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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities:    
Net income [1] $ 1,784 $ 1,048
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and other amortization [1] 982 861
Amortization of acquisition-related intangible assets [1] 1,416 1,554
Amortization of financing costs and debt discounts [1] 33 41
Share-based compensation [1] 244 190
Deferred income taxes [1] (402) (266)
Net gain on sale of business and other assets [1] (27) 0
Income from investments in unconsolidated affiliates [1] (222) (80)
Distributions from unconsolidated affiliates [1] 58 17
Non-cash impairment charges [1] 0 6
Other operating activities [1] (2) (26)
Changes in assets and liabilities, net of effects from acquisitions and dispositions:    
Trade accounts receivable [1] (521) (298)
Prepaid expenses and other assets [1] (203) (242)
Contract costs [1] (230) (210)
Accounts payable and other liabilities [1] 105 97
Contract liabilities [1] (30) (1)
Net cash provided by operating activities [1] 2,985 2,691
Cash flows from investing activities:    
Capital expenditures, including capitalized software and other intangibles [1] (1,148) (814)
Net proceeds from sale of business and other assets [1] 218 0
Payments for acquisition of businesses, net of cash acquired [1] (682) (495)
Distributions from unconsolidated affiliates [1] 110 91
Purchases of investments [1] (45) (250)
Proceeds from sale of investments [1] 13 503
Net cash used in investing activities [1] (1,534) (965)
Cash flows from financing activities:    
Debt proceeds [1] 1,450 5,177
Debt repayments, including debt financing costs [1] (2,945) (6,515)
Net proceeds from commercial paper and short-term borrowings [1] 2,020 1,388
Proceeds from issuance of treasury stock [1] 96 105
Purchases of treasury stock, including employee shares withheld for tax obligations [1] (1,909) (1,768)
Settlement activity, net [1] 114 386
Distributions paid to noncontrolling interests and redeemable noncontrolling interests [1] (30) (41)
Payments of acquisition-related contingent consideration [1] 0 (36)
Other financing activities [1] 7 (2)
Net cash used in financing activities [1] (1,197) (1,306)
Effect of exchange rate changes on cash and cash equivalents [1] (84) (11)
Net change in cash and cash equivalents [1] 170 409
Cash and cash equivalents, beginning balance [1] 3,205 2,569
Cash and cash equivalents, ending balance [1] $ 3,375 $ 2,978
[1] The company revised, for comparable purposes with the current period’s presentation, the consolidated statement of cash flows presentation for the nine months ended September 30, 2021 to include cash and cash equivalents within settlement assets as a component of total cash and cash equivalents. Additional information is included in Note 1.