v3.24.0.1
Income Taxes (Tables)
12 Months Ended
Dec. 31, 2023
Income Tax Disclosure [Abstract]  
Schedule of earnings before income tax expense
Earnings Before Income Tax Expense
years ended December 31 (in millions)202320222021
Domestic$(3,475)$(4,608)$(1,644)
Foreign9,725 18,085 14,633 
Total earnings before income tax expense$6,250 $13,477 $12,989 
Schedule of income tax expense
Income Tax Expense
years ended December 31 (in millions)202320222021
Current
Domestic$3,272 $2,647 $1,987 
Foreign994 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 
Summary of effective tax rate reconciliation
Effective Tax Rate Reconciliation
years ended December 31202320222021
Statutory tax rate21.0 %21.0 %21.0 %
Effect of foreign operations8.0 (4.4)(5.4)
U.S. tax credits(3.1)(2.8)(2.8)
Non-deductible expenses1.5 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 rate22.0 %12.1 %11.1 %
Schedule of deferred tax assets and liabilities
Deferred Tax Assets and Liabilities
as of December 31 (in millions)20232022
Deferred tax assets
Compensation and employee benefits$519 $497 
Accruals and reserves1,113 1,023 
Chargebacks and rebates1,431 991 
Advance payments298 547 
Net operating losses and other carryforwards14,316 10,391 
Other2,259 1,710 
Total deferred tax assets19,936 15,159 
Valuation allowances(13,478)(9,627)
Total net deferred tax assets6,458 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 
Schedule of unrecognized tax benefits
Unrecognized Tax Benefits
years ended December 31 (in millions)202320222021
Beginning balance$5,670 $5,489 $5,264 
Increase due to current year tax positions129 88 208 
Increase due to prior year tax positions109 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