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Goodwill and Intangible Assets (Tables)
12 Months Ended
Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of changes In goodwill by operating segment
The following table summarizes the changes in goodwill by operating segment ($ in millions):
 
 Managed Care 
Specialty Services
Total
Balance, December 31, 2020$16,974 $1,678 $18,652 
Acquisition and purchase accounting adjustments1,139 29 1,168 
Divestitures— (24)(24)
Reallocation250 (250)— 
Translation impact(25)— (25)
Balance, December 31, 202118,338 1,433 19,771 
Acquisition and purchase accounting adjustments172 905 1,077 
Divestitures— (1,533)(1,533)
Reallocation(4)— 
Impairments(66)(304)(370)
Translation impact(133)— (133)
Balance, December 31, 2022$18,315 $497 $18,812 
Schedule of intangible assets
Intangible assets at December 31, consist of the following ($ in millions):
 Weighted Average Life in Years
 2022202120222021
Purchased contract rights and customer relationships$7,850 $8,068 13.413.5
Trade names983 1,107 15.413.3
Provider contracts612 492 14.013.8
Developed technologies390 369 5.35.4
Intangible assets9,835 10,036 13.413.2
Less accumulated amortization:   
Purchased contract rights and customer relationships(2,193)(1,642) 
Trade names(263)(206) 
Provider contracts(183)(139) 
Developed technologies(285)(225)
Total accumulated amortization(2,924)(2,212) 
Intangible assets, net$6,911 $7,824  
Schedule of amortization expense related to intangible assets Estimated total amortization expense related to the December 31, 2022 intangible assets for each of the five succeeding fiscal years is as follows ($ in millions):
Estimated Total Amortization Expense
2023$723 
2024707 
2025706 
2026689 
2027678