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Consolidated Statements of Cash Flows - USD ($) | 12 Months Ended
--- | ---
Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Cash flows from operating activities: |  |  |
Cash receipts from customers | $ 248,393,000,000 | $ 186,519,000,000 | $ 176,594,000,000
Cash paid for inventory and prescriptions dispensed by retail network pharmacies | (149,655,000,000) | (148,981,000,000) | (146,469,000,000)
Insurance benefits paid | (52,242,000,000) | (6,897,000,000) | (2,810,000,000)
Cash paid to other suppliers and employees | (28,932,000,000) | (17,234,000,000) | (15,348,000,000)
Interest and investment income received | 955,000,000 | 644,000,000 | 21,000,000
Interest paid | (2,954,000,000) | (2,803,000,000) | (1,072,000,000)
Income taxes paid | (2,717,000,000) | (2,383,000,000) | (2,909,000,000)
Net cash provided by operating activities | 12,848,000,000 | 8,865,000,000 | 8,007,000,000
Cash flows from investing activities: |  |  |
Proceeds from sales and maturities of investments | 7,049,000,000 | 817,000,000 | 61,000,000
Purchases of investments | (7,534,000,000) | (692,000,000) | (137,000,000)
Purchases of property and equipment | (2,457,000,000) | (2,037,000,000) | (1,918,000,000)
Proceeds from sale-leaseback transactions | 5,000,000 |  |
Proceeds from sale-leaseback transactions |  | 0 | 265,000,000
Acquisitions (net of cash acquired) | (444,000,000) | (42,226,000,000) | (1,181,000,000)
Proceeds from sale of subsidiary and other assets | 0 | 832,000,000 | 0
Other | 42,000,000 | 21,000,000 | 33,000,000
Net cash used in investing activities | (3,339,000,000) | (43,285,000,000) | (2,877,000,000)
Cash flows from financing activities: |  |  |
Net repayments of short-term debt | (720,000,000) | (556,000,000) | (598,000,000)
Proceeds from issuance of long-term debt | 3,736,000,000 | 44,343,000,000 | 0
Repayments of long-term debt | (8,336,000,000) | (5,522,000,000) | 0
Derivative settlements | (25,000,000) | 446,000,000 | 0
Repurchase of common stock | 0 | 0 | (4,361,000,000)
Dividends paid | (2,603,000,000) | (2,038,000,000) | (2,049,000,000)
Proceeds from exercise of stock options | 210,000,000 | 242,000,000 | 329,000,000
Payments for taxes related to net share settlement of equity awards | (112,000,000) | (97,000,000) | (71,000,000)
Other | 0 | 1,000,000 | (1,000,000)
Net cash provided by (used in) financing activities | (7,850,000,000) | 36,819,000,000 | (6,751,000,000)
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | (4,000,000) | 1,000,000
Net increase (decrease) in cash, cash equivalents and restricted cash | 1,659,000,000 | 2,395,000,000 | (1,620,000,000)
Cash, cash equivalents and restricted cash at the beginning of the period | 4,295,000,000 | 1,900,000,000 | 3,520,000,000
Cash, cash equivalents and restricted cash at the end of the period | 5,954,000,000 | 4,295,000,000 | 1,900,000,000
Reconciliation of net income (loss) to net cash provided by operating activities: |  |  |
Net income (loss) | 6,631,000,000 | (596,000,000) | 6,623,000,000
Adjustments required to reconcile net income (loss) to net cash provided by operating activities: |  |  |
Depreciation and amortization | 4,371,000,000 | 2,718,000,000 | 2,479,000,000
Goodwill impairments | 0 | 6,149,000,000 | 181,000,000
Loss on settlement of defined benefit pension plans | 0 | 0 | 187,000,000
Stock-based compensation | 453,000,000 | 280,000,000 | 234,000,000
Loss on sale of subsidiary | 205,000,000 | 86,000,000 | 0
Loss on early extinguishment of debt | 79,000,000 | 0 | 0
Deferred income taxes | (654,000,000) | 87,000,000 | (1,334,000,000)
Other noncash items | 264,000,000 | 253,000,000 | 53,000,000
Change in operating assets and liabilities, net of effects from acquisitions: |  |  |
Accounts receivable, net | (2,158,000,000) | (1,139,000,000) | (941,000,000)
Inventories | (1,075,000,000) | (1,153,000,000) | (514,000,000)
Other assets | (614,000,000) | (3,000,000) | (338,000,000)
Accounts payable and pharmacy claims and discounts payable | 3,550,000,000 | 2,329,000,000 | 1,710,000,000
Health care costs payable and other insurance liabilities | 320,000,000 | (311,000,000) | 0
Other liabilities | $ 1,476,000,000 | $ 165,000,000 | $ (333,000,000)

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- Definition Amount of cash (inflow) outflow from investing activities classified as other. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 3 -Subparagraph (SX 210.12-04(a)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24072-122690 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3213-108585 Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3179-108585 + Details
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- Definition The cash outflow to reacquire common stock during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585 + Details
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- Definition Cash outflow in the form of capital distributions and dividends to common shareholders, preferred shareholders and noncontrolling interests. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585 + Details
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- Definition Amount of cash outflow to satisfy grantee's tax withholding obligation for award under share-based payment arrangement. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585 + Details
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- Definition The cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the purchase of all investments (debt, security, other) during the period. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3213-108585 + Details
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- Definition The cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3213-108585 + Details
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- Definition Cash payments to suppliers for goods and services provided and to employees for services provided. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3536-108585 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 17 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3367-108585 Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 17 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3367-108585 + Details
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- Definition Cash receipts from customers during the current period which are usually for sales of goods and services. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3536-108585 + Details
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- Definition This element represents the cash inflow during the period from the sale of a component of the entity. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3179-108585 + Details
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- Definition Cash received for dividends and interest on the entity's equity and debt investments during the current period. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 16 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3337-108585 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3536-108585 + Details
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- Definition The cash inflow from a debt initially having maturity due after one year or beyond the operating cycle, if longer. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 + Details
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- Definition Amount of cash inflow (outflow) from financing activities classified as other. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 3 -Subparagraph (SX 210.12-04(a)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24072-122690 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3291-108585 + Details
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- Definition The net cash inflow or outflow for borrowing having initial term of repayment within one year or the normal operating cycle, if longer. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 3 -Subparagraph (SX 210.12-04(a)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24072-122690 + Details
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- Definition Amount of cash inflow from exercise of option under share-based payment arrangement. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2A -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=116856206&loc=SL79508275-113901 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 14 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3255-108585 + Details
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