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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Cash flows from operating activities:    
Cash receipts from customers $ 184,519 $ 132,275
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (109,958) (107,920)
Insurance benefits paid (38,812) (2,400)
Cash paid to other suppliers and employees (21,411) (12,305)
Interest and investment income received 756 406
Interest paid (2,675) (1,759)
Income taxes paid (2,205) (1,911)
Net cash provided by operating activities 10,214 6,386
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 5,616 43
Purchases of investments (6,011) (97)
Purchases of property and equipment (1,890) (1,452)
Acquisitions (net of cash acquired) (361) (616)
Proceeds from sale of subsidiary 0 725
Other 16 11
Net cash used in investing activities (2,630) (1,386)
Cash flows from financing activities:    
Net borrowings (repayments) of short-term debt 350 (1,276)
Proceeds from issuance of long-term debt 3,458 39,376
Repayments of long-term debt (8,350) (2,266)
Derivative settlements (25) 446
Dividends paid (1,952) (1,528)
Proceeds from exercise of stock options 183 214
Payments for taxes related to net share settlement of equity awards (85) (39)
Other 11 0
Net cash provided by (used in) financing activities (6,410) 34,927
Net increase in cash, cash equivalents and restricted cash 1,174 39,927
Cash, cash equivalents and restricted cash at the beginning of the period 4,295 1,900
Cash, cash equivalents and restricted cash at the end of the period 5,469 41,827
Reconciliation of net income (loss) to net cash provided by operating activities:    
Net income (loss) 4,887 (175)
Adjustments required to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 3,275 1,911
Goodwill impairment 0 3,921
Stock-based compensation 355 172
Loss on sale of subsidiary 205 86
Loss on early extinguishment of debt 79 0
Deferred income taxes and other noncash items (38) 210
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (2,312) (1,725)
Inventories 413 472
Other assets (374) (3)
Accounts payable and pharmacy claims and discounts payable 2,330 1,839
Health care costs payable and other insurance liabilities 535 0
Other liabilities 859 (322)
Net cash provided by operating activities $ 10,214 $ 6,386