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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash flows from operating activities:      
Net income $ 6,552 $ 5,893 $ 7,264
Depreciation, amortization and other 3,417 3,398 3,601
Stock-based compensation expense 401 341 330
Deferred income taxes (1,198) (453) (287)
Acquired in-process research and development 0 1,505 0
Adjustments for equity method investments 891 33 65
Loss on divestiture 567 0 0
Other items, net (176) (262) (260)
Changes in operating assets and liabilities, net of acquisitions:      
Trade receivables, net (746) (429) (427)
Inventories (742) (165) (215)
Other assets 258 (237) 129
Accounts payable 154 (69) 45
Accrued income taxes, net (647) (854) (249)
Long-term tax liabilities 229 204 (482)
Other liabilities 761 356 983
Net cash provided by operating activities 9,721 9,261 10,497
Cash flows from investing activities:      
Purchases of marketable securities (2,587) (8,900) (8,477)
Proceeds from sales of marketable securities 98 4,403 2,597
Proceeds from maturities of marketable securities 1,120 8,831 4,381
Purchases of property, plant and equipment (936) (880) (608)
Cash paid for acquisitions, net of cash acquired (3,839) (2,529) 0
Purchases of equity method investments (18) (157) (3,219)
Proceeds from Divestiture of Businesses, Net of Cash Divested 130 0 0
Other (12) (35) (75)
Net cash (used in) provided by investing activities (6,044) 733 (5,401)
Cash flows from financing activities:      
Net proceeds from issuance of debt 6,919 4,945 8,914
Extinguishment of debt (297) 0 0
Repayment of debt 0 (4,150) (6,450)
Repurchases of common stock (6,360) (4,975) (3,486)
Dividends paid (4,196) (4,013) (3,755)
Other (103) (78) (90)
Net cash used in financing activities (4,037) (8,271) (4,867)
(Decrease) increase in cash and cash equivalents (360) 1,723 229
Cash and cash equivalents at beginning of year 7,989 6,266 6,037
Cash and cash equivalents at end of year $ 7,629 $ 7,989 $ 6,266