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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: |  |
Cash receipts from customers | $ 283,378 | $ 264,538
Cash paid for inventory, prescriptions dispensed and health services rendered | (157,849) | (145,469)
Insurance benefits paid | (88,769) | (80,357)
Cash paid to other suppliers and employees | (27,308) | (28,933)
Interest and investment income received | 1,494 | 1,288
Interest paid | (2,529) | (2,391)
Income taxes paid | (1,168) | (1,429)
Net cash provided by operating activities | 7,249 | 7,247
Cash flows from investing activities: |  |
Proceeds from sales and maturities of investments | 9,640 | 7,634
Purchases of investments | (11,045) | (12,677)
Purchases of property and equipment | (2,048) | (2,013)
Acquisitions | (429) | (85)
Other | 9 | 75
Net cash used in investing activities | (3,873) | (7,066)
Cash flows from financing activities: |  |
Commercial paper borrowings (repayments), net | (872) | 600
Proceeds from issuance of long-term debt | 3,969 | 4,959
Repayments of long-term debt | (3,609) | (1,706)
Repurchase of common stock | 0 | (3,023)
Dividends paid | (2,552) | (2,535)
Proceeds from exercise of stock options | 308 | 342
Payments for taxes related to net share settlement of equity awards | (145) | (181)
Other | (7) | (22)
Net cash used in financing activities | (2,908) | (1,566)
Net increase (decrease) in cash, cash equivalents and restricted cash | 468 | (1,385)
Cash, cash equivalents and restricted cash at the beginning of the period | 8,884 | 8,525
Cash, cash equivalents and restricted cash at the end of the period | 9,352 | 7,140
Reconciliation of net income (loss) to net cash provided by operating activities: |  |
Net income (loss) | (1,195) | 2,963
Adjustments required to reconcile net income (loss) to net cash provided by operating activities: |  |
Depreciation and amortization | 3,459 | 3,450
Goodwill impairment | 5,725 | 0
Stock-based compensation | 400 | 403
Loss on sale of subsidiary | 236 | 0
Gain on deconsolidation of subsidiary | (483) | 0
Restructuring charges (impairment of long-lived assets) | 0 | 840
Deferred income taxes and other items | (440) | (912)
Change in operating assets and liabilities, net of effects from acquisitions: |  |
Accounts receivable, net | (7,537) | (986)
Inventories | (982) | 355
Other assets | (588) | (850)
Accounts payable and pharmacy claims and discounts payable | 5,052 | 2,169
Health care costs payable and other insurance liabilities | 734 | 2,878
Other liabilities | 2,868 | (3,063)
Net cash provided by operating activities | $ 7,249 | $ 7,247

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