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Consolidated Statement of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
Cash Flows from Operating Activities of Continuing Operations |  |  |
Net income from continuing operations | $ 377 | $ 14,526 | $ 12,358
Adjustments to reconcile net income from continuing operations to net cash provided by operating activities of continuing operations: |  |  |
Amortization | 2,044 | 2,085 | 1,636
Depreciation | 1,828 | 1,824 | 1,578
Intangible asset impairment charges | 792 | 1,749 | 302
(Income) loss from investments in equity securities, net | (340) | 1,419 | (1,940)
Charge for the acquisition of Prometheus Biosciences, Inc. | 10,217 | 0 | 0
Charge for the acquisition of Imago BioSciences, Inc. | 1,192 | 0 | 0
Charge for the acquisition of Pandion Therapeutics, Inc. | 0 | 0 | 1,556
Deferred income taxes | (1,899) | (1,568) | 187
Share-based compensation | 645 | 541 | 479
Other | 355 | 1,301 | 805
Net changes in assets and liabilities: |  |  |
Accounts receivable | (1,148) | (644) | (2,033)
Inventories | (816) | (161) | (674)
Trade accounts payable | (380) | (289) | 405
Accrued and other current liabilities | 1,783 | (50) | 277
Income taxes payable | 214 | 380 | (540)
Noncurrent liabilities | 456 | (545) | 484
Other | (2,314) | (1,473) | (1,758)
Net Cash Provided by Operating Activities of Continuing Operations | 13,006 | 19,095 | 13,122
Cash Flows from Investing Activities of Continuing Operations |  |  |
Capital expenditures | (3,863) | (4,388) | (4,448)
Purchases of securities and other investments | (955) | (1,204) | (1)
Proceeds from sale of Seagen Inc. common stock | 1,145 | 0 | 0
Proceeds from sales of securities and other investments | 1,658 | 721 | 1,026
Acquisition of Prometheus Biosciences, Inc., net of cash acquired | (10,705) | 0 | 0
Acquisition of Imago BioSciences Inc., net of cash acquired | (1,327) | 0 | 0
Acquisition of Acceleron Pharma Inc., net of cash acquired | 0 | 0 | (11,174)
Acquisition of Pandion Therapeutics, Inc., net of cash acquired | 0 | 0 | (1,554)
Other acquisitions, net of cash acquired | 0 | (121) | (179)
Other | (36) | 32 | (91)
Net Cash Used in Investing Activities of Continuing Operations | (14,083) | (4,960) | (16,421)
Cash Flows from Financing Activities of Continuing Operations |  |  |
Net change in short-term borrowings | 0 | 0 | (3,986)
Payments on debt | (1,755) | (2,251) | (2,319)
Proceeds from issuance of debt | 5,939 | 0 | 7,936
Distribution from Organon & Co. | 0 | 0 | 9,000
Purchases of treasury stock | (1,346) | 0 | (840)
Dividends paid to stockholders | (7,445) | (7,012) | (6,610)
Proceeds from exercise of stock options | 125 | 384 | 202
Other | (328) | (240) | (286)
Net Cash (Used in) Provided by Financing Activities of Continuing Operations | (4,810) | (9,119) | 3,097
Cash Flows from Discontinued Operations |  |  |
Net cash provided by operating activities | 0 | 0 | 987
Net cash used in investing activities | 0 | 0 | (134)
Net cash used in financing activities | 0 | 0 | (504)
Net Cash Flows Provided by Discontinued Operations | 0 | 0 | 349
Effect of Exchange Rate Changes on Cash, Cash Equivalents and Restricted Cash | 23 | (410) | (133)
Net (Decrease) Increase in Cash, Cash Equivalents and Restricted Cash | (5,864) | 4,606 | 14
Cash, Cash Equivalents and Restricted Cash at Beginning of Year (includes $79, $71 and $103 of restricted cash at January 1, 2023, 2022 and 2021, respectively, included in Other current assets) | 12,773 | 8,167 | 8,153
Cash, Cash Equivalents and Restricted Cash at End of Year (includes $68, $79 and $71 of restricted cash at December 31, 2023, 2022 and 2021, respectively, included in Other current assets) | $ 6,909 | $ 12,773 | $ 8,167

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- Definition Increase (decrease) in cash associated with the entity's discontinued operations. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Topic 230 -SubTopic 10 -Name Accounting Standards Codification -Section 45 -Paragraph 24 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-24 + Details
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- Definition Amount of cash inflow (outflow) of financing activities, excluding discontinued operations. Financing activity cash flows include obtaining resources from owners and providing them with a return on, and a return of, their investment; borrowing money and repaying amounts borrowed, or settling the obligation; and obtaining and paying for other resources obtained from creditors on long-term credit. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Topic 230 -SubTopic 10 -Name Accounting Standards Codification -Section 45 -Paragraph 24 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-24 + Details
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- Definition The cash outflow to reacquire common stock during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-15 + Details
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- Definition Amount of cash outflow in the form of ordinary dividends to common shareholders of the parent entity. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-15 + Details
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- Definition The cash outflow associated with a third acquisition of a business, net of the cash acquired from the purchase. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Topic 230 -SubTopic 10 -Name Accounting Standards Codification -Section 45 -Paragraph 13 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-13 + Details
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- Definition The cash outflow associated with the purchase of all investments (debt, security, other) during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Topic 230 -SubTopic 10 -Name Accounting Standards Codification -Section 45 -Paragraph 13 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482740/230-10-45-13 + Details
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