v3.22.1
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Cash flows from operating activities:    
Net earnings $ 852 $ 697
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 390 361
Stock compensation expense 70 51
(Gain) loss on debt extinguishment (3) 46
Deferred income taxes 12 156
Other adjustments, net 22 2
Changes in assets and liabilities    
Premium and trade receivables (3,099) (1,891)
Other assets (299) (287)
Medical claims liabilities 1,767 405
Unearned revenue 81 48
Accounts payable and accrued expenses 957 32
Other long-term liabilities 401 423
Net cash provided by operating activities 1,151 43
Cash flows from investing activities:    
Capital expenditures (242) (187)
Purchases of investments (1,700) (1,653)
Sales and maturities of investments 1,047 1,391
Acquisitions, net of cash acquired (1,504) (158)
Other investing activities, net (2) 0
Net cash used in investing activities (2,401) (607)
Cash flows from financing activities:    
Proceeds from long-term debt 100 2,317
Payments of long-term debt (526) (2,295)
Common stock repurchases (71) (29)
Payments for debt extinguishment (27) (54)
Debt issuance costs 0 (27)
Other financing activities, net 26 15
Net cash used in financing activities (498) (73)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash 33 (16)
Net decrease in cash, cash equivalents and restricted cash and cash equivalents (1,715) (653)
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 13,214 10,957
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 11,499 10,304
Supplemental disclosures of cash flow information:    
Interest paid 139 130
Income taxes paid 11 20
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:    
Cash and cash equivalents 11,237 9,627
Restricted cash and cash equivalents, included in restricted deposits 262 677
Total cash, cash equivalents, and restricted cash and cash equivalents $ 11,499 $ 10,304

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