Income Taxes (Tables)
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12 Months Ended |
Dec. 31, 2023 |
| Income Tax Disclosure [Abstract] |
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| Schedule of earnings before income tax expense |
Earnings Before Income Tax Expense | | | | | | | | | | | | | | | | | | | years ended December 31 (in millions) | 2023 | | 2022 | | 2021 | | Domestic | $ | (3,475) | | | $ | (4,608) | | | $ | (1,644) | | | Foreign | 9,725 | | | 18,085 | | | 14,633 | | | Total earnings before income tax expense | $ | 6,250 | | | $ | 13,477 | | | $ | 12,989 | |
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| Schedule of income tax expense |
Income Tax Expense | | | | | | | | | | | | | | | | | | | years ended December 31 (in millions) | 2023 | | 2022 | | 2021 | | Current | | | | | | | Domestic | $ | 3,272 | | | $ | 2,647 | | | $ | 1,987 | | | Foreign | 994 | | | 916 | | | 351 | | | Total current taxes | $ | 4,266 | | | $ | 3,563 | | | $ | 2,338 | | | Deferred | | | | | | | Domestic | $ | (2,324) | | | $ | (1,512) | | | $ | (839) | | | Foreign | (565) | | | (419) | | | (59) | | | Total deferred taxes | $ | (2,889) | | | $ | (1,931) | | | $ | (898) | | | Total income tax expense | $ | 1,377 | | | $ | 1,632 | | | $ | 1,440 | |
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| Summary of effective tax rate reconciliation |
Effective Tax Rate Reconciliation | | | | | | | | | | | | | | | | | | | years ended December 31 | 2023 | | 2022 | | 2021 | | Statutory tax rate | 21.0 | % | | 21.0 | % | | 21.0 | % | | Effect of foreign operations | 8.0 | | | (4.4) | | | (5.4) | | | U.S. tax credits | (3.1) | | | (2.8) | | | (2.8) | | | | | | | | | Non-deductible expenses | 1.5 | | | 0.6 | | | 0.3 | | | Tax law changes | (3.8) | | | (2.4) | | | (2.0) | | | Tax audits and settlements | (1.1) | | | 0.9 | | | (0.4) | | | All other, net | (0.5) | | | (0.8) | | | 0.4 | | | Effective tax rate | 22.0 | % | | 12.1 | % | | 11.1 | % |
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| Schedule of deferred tax assets and liabilities |
Deferred Tax Assets and Liabilities | | | | | | | | | | | | | as of December 31 (in millions) | 2023 | | 2022 | | Deferred tax assets | | | | | Compensation and employee benefits | $ | 519 | | | $ | 497 | | | Accruals and reserves | 1,113 | | | 1,023 | | | Chargebacks and rebates | 1,431 | | | 991 | | | Advance payments | 298 | | | 547 | | | Net operating losses and other carryforwards | 14,316 | | | 10,391 | | | Other | 2,259 | | | 1,710 | | | Total deferred tax assets | 19,936 | | | 15,159 | | | Valuation allowances | (13,478) | | | (9,627) | | | Total net deferred tax assets | 6,458 | | | 5,532 | | | Deferred tax liabilities | | | | | Excess of book basis over tax basis of intangible assets | (1,535) | | | (3,590) | | | Excess of book basis over tax basis in investments | (374) | | | (340) | | | Other | (746) | | | (772) | | | Total deferred tax liabilities | (2,655) | | | (4,702) | | Net deferred tax assets | $ | 3,803 | | | $ | 830 | |
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| Schedule of unrecognized tax benefits |
Unrecognized Tax Benefits | | | | | | | | | | | | | | | | | | | years ended December 31 (in millions) | 2023 | | 2022 | | 2021 | | Beginning balance | $ | 5,670 | | | $ | 5,489 | | | $ | 5,264 | | | | | | | | | Increase due to current year tax positions | 129 | | | 88 | | | 208 | | | Increase due to prior year tax positions | 109 | | | 243 | | | 137 | | | Decrease due to prior year tax positions | (21) | | | (33) | | | (62) | | | Settlements | (86) | | | (7) | | | (24) | | | Lapse of statutes of limitations | (39) | | | (110) | | | (34) | | | Ending balance | $ | 5,762 | | | $ | 5,670 | | | $ | 5,489 | |
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