Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities
Net earnings	$ 7,882	$ 5,687	$ 5,309
Adjustments to reconcile net earnings to net cash from operating activities:
Depreciation	464	471	425
Amortization of intangible assets	1,553	1,294	1,076
Change in fair value of contingent consideration liabilities	3,091	49	626
Stock-based compensation	430	421	365
Upfront costs and milestones related to collaborations	490	1,061	470
Gain on divestitures	(330)	0	0
Intangible asset impairment	1,030	5,070	354
Impacts related to U.S. tax reform	0	424	1,242
Other, net	43	76	84
Changes in operating assets and liabilities:
Accounts receivable	(74)	(591)	(391)
Inventories	(231)	(226)	93
Prepaid expenses and other assets	97	(499)	(118)
Accounts payable and other liabilities	(1,121)	190	425
Cash flows from operating activities	13,324	13,427	9,960
Cash flows from investing activities
Acquisitions and investments	(1,135)	(736)	(308)
Acquisitions of property and equipment	(552)	(638)	(529)
Purchases of investment securities	(583)	(1,792)	(2,230)
Sales and maturities of investment securities	2,699	2,160	2,793
Other	167	0	0
Cash flows from investing activities	596	(1,006)	(274)
Cash flows from financing activities
Net change in commercial paper borrowings	(699)	299	23
Proceeds from issuance of other short-term borrowings	0	3,002	0
Repayments of other short-term borrowings	(3,000)	0	0
Proceeds from issuance of long-term debt	31,482	5,963
Repayments of long-term debt and finance lease obligations	(1,536)	(6,035)	(25)
Debt issuance costs	(424)	(40)	0
Dividends paid	(6,366)	(5,580)	(4,107)
Purchases of treasury stock	(629)	(12,014)	(1,410)
Proceeds from the exercise of stock options	8	73	254
Payments of contingent consideration liabilities	(163)	(78)	(268)
Other, net	35	14	21
Cash flows from financing activities	18,708	(14,396)	(5,512)
Effect of exchange rate changes on cash and equivalents	7	(39)	29
Net change in cash and equivalents	32,635	(2,014)	4,203
Cash and equivalents, beginning of year	7,289	9,303	5,100
Cash and equivalents, end of year	39,924	7,289	9,303
Other supplemental information
Interest paid, net of portion capitalized	1,794	1,215	1,099
Income taxes paid	$ 1,447		$ 1,696
Income taxes received		$ 35