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Income Taxes - Reconciliation of the Tax Provision at the U.S. Federal Statutory Rate to the Provision for Income Taxes (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Income Tax Disclosure [Abstract]      
Earnings before income tax $ 1,962 $ 1,813 $ 2,773
Loss (earnings) attributable to flow through noncontrolling interest (6) 2 9
Earnings less noncontrolling interest before income tax expense 1,956 1,815 2,782
Tax provision at the U.S. federal statutory rate 411 381 584
State income taxes, net of federal income tax benefit 50 63 106
Nondeductible compensation 49 40 54
Nondeductible PBM legal settlement (5) 78 0
Nontaxable divestiture (gains) losses 111 (95) 0
Deferred taxes for investments in subsidiaries 84 0 0
ACA health insurer fee 0 0 316
Audit settlement 0 0 (71)
Valuation allowance (17) 29 (11)
Nondeductible goodwill 69 0 16
Other, net 8 (19) (15)
Income tax expense $ 760 $ 477 $ 979