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v3.22.4

Consolidated Statements of Cash Flows - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020
Operating activities: |  |  |
Net income | $ 792 | $ 659 | $ 673
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation and amortization | 176 | 131 | 88
Deferred income taxes | (66) | (24) | (19)
Share-based compensation | 103 | 72 | 57
Loss on debt repayment | 0 | 25 | 15
Impairment | 208 | 0 | 0
Other, net | 8 | 33 | 12
Changes in operating assets and liabilities, net of the effect of acquisitions: |  |  |
Receivables | (95) | (415) | (100)
Prepaid expenses and other current assets | (124) | (19) | (16)
Medical claims and benefits payable | 153 | 471 | 544
Amounts due government agencies | (428) | 1,046 | 446
Accounts payable, accrued liabilities and other | 55 | 138 | 86
Deferred revenue | (11) | (5) | 126
Income taxes | 2 | 7 | (14)
Net cash provided by operating activities | 773 | 2,119 | 1,898
Investing activities: |  |  |
Purchases of investments | (1,913) | (2,713) | (670)
Proceeds from sales and maturities of investments | 1,398 | 1,329 | 1,097
Net cash paid in business combinations | (134) | (129) | (755)
Purchases of property, equipment and capitalized software | (91) | (77) | (74)
Other, net | (50) | (63) | 2
Net cash provided by (used in) investing activities | (790) | (1,653) | (400)
Financing activities: |  |  |
Common stock purchases | (400) | (128) | (606)
Common stock withheld to settle employee tax obligations | (54) | (53) | (8)
Contingent consideration liabilities settled | (20) | (20) | 0
Proceeds from senior notes offerings, net of issuance costs | 0 | 740 | 1,429
Repayment of senior notes | 0 | (723) | (338)
Repayment of term loan facility | 0 | 0 | (600)
Proceeds from borrowings under term loan facility | 0 | 0 | 380
Cash paid for partial termination of warrants | 0 | 0 | (30)
Cash paid for partial settlement of conversion option | 0 | 0 | (27)
Cash received for partial settlement of call option | 0 | 0 | 27
Repayment of principal amount of convertible senior notes | 0 | 0 | (12)
Other, net | 33 | 1 | 2
Net cash (used in) provided by financing activities | (441) | (183) | 217
Net (decrease) increase in cash and cash equivalents, and restricted cash and cash equivalents | (458) | 283 | 1,715
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period | 4,506 | 4,223 | 2,508
Cash and cash equivalents, and restricted cash and cash equivalents at end of period | 4,048 | 4,506 | 4,223
Cash paid during the period for: |  |  |
Income taxes | 340 | 235 | 321
Interest | $ 108 | $ 127 | $ 112

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