v3.22.2.2
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
Cash flows from operating activities:    
Net earnings $ 1,421 $ 743
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 1,178 1,098
Stock compensation expense 180 127
Impairment 1,739 229
(Gain) loss on debt extinguishment (26) 125
(Gain) on acquisition (2) (309)
Deferred income taxes (682) (143)
(Gain) loss on divestitures (503) 62
Other adjustments, net 164 (6)
Changes in assets and liabilities    
Premium and trade receivables (1,274) (1,723)
Other assets 152 (124)
Medical claims liabilities 1,976 1,661
Unearned revenue 1,964 (169)
Accounts payable and accrued expenses 686 993
Other long-term liabilities 863 964
Other operating activities, net 1 2
Net cash provided by operating activities 7,837 3,530
Cash flows from investing activities:    
Capital expenditures (771) (662)
Purchases of investments (5,118) (5,253)
Sales and maturities of investments 2,842 4,069
Acquisitions, net of cash acquired (1,457) (534)
Divestiture proceeds, net of divested cash 1,362 (62)
Net cash used in investing activities (3,142) (2,442)
Cash flows from financing activities:    
Proceeds from long-term debt 357 9,247
Payments and repurchases of long-term debt (1,202) (7,411)
Common stock repurchases (1,663) (49)
Payments for debt extinguishment (14) (157)
Debt issuance costs 0 (72)
Other financing activities, net 57 39
Net cash (used in) provided by financing activities (2,465) 1,597
Effect of exchange rate changes on cash, cash equivalents, and restricted cash (37) (8)
Net increase in cash, cash equivalents, and restricted cash and cash equivalents 2,193 2,677
Cash and cash equivalents reclassified from (to) held for sale (192) 0
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 15,215 13,634
Supplemental disclosures of cash flow information:    
Interest paid 462 479
Income taxes paid 448 477
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 14,987 13,423
Restricted cash and cash equivalents, included in restricted deposits 228 211
Total cash, cash equivalents, and restricted cash and cash equivalents $ 15,215 $ 13,634

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