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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2021
Jun. 30, 2020
Cash flows from operating activities:    
Cash receipts from customers $ 136,621 $ 129,218
Cash paid for inventory and prescriptions dispensed by retail network pharmacies (79,316) (76,381)
Insurance benefits paid (31,245) (26,483)
Cash paid to other suppliers and employees (14,900) (14,688)
Interest and investment income received 394 395
Interest paid (1,263) (1,407)
Income taxes paid (1,552) (230)
Net cash provided by operating activities 8,739 10,424
Cash flows from investing activities:    
Proceeds from sales and maturities of investments 3,947 2,710
Purchases of investments (5,570) (3,688)
Purchases of property and equipment (1,315) (1,190)
Acquisitions (net of cash acquired) (108) (768)
Other 72 6
Net cash used in investing activities (2,974) (2,930)
Cash flows from financing activities:    
Proceeds from issuance of long-term debt 0 3,946
Repayments of long-term debt (5,423) (1,016)
Dividends paid (1,306) (1,315)
Proceeds from exercise of stock options 330 166
Payments for taxes related to net share settlement of equity awards (159) (68)
Other 0 (16)
Net cash provided by (used in) financing activities (6,558) 1,697
Net increase (decrease) in cash, cash equivalents and restricted cash (793) 9,191
Cash, cash equivalents and restricted cash at the beginning of the period 8,130 5,954
Cash, cash equivalents and restricted cash at the end of the period 7,337 15,145
Reconciliation of net income to net cash provided by operating activities:    
Net income 5,015 4,998
Adjustments required to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 2,263 2,188
Stock-based compensation 232 179
Deferred income taxes and other noncash items (370) (101)
Change in operating assets and liabilities, net of effects from acquisitions:    
Accounts receivable, net (2,384) (2,233)
Inventories 1,517 1,003
Other assets (145) (560)
Accounts payable and pharmacy claims and discounts payable 1,702 1,671
Health care costs payable and other insurance liabilities 104 (415)
Other liabilities 805 3,694
Net cash provided by operating activities $ 8,739 $ 10,424