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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Cash flows from operating activities:    
Cash receipts from customers $ 129,218 $ 120,808
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (76,381) (70,567)
Insurance benefits paid (26,483) (25,992)
Cash paid to other suppliers and employees (14,688) (14,497)
Interest and investment income received 395 512
Interest paid (1,407) (1,502)
Income taxes paid (230) (1,476)
Net cash provided by operating activities 10,424 7,286
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 2,710 3,786
Purchases of investments (3,688) (4,062)
Purchases of property and equipment (1,190) (1,289)
Acquisitions (net of cash acquired) (768) (250)
Other 6 14
Net cash used in investing activities (2,930) (1,801)
Cash flows from financing activities:    
Net repayments of short-term debt 0 (275)
Proceeds from issuance of long-term debt 3,946 0
Repayments of long-term debt (1,016) (1,899)
Dividends paid (1,315) (1,306)
Proceeds from exercise of stock options 166 111
Payments for taxes related to net share settlement of equity awards (68) (80)
Other (16) 7
Net cash provided by (used in) financing activities 1,697 (3,442)
Net increase in cash, cash equivalents and restricted cash 9,191 2,043
Cash, cash equivalents and restricted cash at the beginning of the period 5,954 4,295
Cash, cash equivalents and restricted cash at the end of the period 15,145 6,338
Reconciliation of net income to net cash provided by operating activities:    
Net income 4,998 3,358
Adjustments required to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 2,188 2,183
Stock-based compensation 179 226
Deferred income taxes and other noncash items (101) (42)
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (2,233) (681)
Inventories 1,003 939
Other assets (560) (314)
Accounts payable and pharmacy claims and discounts payable 1,671 917
Health care costs payable and other insurance liabilities (415) 496
Other liabilities 3,694 204
Net cash provided by operating activities $ 10,424 $ 7,286