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Summary of Stock Option Grants (Detail) - USD ($)
$ / shares in Units, shares in Millions, $ in Millions
12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Stock options grant shares      
Outstanding at beginning of year 14.6 16.6 18.9
Granted 1.8 2.0 2.7
Exercised (2.8) (3.6) (4.5)
Forfeited/expired (0.2) (0.4) (0.5)
Outstanding at end of year 13.4 14.6 16.6
Exercisable at end of year 8.8 9.2 10.0
Stock options grant weighted-average exercise price      
Outstanding at beginning of year $ 124.21 $ 113.06 $ 101.55
Granted 214.18 175.17 157.95
Exercised 104.58 97.70 89.31
Forfeited/expired 184.69 154.65 137.08
Outstanding at end of year 139.44 $ 124.21 $ 113.06
Exercisable at end of year $ 118.46    
Stock options grant Weighted-average remaining contractual life      
Outstanding at end of year 5 years 9 months 18 days    
Exercisable at end of year 4 years 7 months 6 days    
Stock options grant aggregate intrinsic value      
Outstanding at end of year $ 1,005.5    
Exercisable at end of year $ 843.1