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Acquisitions and Dispositions
6 Months Ended
Jun. 30, 2019
Business Combinations [Abstract]  
Acquisitions and Dispositions
NOTE 2 — ACQUISITIONS AND DISPOSITIONS
During the six months ended June 30, 2019, we paid $1.397 billion to acquire a
seven
-hospital health system in North Carolina and $107 million to acquire other nonhospital health care entities. During the six months ended June 30, 2018, we paid $360 million to acquire a hospital facility and $178 million to acquire other nonhospital health care entities. Purchase price amounts have been allocated to the related assets acquired and liabilities assumed based upon their respective fair values. The purchase price paid in excess of the fair value of identifiable net assets of these acquired entities aggregated $201 million for the six months ended June 30, 2019. The consolidated financial statements include the accounts and operations of the acquired entities subsequent to the respective acquisition dates. The pro forma effects of these acquired entities on our results of operations for periods prior to the respective acquisition dates were not significant.
During the six months ended June 30, 2019, we received proceeds of $25 million and recognized a net pretax loss of $1 million related to a sale of a hospital facility in one of our Louisiana markets. During the six months ended June 30, 2019, we also received proceeds of $16 million and recognized a net pretax gain of $18 million related to sales of real estate and other investments. During the six months ended June 30, 2018, we received proceeds of $758 million and recognized a net pretax gain of $372 million related to the sale of the two hospital facilities in our Oklahoma market. During the six months ended June 30, 2018, we also received 
proceeds of $41 million and recognized a net pretax gain of $42 million related to sales of real estate and other investments.