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v3.25.3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions | 9 Months Ended
--- | ---
Sep. 30, 2025 | Sep. 30, 2024
Cash flows from operating activities: |  |
Net income | $ 5,619 | $ 4,971
Increase (decrease) in cash from operating assets and liabilities: |  |
Accounts receivable | 345 | 55
Inventories and other assets | (125) | 184
Accounts payable and accrued expenses | 29 | 77
Depreciation and amortization | 2,612 | 2,456
Income taxes | 1,314 | (67)
Losses (gains) on sales of facilities | 4 | (209)
Amortization of debt issuance costs and discounts | 32 | 26
Share-based compensation | 301 | 275
Other | 146 | 187
Net cash provided by operating activities | 10,277 | 7,955
Cash flows from investing activities: |  |
Purchase of property and equipment | (3,455) | (3,590)
Acquisition of hospitals and health care entities | (361) | (224)
Sales of hospitals and health care entities | 177 | 312
Change in investments | (26) | (85)
Other | (6) | 0
Net cash used in investing activities | (3,671) | (3,587)
Cash flows from financing activities: |  |
Issuance of long-term debt | 5,233 | 7,495
Net change in short-term borrowings and revolving credit facilities | 1,906 | (1,880)
Repayment of long-term debt | (5,834) | (2,346)
Distributions to noncontrolling interests | (631) | (530)
Payment of debt issuance costs | (57) | (67)
Payment of dividends | (517) | (525)
Repurchase of common stock | (7,509) | (4,342)
Other | (142) | (224)
Net cash used in financing activities | (7,551) | (2,419)
Effect of exchange rate changes on cash and cash equivalents | 9 | 4
Change in cash and cash equivalents | (936) | 1,953
Cash and cash equivalents at beginning of period | 1,933 | 935
Cash and cash equivalents at end of period | 997 | 2,888
Interest payments | 1,696 | 1,405
Income tax payments, net | $ 227 | $ 1,486

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