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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Operating activities:    
Net income $ 875 $ 736
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 128 129
Deferred income taxes (33) (35)
Share-based compensation 88 80
Other, net 3 (3)
Changes in operating assets and liabilities:    
Receivables (132) (15)
Prepaid expenses and other current assets (69) (110)
Medical claims and benefits payable 611 251
Amounts due government agencies 377 (360)
Accounts payable, accrued liabilities and other (137) (40)
Deferred revenue 332 293
Income taxes 309 59
Net cash provided by operating activities 2,352 985
Investing activities:    
Purchases of investments (1,295) (1,764)
Proceeds from sales and maturities of investments 670 1,082
Net cash paid in business combinations (3) (134)
Purchases of property, equipment and capitalized software (89) (81)
Other, net (2) (41)
Net cash used in investing activities (719) (938)
Financing activities:    
Common stock withheld to settle employee tax obligations (60) (53)
Common stock purchases 0 (200)
Contingent consideration liabilities settled 0 (20)
Other, net (1) 15
Net cash used in financing activities (61) (258)
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents 1,572 (211)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period 4,048 4,506
Cash, cash equivalents, and restricted cash and cash equivalents at end of period $ 5,620 $ 4,295