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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Millions | 9 Months Ended
--- | ---
Sep. 30, 2023 | Sep. 30, 2022
Cash flows from operating activities |  |
Net income | $ 3,024 | $ 2,820
Adjustments to reconcile net income to net cash provided by operating activities: |  |
Gain on sale of Gentiva Hospice | 0 | (240)
Loss on investment securities, net | 49 | 136
Equity in net losses (earnings) | 39 | (1)
Stock-based compensation | 142 | 173
Depreciation | 628 | 555
Amortization | 51 | 73
Impairment of property and equipment | 31 | 144
Deferred income taxes | 0 | (33)
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed: |  |
Receivables | (126) | 11
Other assets | (935) | (465)
Benefits payable | 870 | 948
Other liabilities | 39 | (195)
Unearned revenues | 7,250 | 5,758
Other | 53 | 30
Net cash provided by operating activities | 11,115 | 9,714
Cash flows from investing activities |  |
Proceeds from sale of Gentiva Hospice, net | 0 | 2,708
Acquisitions, net of cash and cash equivalents acquired | (223) | (293)
Purchases of property and equipment, net | (721) | (862)
Purchases of investment securities | (3,366) | (4,740)
Proceeds from maturities of investment securities | 885 | 1,214
Proceeds from sales of investment securities | 815 | 1,979
Net cash (used in) provided by investing activities | (2,610) | 6
Cash flows from financing activities |  |
Receipts from contract deposits, net | 2,481 | 3,787
Proceeds from issuance of senior notes, net | 1,215 | 744
Repayments of senior notes | (1,719) | 0
Proceeds from issuance (repayments) of commercial paper, net | 1,618 | (660)
Repayment of term loan | (500) | (2,000)
Debt issue costs | (4) | (2)
Change in book overdraft | (52) | (89)
Common stock repurchases | (1,002) | (1,032)
Dividends paid | (320) | (291)
Other | (135) | (13)
Net cash provided by financing activities | 1,582 | 444
Increase in cash and cash equivalents | 10,087 | 10,164
Cash and cash equivalents at beginning of period | 5,061 | 3,394
Cash and cash equivalents at end of period | 15,148 | 13,558
Supplemental cash flow disclosures: |  |
Interest payments | 317 | 256
Income tax payments, net | 957 | 751
Details of businesses acquired in purchase transactions: |  |
Fair value of assets acquired, net of cash and cash equivalents acquired | 454 | 411
Less: Fair value of liabilities assumed | (236) | (65)
Less: Noncontrolling interests acquired | 5 | (53)
Cash paid for acquired businesses, net of cash and cash equivalents acquired | $ 223 | $ 293

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