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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Statement of Cash Flows [Abstract]    
Net earnings $ 1,372 $ 241
Adjustments to reconcile net earnings to net cash from operating activities:    
Depreciation 183 179
Amortization of intangible assets 1,891 1,948
Deferred income taxes (389) (267)
Change in fair value of contingent consideration liabilities 660 1,872
Payment for Contingent Consideration Liability, Operating Activities (391) (14)
Stock-based compensation 348 313
Acquired IPR&D and milestones 164 150
Impairment of intangible assets 0 710
Other, net (45) (128)
Changes in operating assets and liabilities, net of acquisitions:    
Accounts receivable (702) (195)
Inventories (75) (185)
Prepaid expenses and other assets 284 (167)
Accounts payable and other liabilities 362 (451)
Income tax assets and liabilities, net 378 187
Cash flows from operating activities 4,040 4,193
Cash flows from investing activities    
Payments to Acquire Businesses, Net of Cash Acquired (9,199) 0
Other acquisitions and investments (190) (353)
Acquisitions of property and equipment (193) (175)
Purchases of investment securities (6) (19)
Sales and maturities of investment securities 6 22
Other, net (6) 26
Cash flows from investing activities (9,588) (499)
Cash flows from financing activities    
Proceeds from Short-Term Debt 5,008 0
Repayments of other short-term borrowings (5,005) 0
Proceeds from issuance of long-term debt 14,963  
Repayments of long-term debt and finance lease obligations (103) (1,351)
Payments of Debt Issuance Costs (99) 0
Dividends paid (2,772) (2,661)
Purchases of treasury stock (1,324) (1,955)
Proceeds from the exercise of stock options 127 65
Payments of contingent consideration liabilities 0 (311)
Other, net 24 21
Cash flows from financing activities 10,819 (6,192)
Effect of exchange rate changes on cash and equivalents (18) 8
Net change in cash and equivalents 5,253 (2,490)
Cash and equivalents, beginning of period 12,814 9,201
Cash and equivalents, end of period $ 18,067 $ 6,711