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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: |  |
Cash receipts from customers | $ 264,538 | $ 260,300
Cash paid for inventory, prescriptions dispensed and health services rendered | (145,469) | (153,051)
Insurance benefits paid | (80,357) | (61,658)
Cash paid to other suppliers and employees | (28,933) | (26,038)
Interest and investment income received | 1,288 | 1,174
Interest paid | (2,391) | (2,049)
Income taxes paid | (1,429) | (2,616)
Net cash provided by operating activities | 7,247 | 16,062
Cash flows from investing activities: |  |
Proceeds from sales and maturities of investments | 7,634 | 5,547
Purchases of investments | (12,677) | (6,625)
Purchases of property and equipment | (2,013) | (2,120)
Acquisitions (net of cash and restricted cash acquired) | (85) | (16,492)
Other | 75 | 43
Net cash used in investing activities | (7,066) | (19,647)
Cash flows from financing activities: |  |
Commercial paper borrowings (repayments), net | 600 | 0
Proceeds from issuance of short-term loan | 0 | 5,000
Repayment of short-term loan | 0 | (5,000)
Proceeds from issuance of long-term debt | 4,959 | 10,898
Repayments of long-term debt | (1,706) | (2,734)
Repurchase of common stock | (3,023) | (2,013)
Dividends paid | (2,535) | (2,353)
Proceeds from exercise of stock options | 342 | 242
Payments for taxes related to net share settlement of equity awards | (181) | (175)
Other | (22) | (210)
Net cash provided by (used in) financing activities | (1,566) | 3,655
Net increase (decrease) in cash, cash equivalents and restricted cash | (1,385) | 70
Cash, cash equivalents and restricted cash at the beginning of the period | 8,525 | 13,305
Cash, cash equivalents and restricted cash at the end of the period | 7,140 | 13,375
Reconciliation of net income to net cash provided by operating activities: |  |
Net income | 2,963 | 6,321
Adjustments required to reconcile net income to net cash provided by operating activities: |  |
Depreciation and amortization | 3,450 | 3,232
Stock-based compensation | 403 | 461
Restructuring charges (impairment of long-lived assets) | 840 | 152
Deferred income taxes and other items | (912) | (163)
Change in operating assets and liabilities, net of effects from acquisitions: |  |
Accounts receivable, net | (986) | (3,920)
Inventories | 355 | 1,305
Other assets | (850) | (518)
Accounts payable and pharmacy claims and discounts payable | 2,169 | 2,466
Health care costs payable and other insurance liabilities | 2,878 | 4,679
Other liabilities | (3,063) | 2,047
Net cash provided by operating activities | $ 7,247 | $ 16,062

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