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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
Operating activities      
Net earnings $ 17,732 $ 15,769 $ 14,239
Noncash items:      
Depreciation and amortization 3,103 2,891 2,720
Deferred income taxes 130 (8) 230
Share-based compensation 800 679 697
Other, net (944) (52) (106)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances:      
Accounts receivable (1,000) (688) 162
Other assets (1,031) (2,195) (1,563)
Medical costs payable 2,701 152 1,221
Accounts payable and other liabilities 1,162 5,348 733
Unearned revenues (310) 278 130
Cash flows from operating activities 22,343 22,174 18,463
Investing activities      
Purchases of investments (17,139) (16,577) (18,131)
Sales of investments 7,045 6,489 8,536
Maturities of investments 8,251 7,252 7,091
Cash paid for acquisitions, net of cash assumed (4,821) (7,139) (8,343)
Purchases of property, equipment and capitalized software (2,454) (2,051) (2,071)
Other, net (1,254) (506) 219
Cash flows used for investing activities (10,372) (12,532) (12,699)
Financing activities      
Common share repurchases (5,000) (4,250) (5,500)
Cash dividends paid (5,280) (4,584) (3,932)
Proceeds from common stock issuances 1,355 1,440 1,037
Repayments of long-term debt (3,150) (3,150) (1,750)
(Repayments of) proceeds from short-term borrowings, net (1,302) 872 300
Proceeds from issuance of long-term debt 6,933 4,864 5,444
Customer funds administered 622 1,677 13
Purchases of redeemable noncontrolling interest (1,338) 0 (618)
Other, net (295) (459) (619)
Cash flows used for financing activities (7,455) (3,590) (5,625)
Effect of exchange rate changes on cash and cash equivalents (62) (116) (20)
Increase in cash and cash equivalents 4,454 5,936 119
Cash and cash equivalents, beginning of period 16,921 10,985 10,866
Cash and cash equivalents, end of period 21,375 16,921 10,985
Supplemental cash flow disclosures      
Cash paid for interest 1,653 1,704 1,627
Cash paid for income taxes $ 3,966 $ 4,935 $ 3,542