Year Ended December 31,

2023

2022

(Unaudited)

Cash flows from operating activities:

Net earnings

$           2,699

$           1,202

Adjustments to reconcile net earnings to net cash provided by operating activities

Depreciation and amortization

1,293

1,430

Stock compensation expense

216

234

Impairment

529

2,318

(Gain) loss on debt extinguishment

—

(25)

(Gain) on acquisition

—

(2)

Deferred income taxes

(78)

(631)

(Gain) loss on divestitures, net

(152)

(772)

Loss on disposal of equipment

—

221

Other adjustments, net

172

(31)

Changes in assets and liabilities

  Premium and trade receivables

(2,380)

(1,627)

  Other assets

5

128

  Medical claims liabilities

1,261

2,397

  Unearned revenue

238

31

  Accounts payable and accrued expenses

3,398

421

  Other long-term liabilities

856

842

  Other operating activities, net

(4)

125

Net cash provided by operating activities

8,053

6,261

Cash flows from investing activities:

Capital expenditures

(799)

(1,004)

Purchases of investments

(6,622)

(6,736)

Sales and maturities of investments

5,523

3,802

Acquisitions, net of cash acquired

—

(1,460)

Divestiture proceeds, net of divested cash

707

2,477

Net cash (used in) investing activities

(1,191)

(2,921)

Cash flows from financing activities:

Proceeds from long-term debt

2,335

360

Payments and repurchases of long-term debt

(2,316)

(1,490)

Common stock repurchases

(1,633)

(3,096)

Proceeds from common stock issuances

44

70

Payments for debt extinguishment

—

(14)

Purchase of noncontrolling interest

(88)

—

Other financing activities, net

—

(27)

Net cash (used in) financing activities

(1,658)

(4,197)

Effect of exchange rate changes on cash, cash equivalents and restricted cash

(32)

(11)

Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents

5,172

(868)

Cash and cash equivalents reclassified from (to) held for sale

(50)

(16)

Cash, cash equivalents and restricted cash and cash equivalents, beginning of period

12,330

13,214

Cash, cash equivalents and restricted cash and cash equivalents, end of period

$         17,452

$         12,330

Supplemental disclosures of cash flow information:

Interest paid

$              688

$              657

Income taxes paid

$              883

$           1,222

Equity issued in connection with acquisitions

$                —

$                60

The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within

the Consolidated Balance Sheets to the totals above:

December 31,

2023

2022

Cash and cash equivalents

$         17,193

$         12,074

Restricted cash and cash equivalents, included in restricted deposits

259

256

Total cash, cash equivalents and restricted cash and cash equivalents

$         17,452

$         12,330