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Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Operating activities
Net earnings	$ 15,769	$ 14,239	$ 12,382
Noncash items:
Depreciation and amortization	2,891	2,720	2,428
Deferred income taxes	(8)	230	42
Share-based compensation	679	697	638
Other, net	(52)	(106)	(71)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:
Accounts receivable	(688)	162	(1,351)
Other assets	(2,195)	(1,563)	(750)
Medical costs payable	152	1,221	1,831
Accounts payable and other liabilities	5,348	733	526
Unearned revenues	278	130	38
Cash flows from operating activities	22,174	18,463	15,713
Investing activities
Purchases of investments	(16,577)	(18,131)	(14,010)
Sales of investments	6,489	8,536	3,641
Maturities of investments	7,252	7,091	6,270
Cash paid for acquisitions, net of cash assumed	(7,139)	(8,343)	(5,997)
Purchases of property, equipment and capitalized software	(2,051)	(2,071)	(2,063)
Other, net	(506)	219	(226)
Cash flows used for investing activities	(12,532)	(12,699)	(12,385)
Financing activities
Common share repurchases	(4,250)	(5,500)	(4,500)
Cash dividends paid	(4,584)	(3,932)	(3,320)
Proceeds from common stock issuances	1,440	1,037	838
Repayments of long-term debt	(3,150)	(1,750)	(2,600)
Proceeds from (repayments of) short-term borrowings, net	872	300	(201)
Proceeds from issuance of long-term debt	4,864	5,444	6,935
Customer funds administered	1,677	13	(131)
Other, net	(459)	(1,237)	(1,386)
Cash flows used for financing activities	(3,590)	(5,625)	(4,365)
Effect of exchange rate changes on cash and cash equivalents	(116)	(20)	(78)
Increase (decrease) in cash and cash equivalents	5,936	119	(1,115)
Cash and cash equivalents, beginning of period	10,985	10,866	11,981
Cash and cash equivalents, end of period	16,921	10,985	10,866
Supplemental cash flow disclosures
Cash paid for interest	1,704	1,627	1,410
Cash paid for income taxes	$ 4,935	$ 3,542	$ 3,257

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