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v3.25.0.1

Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022
Operating activities |  |  |
Net earnings | $ 15,242 | $ 23,144 | $ 20,639
Noncash items: |  |  |
Depreciation and amortization | 4,099 | 3,972 | 3,400
Deferred income taxes | (296) | (245) | (673)
Share-based compensation | 1,018 | 1,059 | 925
Loss on sale of subsidiary and subsidiaries held for sale | 8,310 | 0 | 0
Gains on dispositions and other strategic transactions | (3,333) | (489) | (588)
Other, net | (28) | (16) | 257
Net change in other operating items, net of effects from acquisitions and dispositions: |  |  |
Accounts receivable | (1,437) | (3,114) | (2,523)
Other assets | (4,140) | (2,444) | (1,374)
Medical costs payable | 2,503 | 3,482 | 4,053
Accounts payable and other liabilities | 2,463 | 3,516 | 1,964
Unearned revenues | (197) | 203 | 126
Cash flows from operating activities | 24,204 | 29,068 | 26,206
Investing activities |  |  |
Purchases of investments | (27,308) | (18,314) | (18,825)
Sales of investments | 18,514 | 7,307 | 5,907
Maturities of investments | 9,319 | 9,230 | 6,081
Cash paid for acquisitions and other transactions, net of cash assumed | (13,408) | (10,136) | (21,458)
Purchases of property, equipment and capitalized software | (3,499) | (3,386) | (2,802)
Loans to care providers - cyberattack | (9,033) | 0 | 0
Repayments of care provider loans - cyberattack | 4,514 | 0 | 0
Cash received from dispositions and other strategic transactions, net | 2,041 | 685 | 3,414
Other, net | (1,667) | (960) | (793)
Cash flows used for investing activities | (20,527) | (15,574) | (28,476)
Financing activities |  |  |
Common share repurchases | (9,000) | (8,000) | (7,000)
Cash dividends paid | (7,533) | (6,761) | (5,991)
Proceeds from common stock issuances | 1,846 | 1,353 | 1,253
Repayments of long-term debt | (3,000) | (2,125) | (3,015)
(Repayments of) proceeds from short-term borrowings, net | (151) | 11 | 732
Proceeds from issuance of long-term debt | 17,811 | 6,394 | 14,819
Customer funds administered | (1,560) | (521) | 5,548
Purchases of redeemable noncontrolling interests | (280) | (730) | (176)
Other, net | (1,645) | (1,150) | (1,944)
Cash flows (used for) from financing activities | (3,512) | (11,529) | 4,226
Effect of exchange rate changes on cash and cash equivalents | (61) | 97 | 34
Increase in cash and cash equivalents, including cash within businesses held for sale | 104 | 2,062 | 1,990
Less: cash within businesses held for sale | (219) | 0 | 0
Net (decrease) increase in cash and cash equivalents | (115) | 2,062 | 1,990
Cash and cash equivalents, beginning of period | 25,427 | 23,365 | 21,375
Cash and cash equivalents, end of period | 25,312 | 25,427 | 23,365
Supplemental cash flow disclosures |  |  |
Cash paid for interest | 3,594 | 3,035 | 1,945
Cash paid for income taxes | $ 4,620 | $ 6,078 | $ 5,222

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