 264 332
Change in operating assets and liabilities, net of effects from acquisitions:      
Accounts receivable, net (1,301) (6,260) (2,971)
Inventories (102) 1,233 (1,435)
Other assets (38) (510) (491)
Accounts payable and pharmacy claims and discounts payable 2,335 3,618 4,260
Health care costs payable and other insurance liabilities 2,757 394 992
Other liabilities (3,542) 1,540 6,463
Net cash provided by operating activities $ 9,107 $ 13,426 $ 16,177