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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 earnings | $ 7,209 | $ 6,433 | $ 3,646
Less: earnings from discontinued operations, net of income taxes | 0 | (86) | 0
Net earnings from continuing operations | 7,209 | 6,347 | 3,646
Noncash items: |  |  |
Depreciation | 738 | 718 | 637
Amortization of intangible assets | 1,484 | 1,450 | 1,138
Amortization of acquisition-related inventory fair value step-up | 0 | 59 | 457
Stock-based compensation expense | 336 | 218 | 187
Contract settlement expense | 0 | 542 | 0
Pretax loss on early extinguishment of borrowings | 0 | 96 | 26
Pretax gain on sale of product lines and investment (gains) losses | 271 | (414) | (455)
Change in deferred income taxes | (559) | (229) | 518
Change in trade accounts receivable, net | (477) | (611) | (264)
Change in inventories | (486) | (502) | (123)
Change in trade accounts payable | 5 | 549 | 227
Change in prepaid expenses and other assets | (78) | (4) | 102
Change in accrued expenses and other liabilities | 76 | 139 | 119
Total operating cash provided by continuing operations | 8,519 | 8,358 | 6,215
Total operating cash used in discontinued operations | 0 | 0 | (7)
Net cash provided by operating activities | 8,519 | 8,358 | 6,208
Cash flows from investing activities: |  |  |
Cash paid for acquisitions | (637) | (10,961) | (20,971)
Payments for additions to property, plant and equipment | (1,152) | (1,294) | (791)
Proceeds from sales of property, plant and equipment | 9 | 13 | 2
Payments for purchases of investments | (523) | (934) | (342)
Proceeds from sales of investments | 18 | 126 | 13
Proceeds from sale of product lines | 0 | 26 | 826
All other investing activities | 51 | 37 | 24
Net cash used in investing activities for continuing operations | (2,234) | (12,987) | (21,239)
Cash flows from financing activities: |  |  |
Proceeds from the issuance of common stock in connection with stock-based compensation | 31 | 86 | 153
Proceeds from the public offering of common stock, net of issuance costs | 0 | 0 | 1,729
Proceeds from the public offering of preferred stock, net of issuance costs | 0 | 0 | 1,668
Payment of dividends | (818) | (742) | (615)
Net (repayments of) proceeds from borrowings (maturities of 90 days or less) | (723) | 2,265 | (4,637)
Proceeds from borrowings (maturities longer than 90 days) | 0 | 984 | 8,670
Repayments of borrowings (maturities longer than 90 days) | (965) | (1,186) | (5,933)
Make-whole premiums to redeem borrowings prior to maturity | 0 | (96) | (26)
All other financing activities | (95) | (16) | (3)
Net cash (used in) provided by financing activities for continuing operations | (2,570) | 1,295 | 1,006
Effect of exchange rate changes on cash and equivalents | (306) | (115) | 148
Net change in cash and equivalents | 3,409 | (3,449) | (13,877)
Beginning balance of cash and equivalents | 2,586 | 6,035 | 19,912
Ending balance of cash and equivalents | $ 5,995 | $ 2,586 | $ 6,035

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