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v3.22.4

Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Operating activities |  |  |
Net earnings | $ 20,639 | $ 17,732 | $ 15,769
Noncash items: |  |  |
Depreciation and amortization | 3,400 | 3,103 | 2,891
Deferred income taxes | (673) | 130 | (8)
Share-based compensation | 925 | 800 | 679
Other, net | (331) | (944) | (52)
Net change in other operating items, net of effects from acquisitions and changes in AARP balances: |  |  |
Accounts receivable | (2,523) | (1,000) | (688)
Other assets | (1,374) | (1,031) | (2,195)
Medical costs payable | 4,053 | 2,701 | 152
Accounts payable and other liabilities | 1,964 | 1,162 | 5,348
Unearned revenues | 126 | (310) | 278
Cash flows from operating activities | 26,206 | 22,343 | 22,174
Investing activities |  |  |
Purchases of investments | (18,825) | (17,139) | (16,577)
Sales of investments | 5,907 | 7,045 | 6,489
Maturities of investments | 6,081 | 8,251 | 7,252
Cash paid for acquisitions, net of cash assumed | (21,458) | (4,821) | (7,139)
Purchases of property, equipment and capitalized software | (2,802) | (2,454) | (2,051)
Cash received from dispositions | 3,414 | 15 | 221
Other, net | (793) | (1,269) | (727)
Cash flows used for investing activities | (28,476) | (10,372) | (12,532)
Financing activities |  |  |
Common share repurchases | (7,000) | (5,000) | (4,250)
Cash dividends paid | (5,991) | (5,280) | (4,584)
Proceeds from common stock issuances | 1,253 | 1,355 | 1,440
Repayments of long-term debt | (3,015) | (3,150) | (3,150)
Proceeds from (repayments of) short-term borrowings, net | 732 | (1,302) | 872
Proceeds from issuance of long-term debt | 14,819 | 6,933 | 4,864
Customer funds administered | 5,548 | 622 | 1,677
Purchases of redeemable noncontrolling interests | (176) | (1,338) | 0
Other, net | (1,944) | (295) | (459)
Cash flows from (used for) financing activities | 4,226 | (7,455) | (3,590)
Effect of exchange rate changes on cash and cash equivalents | 34 | (62) | (116)
Increase in cash and cash equivalents | 1,990 | 4,454 | 5,936
Cash and cash equivalents, beginning of period | 21,375 | 16,921 | 10,985
Cash and cash equivalents, end of period | 23,365 | 21,375 | 16,921
Supplemental cash flow disclosures |  |  |
Cash paid for interest | 1,945 | 1,653 | 1,704
Cash paid for income taxes | $ 5,222 | $ 3,966 | $ 4,935

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