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v3.24.3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions | 9 Months Ended
--- | ---
Sep. 30, 2024 | Sep. 30, 2023
Cash flows from operating activities: |  |
Net income | $ 4,971 | $ 4,230
Increase (decrease) in cash from operating assets and liabilities: |  |
Accounts receivable | 55 | (168)
Inventories and other assets | 184 | (274)
Accounts payable and accrued expenses | 77 | 211
Depreciation and amortization | 2,456 | 2,288
Income taxes | (67) | 61
Losses (gains) on sales of facilities | (209) | 12
Amortization of debt issuance costs and discounts | 26 | 26
Share-based compensation | 275 | 205
Other | 187 | 166
Net cash provided by operating activities | 7,955 | 6,757
Cash flows from investing activities: |  |
Purchase of property and equipment | (3,590) | (3,585)
Acquisition of hospitals and health care entities | (224) | (281)
Sales of hospitals and health care entities | 312 | 183
Change in investments | (85) | (30)
Other | 0 | (7)
Net cash used in investing activities | (3,587) | (3,720)
Cash flows from financing activities: |  |
Issuance of long-term debt | 7,495 | 3,220
Net change in revolving credit facilities | (1,880) | (1,420)
Repayment of long-term debt | (2,346) | (691)
Distributions to noncontrolling interests | (530) | (497)
Payment of debt issuance costs | (67) | (31)
Payment of dividends | (525) | (501)
Repurchase of common stock | (4,342) | (2,901)
Other | (224) | (234)
Net cash used in financing activities | (2,419) | (3,055)
Effect of exchange rate changes on cash and cash equivalents | 4 | 1
Change in cash and cash equivalents | 1,953 | (17)
Cash and cash equivalents at beginning of period | 935 | 908
Cash and cash equivalents at end of period | 2,888 | 891
Interest payments | 1,405 | 1,460
Income tax payments, net | $ 1,486 | $ 1,070

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