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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Cash flows from operating activities:    
Net income $ 1,048 $ 662
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and other amortization 861 833
Amortization of acquisition-related intangible assets 1,554 1,603
Amortization of financing costs and debt discounts 41 36
Share-based compensation 190 286
Deferred income taxes (266) (125)
Gain on sale of businesses 0 (464)
Income from investments in unconsolidated affiliates (80) (3)
Distributions from unconsolidated affiliates 17 12
Non-cash impairment charges 6 44
Other operating activities (26) (4)
Changes in assets and liabilities, net of effects from acquisitions and dispositions:    
Trade accounts receivable (298) 460
Prepaid expenses and other assets (242) (150)
Contract costs (210) (229)
Accounts payable and other liabilities 97 34
Contract liabilities (1) (34)
Net cash provided by operating activities 2,691 2,961
Cash flows from investing activities:    
Capital expenditures, including capitalized software and other intangibles (814) (689)
Proceeds from sale of businesses 0 578
Payments for acquisition of businesses, net of cash acquired (495) (137)
Distributions from unconsolidated affiliates 91 94
Purchases of investments (250) 0
Proceeds from sale of investments 503 0
Net cash used in investing activities (965) (154)
Cash flows from financing activities:    
Debt proceeds 5,177 8,125
Debt repayments (6,515) (9,307)
Net proceeds from (repayments of) commercial paper and short-term borrowings 1,388 (28)
Payments of debt financing costs 0 (16)
Proceeds from issuance of treasury stock 105 108
Purchases of treasury stock, including employee shares withheld for tax obligations (1,768) (1,612)
Distributions paid to noncontrolling interests and redeemable noncontrolling interests (41) (61)
Payments of acquisition-related contingent consideration (36) 0
Other financing activities (2) 6
Net cash used in financing activities (1,692) (2,785)
Effect of exchange rate changes on cash, cash equivalents and restricted cash (11) (4)
Net change in cash, cash equivalents and restricted cash 23 18
Cash, cash equivalents and restricted cash, beginning balance 919 933
Cash, cash equivalents and restricted cash, ending balance $ 942 $ 951