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      CVS HEALTH REPORTS FIRST QUARTER RESULTS, COMPLETES ACQUISITIONS OF SIGNIFY HEALTH AND OAK STREET HEALTH


      News provided by

      CVS Health Corporation

      May 03, 2023, 06:30 ET

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      WOONSOCKET, R.I., May 3, 2023 /PRNewswire/ -- CVS Health Corporation (NYSE: CVS) today announced operating results for the three months ended March 31, 2023.

      FIRST QUARTER HIGHLIGHTS

      Continue Reading
      CVS Health Corporation
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      CVS Health Corporation
      CVS Health logo (PRNewsFoto/CVS Health)
      CVS Health logo (PRNewsFoto/CVS Health)

      • Total revenues increased to $85.3 billion, up 11.0% compared to prior year
      • GAAP diluted EPS of $1.65 and Adjusted EPS of $2.20
      • Generated cash flow from operations of $7.4 billion

      KEY FINANCIAL DATA


      Three Months Ended

      March 31,

      In millions, except per share amounts

      2023


      2022


      Change

      Total revenues 

      $   85,278


      $   76,826


      $     8,452

      Operating income

      3,446


      3,545


      (99)

      Adjusted operating income (1)

      4,370


      4,607


      (237)

      Diluted earnings per share

      $       1.65


      $       1.77


      $     (0.12)

      Adjusted EPS (2)

      $       2.20


      $       2.30


      $     (0.10)


      Note: Financial information for the three months ended March 31, 2022 throughout this press release has been revised to conform with certain current period financial statement changes as described on page 2.

      2023 FULL-YEAR GUIDANCE

      • Revised GAAP diluted EPS guidance range to $6.90 to $7.12 from $7.73 to $7.93
      • Revised Adjusted EPS guidance range to $8.50 to $8.70 from $8.70 to $8.90
      • Confirmed cash flow from operations guidance range of $12.5 billion to $13.5 billion

      CEO Commentary

      "We delivered another strong quarter while executing on the strategy we outlined in December 2021, leading to the close of the Signify Health acquisition followed quickly by Oak Street Health. These additions are core to our strategy and will help unlock future growth as we push further into value-based care, which prioritizes keeping people healthy."
      -Karen S. Lynch, CVS Health President and CEO

      IN THE SPOTLIGHT

      On March 29, 2023, completed the acquisition of Signify Health for approximately $7.8 billion, adding best-in-class capabilities for in-home services and a platform to accelerate growth in value-based care, representing a critical step in advancing the Company's health care services strategy.

      On May 2, 2023, completed the acquisition of Oak Street Health for approximately $10.6 billion, adding a leading multi-payor, value-based primary care company with approximately 600 primary care providers and more than 170 medical centers across 21 states.

      Realigned the composition of the Company's segments including the creation of a Health Services segment, comprised of the Company's pharmacy benefit management operations, health care services and provider enablement solutions, as well as a Pharmacy & Consumer Wellness segment, comprised of enterprise pharmacy fulfillment and retail front store operations.

      Returned $779 million to shareholders through dividends and repurchased 22.8 million shares of common stock.

      The Company presents both GAAP and non-GAAP financial measures in this press release to assist in the comparison of the Company's past financial performance with its current financial performance. See "Non-GAAP Financial Information" beginning on page 12 and endnotes beginning on page 24 for explanations of non-GAAP financial measures presented in this press release. See pages 14 through 15 and page 23 for reconciliations of each non-GAAP financial measure used in this release to the most directly comparable GAAP financial measure.

      Consolidated First Quarter Results


      Three Months Ended

      March 31,

      In millions, except per share amounts

      2023


      2022


      Change

      Total revenues 

      $  85,278


      $  76,826


      $    8,452

      Operating income

      3,446


      3,545


      (99)

      Adjusted operating income (1)

      4,370


      4,607


      (237)

      Net income

      2,142


      2,355


      (213)

      Diluted earnings per share

      $      1.65


      $      1.77


      $     (0.12)

      Adjusted EPS (2)

      $      2.20


      $      2.30


      $     (0.10)

      Q1 2023 Financial Statement Changes

      The Company's financial information for the three months ended March 31, 2023 reflects the following items:

      • Effective for the first quarter of 2023, the Company realigned the composition of its segments to correspond with changes made to its operating model and how the business is managed. As a result of this realignment, the Company formed a new Health Services segment, which in addition to providing a full range of pharmacy benefit management ("PBM") solutions, also delivers health care services in the Company's medical clinics, virtually, and in the home, as well as provider enablement solutions. In addition, the Company created a new Pharmacy & Consumer Wellness segment, which includes its retail and long-term care pharmacy operations and related pharmacy services, as well as its retail front store operations. This segment will also provide pharmacy fulfillment services to support the Health Services segment's specialty and mail order pharmacy offerings. The Company also discontinued its former segment reporting practice for activity under its Maintenance Choice® program as described within the supplemental information beginning on page 15. Following this segment realignment, the Company's four reportable segments are: Health Care Benefits, Health Services, Pharmacy & Consumer Wellness and Corporate/Other.
      • Effective January 1, 2023, the Company adopted a new accounting standard related to the accounting for long-duration insurance contracts using a modified retrospective transition method. Refer to Note 1 ''Significant Accounting Policies'' in the Company's Quarterly Report on Form 10-Q for the period ended March 31, 2023 for further information regarding the adoption of this accounting standard.
      • Effective for the first quarter of 2023, the impact of net realized capital gains or losses are excluded from adjusted operating income as further described on page 11.

      Prior period financial information has been revised to conform with the current period presentation.

      Q1 2023 Financial Results

      For the three months ended March 31, 2023 compared to the prior year:

      • Total revenues increased 11.0% driven by growth across all segments.
      • Operating income decreased 2.8% primarily due to the write-down of the Company's Omnicare® long-term care business ("LTC business"), the decrease in adjusted operating income described below and an increase in acquisition-related transaction and integration costs compared to the prior year. The decrease in operating income was partially offset by the absence of a $484 million opioid litigation charge recorded in the prior year and a decrease in amortization of intangible assets compared to the prior year.
      • Adjusted operating income decreased 5.1% primarily driven by declines in the Pharmacy & Consumer Wellness segment, partially offset by increases in the Health Services segment. See pages 3 through 5 for additional discussion of adjusted operating income performance of the Company's segments.
      • Interest expense remained relatively consistent, increasing to $589 million from $586 million.
      • The effective income tax rate increased to 25.6% compared to 21.5% primarily due to the absence of the impact of certain discrete tax items concluded in the first quarter of 2022. The Company's adjusted effective income tax rate (3) remained relatively consistent compared to prior year.

      Health Care Benefits Segment

      The Health Care Benefits segment offers a full range of insured and self-insured ("ASC") medical, pharmacy, dental and behavioral health products and services. The segment results for the three months ended March 31, 2023 and 2022 were as follows:


      Three Months Ended

      March 31,

      In millions, except percentages

      2023


      2022


      Change

      Total revenues

      $  25,877


      $  23,094


      $    2,783

      Adjusted operating income (1)

      1,824


      1,861


      (37)

      Medical benefit ratio ("MBR") (4)

      84.6 %


      83.4 %


      1.2 %

      Medical membership (5)

      25.5


      24.5


      1.0

      • Total revenues increased 12.1% for the three months ended March 31, 2023 compared to the prior year driven by growth across all product lines.
      • Adjusted operating income decreased slightly in the three months ended March 31, 2023 compared to the prior year primarily driven by the continued progression towards normalized utilization and lower impact from favorable development of prior-years' health care cost estimates in the three months ended March 31, 2023 compared to the prior year. These decreases were largely offset by higher net investment income and membership growth across all product lines in the three months ended March 31, 2023.
      • The MBR increased to 84.6% in the three months ended March 31, 2023 compared to 83.4% in the prior year reflective of the continued progression towards normalized utilization and lower impact from favorable development of prior-years' health care cost estimates in the three months ended March 31, 2023 compared to the prior year.
      • Medical membership as of March 31, 2023 of 25.5 million increased 1.1 million members compared with December 31, 2022, reflecting increases across all product lines including an increase of approximately 900,000 members related to the individual exchange business within the Commercial product line.
      • The segment experienced favorable development of prior-years' health care cost estimates in its Government Services and Commercial businesses during the three months ended March 31, 2023, primarily attributable to fourth quarter 2022 performance.
      • Prior years' health care costs payable estimates developed favorably by $693 million during the three months ended March 31, 2023. This development is reported on a basis consistent with the prior years' development reported in the health care costs payable table in the Company's annual audited financial statements and does not directly correspond to an increase in 2023 operating results.

      See the supplemental information on page 18 for additional information regarding the performance of the Health Care Benefits segment.

      Health Services Segment (formerly Pharmacy Services Segment)

      The Health Services segment provides a full range of PBM solutions, delivers health care services in its medical clinics, virtually, and in the home, and offers provider enablement solutions. The segment results for the three months ended March 31, 2023 and 2022 were as follows:


      Three Months Ended

      March 31,

      In millions

      2023


      2022


      Change

      Total revenues

      $  44,591


      $  39,615


      $    4,976

      Adjusted operating income (1)

      1,680


      1,471


      209

      Pharmacy claims processed (6) (7)

      587.3


      566.5


      20.8

      • Total revenues increased 12.6% for the three months ended March 31, 2023 compared to the prior year primarily driven by increased pharmacy claims volume, growth in specialty pharmacy and brand inflation, partially offset by continued pharmacy client price improvements.
      • Adjusted operating income increased 14.2% for the three months ended March 31, 2023 compared to the prior year primarily driven by improved purchasing economics, including increased contributions from the products and services of the Company's group purchasing organization, and increased pharmacy claims volume. These increases were partially offset by continued pharmacy client price improvements and decreased COVID-19 diagnostic testing in the segment's MinuteClinic® walk-in medical clinics compared to the prior year.
      • Pharmacy claims processed increased 3.7% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year. The increase was primarily driven by net new business, increased utilization and the impact of an elevated cough, cold and flu season compared to the prior year. These increases were partially offset by a decrease in COVID-19 vaccinations. Excluding the impact of COVID-19 vaccinations, pharmacy claims processed increased 4.8% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year.

      See the supplemental information on page 20 for additional information regarding the performance of the Health Services segment.

      Pharmacy & Consumer Wellness Segment (formerly Retail/LTC Segment)

      The Pharmacy & Consumer Wellness segment dispenses prescriptions in its retail pharmacies and through its infusion operations, provides ancillary pharmacy services including pharmacy patient care programs, diagnostic testing and vaccination administration, and sells a wide assortment of health and wellness products and general merchandise. The segment also provides pharmacy services to long-term care facilities and pharmacy fulfillment services to support the Health Services segment's specialty and mail order pharmacy offerings. The segment results for the three months ended March 31, 2023 and 2022 were as follows:


      Three Months Ended

      March 31,

      In millions

      2023


      2022


      Change

      Total revenues

      $  27,922


      $  25,898


      $    2,024

      Adjusted operating income (1)

      1,134


      1,573


      (439)

      Prescriptions filled (6) (7)

      404.8


      395.1


      9.7

      • Total revenues increased 7.8% for the three months ended March 31, 2023 compared to the prior year primarily driven by increased prescription and front store volume, pharmacy drug mix and brand inflation. These increases were partially offset by continued pharmacy reimbursement pressure, decreased COVID-19 vaccinations and diagnostic testing and the impact of recent generic introductions.
      • Adjusted operating income decreased 27.9% for the three months ended March 31, 2023 compared to the prior year primarily driven by continued pharmacy reimbursement pressure, decreased COVID-19 vaccinations and diagnostic testing and increased investments in the segment's operations and capabilities. These decreases were partially offset by the increased prescription volume described above and improved generic drug purchasing.
      • Prescriptions filled increased 2.5% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year primarily driven by increased utilization and the impact of an elevated cough, cold and flu season compared to the prior year. These increases were partially offset by a decrease in COVID-19 vaccinations. Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 4.5% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year.

      See the supplemental information on page 21 for additional information regarding the performance of the Pharmacy & Consumer Wellness segment.

      2023 Full-Year Guidance
      The Company revised its full-year 2023 GAAP diluted EPS guidance range to $6.90 to $7.12 from $7.73 to $7.93 and its full-year 2023 Adjusted EPS guidance range to $8.50 to $8.70 from $8.70 to $8.90. The Company also confirmed its full-year 2023 cash flow from operations guidance range of $12.5 billion to $13.5 billion.

      The adjustments between full-year 2023 GAAP diluted EPS and Adjusted EPS include amortization of intangible assets, net realized capital losses, a loss on assets held for sale, acquisition-related transaction and integration costs related to the acquisitions of Signify Health, Inc. ("Signify Health") and Oak Street Health, Inc. ("Oak Street Health"), office real estate optimization charges and the corresponding income tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health.

      Teleconference and Webcast
      The Company will be holding a conference call today for investors at 8:00 a.m. (Eastern Time) to discuss its first quarter results. An audio webcast of the call will be broadcast simultaneously for all interested parties through the Investor Relations section of the CVS Health website at http://investors.cvshealth.com. This webcast will be archived and available on the website for a one-year period following the conference call.

      About CVS Health
      CVS Health is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses, and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.

      Cautionary Statement Concerning Forward-Looking Statements
      The Private Securities Litigation Reform Act of 1995 provides a safe harbor for forward-looking statements made by or on behalf of CVS Health Corporation. Statements in this press release that are forward-looking include, but are not limited to, Ms. Lynch's quotation, the information under the headings "2023 Full-Year Guidance" and "In The Spotlight" and the information included in the reconciliations and endnotes. By their nature, all forward-looking statements are not guarantees of future performance or results and are subject to risks and uncertainties that are difficult to predict and/or quantify. Actual results may differ materially from those contemplated by the forward-looking statements due to the risks and uncertainties related to the impact of COVID-19 and CVS Health's acquisitions of Signify Health and  Oak Street Health as well as additional risks and uncertainties as described in our Securities and Exchange Commission ("SEC") filings, including those set forth in the Risk Factors section and under the heading "Cautionary Statement Concerning Forward-Looking Statements" in our most recently filed Annual Report on Form 10-K, our Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2023 and our Current Reports on Form 8-K.

      You are cautioned not to place undue reliance on CVS Health's forward-looking statements. CVS Health's forward-looking statements are and will be based upon management's then-current views and assumptions regarding future events and operating performance, and are applicable only as of the dates of such statements. CVS Health does not assume any duty to update or revise forward-looking statements, whether as a result of new information, future events, uncertainties or otherwise.                   

      - Tables Follow -

      CVS HEALTH CORPORATION

      Condensed Consolidated Statements of Operations

      (Unaudited)



      Three Months Ended

      March 31,

      In millions, except per share amounts

      2023


      2022

      Revenues:




      Products

      $      58,147


      $      52,522

      Premiums

      24,352


      21,631

      Services

      2,445


      2,505

      Net investment income

      334


      168

      Total revenues

      85,278


      76,826

      Operating costs:




      Cost of products sold

      51,455


      45,509

      Benefit costs

      20,448


      17,923

      Opioid litigation charge

      —


      484

      Loss on assets held for sale

      349


      41

      Operating expenses

      9,580


      9,324

      Total operating costs

      81,832


      73,281

      Operating income

      3,446


      3,545

      Interest expense

      589


      586

      Other income

      (22)


      (42)

      Income before income tax provision

      2,879


      3,001

      Income tax provision

      737


      646

      Net income

      2,142


      2,355

      Net income attributable to noncontrolling interests

      (6)


      (1)

      Net income attributable to CVS Health

      $        2,136


      $        2,354





      Net income per share attributable to CVS Health:




      Basic

      $         1.66


      $         1.79

      Diluted

      $         1.65


      $         1.77

      Weighted average shares outstanding:




      Basic

      1,283


      1,312

      Diluted

      1,291


      1,328

      Dividends declared per share

      $        0.605


      $         0.55

      CVS HEALTH CORPORATION

      Condensed Consolidated Balance Sheets

      (Unaudited)


      In millions

      March 31,
      2023


      December 31,
      2022

      Assets:




      Cash and cash equivalents

      $           14,618


      $           12,945

      Investments

      3,102


      2,778

      Accounts receivable, net

      28,331


      27,276

      Inventories

      18,263


      19,090

      Assets held for sale

      625


      908

      Other current assets

      3,767


      2,636

      Total current assets

      68,706


      65,633

      Long-term investments

      21,612


      21,096

      Property and equipment, net

      12,872


      12,873

      Operating lease right-of-use assets

      17,660


      17,872

      Goodwill

      84,057


      78,150

      Intangible assets, net

      26,368


      24,803

      Separate accounts assets

      3,231


      3,228

      Other assets

      4,824


      4,620

      Total assets

      $         239,330


      $         228,275





      Liabilities:




      Accounts payable

      $           12,527


      $           14,838

      Pharmacy claims and discounts payable

      20,047


      19,423

      Health care costs payable

      10,895


      10,142

      Policyholders' funds

      1,426


      1,500

      Accrued expenses

      21,515


      18,745

      Other insurance liabilities

      4,974


      1,089

      Current portion of operating lease liabilities

      1,679


      1,678

      Current portion of long-term debt

      1,778


      1,778

      Liabilities held for sale

      213


      228

      Total current liabilities

      75,054


      69,421

      Long-term operating lease liabilities

      16,571


      16,800

      Long-term debt

      56,450


      50,476

      Deferred income taxes

      4,095


      4,016

      Separate accounts liabilities

      3,231


      3,228

      Other long-term insurance liabilities

      5,678


      5,835

      Other long-term liabilities

      6,671


      6,730

      Total liabilities

      167,750


      156,506





      Shareholders' equity:




      Preferred stock

      —


      —

      Common stock and capital surplus

      48,306


      48,193

      Treasury stock

      (33,802)


      (31,858)

      Retained earnings

      57,753


      56,398

      Accumulated other comprehensive loss

      (875)


      (1,264)

      Total CVS Health shareholders' equity

      71,382


      71,469

      Noncontrolling interests

      198


      300

      Total shareholders' equity

      71,580


      71,769

      Total liabilities and shareholders' equity

      $         239,330


      $         228,275

      CVS HEALTH CORPORATION

      Condensed Consolidated Statements of Cash Flows

      (Unaudited)



      Three Months Ended

      March 31,

      In millions

      2023


      2022

      Cash flows from operating activities:




      Cash receipts from customers

      $       87,798


      $       74,192

      Cash paid for prescriptions dispensed and health services rendered

      (50,223)


      (44,365)

      Insurance benefits paid

      (19,757)


      (16,616)

      Cash paid to other suppliers and employees

      (9,958)


      (8,969)

      Interest and investment income received

      426


      199

      Interest paid

      (773)


      (782)

      Income taxes paid

      (75)


      (96)

      Net cash provided by operating activities

      7,438


      3,563





      Cash flows from investing activities:




      Proceeds from sales and maturities of investments

      1,891


      2,570

      Purchases of investments

      (2,358)


      (3,474)

      Purchases of property and equipment

      (984)


      (1,051)

      Acquisitions (net of cash acquired)

      (7,094)


      (7)

      Other

      31


      (31)

      Net cash used in investing activities

      (8,514)


      (1,993)





      Cash flows from financing activities:




      Proceeds from issuance of long-term debt

      5,951


      —

      Repayments of long-term debt

      (362)


      (14)

      Repurchase of common stock

      (2,018)


      (2,000)

      Dividends paid

      (779)


      (722)

      Proceeds from exercise of stock options

      96


      297

      Payments for taxes related to net share settlement of equity awards

      (34)


      (62)

      Other

      (128)


      (149)

      Net cash provided by (used in) financing activities

      2,726


      (2,650)

      Net increase (decrease) in cash, cash equivalents and restricted cash

      1,650


      (1,080)

      Cash, cash equivalents and restricted cash at the beginning of the period

      13,305


      12,691

      Cash, cash equivalents and restricted cash at the end of the period

      $       14,955


      $       11,611

      CVS HEALTH CORPORATION

      Condensed Consolidated Statements of Cash Flows

      (Unaudited)



      Three Months Ended

      March 31,

      In millions

      2023


      2022

      Reconciliation of net income to net cash provided by operating activities:




      Net income

      $        2,142


      $        2,355

      Adjustments required to reconcile net income to net cash provided by operating
      activities:




      Depreciation and amortization

      1,001


      1,049

      Stock-based compensation

      103


      89

      Deferred income taxes and other noncash items

      155


      (175)

      Change in operating assets and liabilities, net of effects from acquisitions:




      Accounts receivable, net

      (751)


      (1,967)

      Inventories

      828


      (400)

      Other assets

      (1,255)


      (348)

      Accounts payable and pharmacy claims and discounts payable

      (1,203)


      1,974

      Health care costs payable and other insurance liabilities

      4,382


      1,430

      Other liabilities

      2,036


      (444)

      Net cash provided by operating activities

      $        7,438


      $        3,563

      Non-GAAP Financial Information

      The Company uses non-GAAP financial measures to analyze underlying business performance and trends. The Company believes that providing these non-GAAP financial measures enhances the Company's and investors' ability to compare the Company's past financial performance with its current performance. These non-GAAP financial measures are provided as supplemental information to the financial measures presented in this press release that are calculated and presented in accordance with GAAP. Non-GAAP financial measures should not be considered a substitute for, or superior to, financial measures determined or calculated in accordance with GAAP. The Company's definitions of its non-GAAP financial measures may not be comparable to similarly titled measures reported by other companies.

      Non-GAAP financial measures such as consolidated adjusted operating income, adjusted earnings per share ("EPS") and adjusted income attributable to CVS Health exclude from the relevant GAAP metrics, as applicable: amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance. Effective January 1, 2023, the Company's non-GAAP financial measures also exclude the impact of net realized capital gains or losses, described in further detail below. Prior period financial information throughout this press release has been revised to conform with the current period presentation.

      The Company's Non-GAAP adjusted effective income tax rate excludes from the relevant GAAP metric the corresponding tax benefit or expense related to the amortization of intangible assets, net realized capital gains or losses and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance and certain discrete tax items.

      For the periods covered in this press release, the following items are excluded from the non-GAAP financial measures described above, as applicable, because the Company believes they neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance:

      • The Company's acquisition activities have resulted in the recognition of intangible assets as required under the acquisition method of accounting which consist primarily of trademarks, customer contracts/relationships, covenants not to compete, technology, provider networks and value of business acquired. Definite-lived intangible assets are amortized over their estimated useful lives and are tested for impairment when events indicate that the carrying value may not be recoverable. The amortization of intangible assets is reflected in the unaudited condensed consolidated statements of operations in operating expenses within each segment. Although intangible assets contribute to the Company's revenue generation, the amortization of intangible assets does not directly relate to the underwriting of the Company's insurance products, the services performed for the Company's customers or the sale of the Company's products or services. Additionally, intangible asset amortization expense typically fluctuates based on the size and timing of the Company's acquisition activity. Accordingly, the Company believes excluding the amortization of intangible assets enhances the Company's and investors' ability to compare the Company's past financial performance with its current performance and to analyze underlying business performance and trends. Intangible asset amortization excluded from the related non-GAAP financial measure represents the entire amount recorded within the Company's GAAP financial statements, and the revenue generated by the associated intangible assets has not been excluded from the related non-GAAP financial measure. Intangible asset amortization is excluded from the related non-GAAP financial measure because the amortization, unlike the related revenue, is not affected by operations of any particular period unless an intangible asset becomes impaired or the estimated useful life of an intangible asset is revised.
      • The Company's net realized capital gains and losses arise from various types of transactions, primarily in the course of managing a portfolio of assets that support the payment of insurance liabilities. Net realized capital gains and losses are reflected in the unaudited condensed consolidated statements of operations in net investment income (loss) within each segment. These capital gains and losses are the result of investment decisions, market conditions and other economic developments that are unrelated to the performance of the Company's business, and the amount and timing of these capital gains and losses do not directly relate to the underwriting of the Company's insurance products, the services performed for the Company's customers or the sale of the Company's products or services. Accordingly, the Company believes excluding net realized capital gains and losses enhances the Company's and investors' ability to compare the Company's past financial performance with its current performance and to analyze underlying business performance and trends.
      • During the three months ended March 31, 2023, the loss on assets held for sale relates to the Company's long-term care ("LTC") reporting unit within the Pharmacy & Consumer Wellness segment. During 2022, the Company determined that its LTC business was no longer a strategic asset and committed to a plan to sell it, at which time the LTC business met the criteria for held-for-sale accounting and its net assets were accounted for as assets held for sale. As of March 31, 2023, the net assets of the LTC business continued to meet the criteria for held-for-sale accounting and during the first quarter of 2023, a loss on assets held for sale was recorded to write down the carrying value of the LTC business to the Company's best estimate of the ultimate selling price which reflects its estimated fair value less costs to sell. During the three months ended March 31, 2022, the loss on assets held for sale relates to the Company's international health care business domiciled in Thailand ("Thailand business"), which was included in the Commercial Business reporting unit in the Health Care Benefits segment. The sale of the Thailand business closed in the second quarter of 2022, and the ultimate loss on the sale was not material.
      • During the three months ended March 31, 2023, the acquisition-related transaction and integration costs relate to the acquisitions of Signify Health and Oak Street Health. The acquisition-related transaction and integration costs are reflected in the Company's unaudited condensed consolidated statement of operations in operating expenses within the Corporate/Other segment.
      • During the three months ended March 31, 2023, the office real estate optimization charges primarily relate to the abandonment of leased real estate and the related right-of-use assets and property and equipment in connection with the planned reduction of corporate office real estate space in response to the Company's new flexible work arrangement. The office real estate optimization charges are reflected in the Company's unaudited condensed consolidated statement of operations in operating expenses within the Health Care Benefits, Corporate/Other and Health Services segments.
      • During the three months ended March 31, 2022, the opioid litigation charge relates to an agreement to resolve substantially all opioid claims against the Company by the State of Florida. The opioid litigation charge is reflected within the Corporate/Other segment.
      • The corresponding tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health and Adjusted EPS above. The nature of each non-GAAP adjustment is evaluated to determine whether a discrete adjustment should be made to the adjusted income tax provision. During the three months ended March 31, 2022, the Company's adjusted income tax provision also excludes the impact of certain discrete tax items concluded in the first quarter of 2022.

      See endnotes (1), (2) and (3) on page 24 for definitions of non-GAAP financial measures. Reconciliations of each non-GAAP financial measure to the most directly comparable GAAP financial measure are presented on pages 14 through 15 and page 23.

      Reconciliations of Non-GAAP Financial Measures to the Most Directly Comparable GAAP Financial Measures


      Adjusted Operating Income

      (Unaudited)


      The following are reconciliations of consolidated operating income (GAAP measure) to consolidated adjusted operating income, as well as reconciliations of segment GAAP operating income to segment adjusted operating income:



      Three Months Ended March 31, 2023

      In millions

      Health Care

      Benefits


      Health

      Services


      Pharmacy &

      Consumer

      Wellness


      Corporate/

      Other


      Consolidated

      Totals

      Operating income (loss) (GAAP measure)

      $       1,408


      $    1,638


      $           717


      $      (317)


      $        3,446

      Amortization of intangible assets

      295


      41


      65


      1


      402

      Net realized capital losses

      99


      —


      3


      3


      105

      Loss on assets held for sale

      —


      —


      349


      —


      349

      Acquisition-related transaction and integration costs

      —


      —


      —


      43


      43

      Office real estate optimization charges

      22


      1


      —


      2


      25

      Adjusted operating income (loss) (1)

      $       1,824


      $    1,680


      $        1,134


      $      (268)


      $        4,370




      Three Months Ended March 31, 2022

      In millions

      Health Care

      Benefits


      Health

      Services


      Pharmacy &

      Consumer

      Wellness


      Corporate/

      Other


      Consolidated

      Totals

      Operating income (loss) (GAAP measure)

      $       1,467


      $    1,427


      $         1,435


      $      (784)


      $        3,545

      Amortization of intangible assets

      295


      44


      122


      1


      462

      Net realized capital losses

      58


      —


      16


      1


      75

      Loss on assets held for sale

      41


      —


      —


      —


      41

      Opioid litigation charge

      —


      —


      —


      484


      484

      Adjusted operating income (loss) (1)

      $       1,861


      $    1,471


      $         1,573


      $      (298)


      $        4,607

      Adjusted Earnings Per Share

      (Unaudited)


      The following are reconciliations of net income attributable to CVS Health to adjusted income attributable to CVS Health and calculations of GAAP diluted EPS and Adjusted EPS: 



      Three Months Ended

      March 31, 2023


      Three Months Ended

      March 31, 2022

      In millions, except per share amounts

      Total
      Company


      Per
      Common
      Share


      Total
      Company


      Per
      Common
      Share

      Net income attributable to CVS Health (GAAP measure)

      $      2,136


      $        1.65


      $      2,354


      $        1.77

      Amortization of intangible assets

      402


      0.31


      462


      0.35

      Net realized capital losses

      105


      0.08


      75


      0.06

      Loss on assets held for sale

      349


      0.27


      41


      0.03

      Acquisition-related transaction and integration costs

      43


      0.03


      —


      —

      Office real estate optimization charges

      25


      0.02


      —


      —

      Opioid litigation charge

      —


      —


      484


      0.36

      Tax impact of non-GAAP adjustments

      (221)


      (0.16)


      (368)


      (0.27)

      Adjusted income attributable to CVS Health (2)

      $      2,839


      $        2.20


      $      3,048


      $        2.30









      Weighted average diluted shares outstanding



      1,291




      1,328

      Adjusted Effective Income Tax Rate

      (Unaudited)


      The following are reconciliations of the effective income tax rate (GAAP measure) to the adjusted effective income tax rate:



      Three Months Ended

      March 31,


      2023


      2022

      Effective income tax rate (GAAP measure)

      25.6 %


      21.5 %

      Impact of non-GAAP adjustments

      (0.4)


      3.5

      Adjusted effective income tax rate (3)

      25.2 %


      25.0 %

      Supplemental Information
      (Unaudited)

      The Company's segments maintain separate financial information, and the Company's chief operating decision maker (the "CODM") evaluates the segments' operating results on a regular basis in deciding how to allocate resources among the segments and in assessing segment performance. The CODM evaluates the performance of the Company's segments based on adjusted operating income. Adjusted operating income is defined as operating income (GAAP measure) excluding the impact of amortization of intangible assets and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance as further described in endnote (1). Effective for the first quarter of 2023, adjusted operating income also excludes the impact of net realized capital gains or losses. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company's ability to compare past financial performance with current performance and analyze underlying business performance and trends.

      Segment financial information for the three months ended March 31, 2023 reflects the following items:

      • The realignment of the Company's segments to correspond with changes made to its operating model as described on page 2, including the discontinuance of the former Maintenance Choice segment reporting practice as described in Note (b) of the table below.
      • The impact of the adoption of a new accounting standard related to the accounting for long-duration insurance contracts, which the Company adopted on January 1, 2023 using a modified retrospective transition method. Refer to Note 1 ''Significant Accounting Policies'' in the Company's Quarterly Report on Form 10-Q for the period ended March 31, 2023 for further information regarding the adoption of this accounting standard.
      • The exclusion of the impact of net realized capital gains or losses from adjusted operating income, as described on page 11.

      Segment financial information for the three months ended March 31, 2022 has been revised to conform with current period presentation for these items, the impact of which are reflected in the "Adjustments" lines of the table below.

      The following is a reconciliation of financial measures of the Company's segments to the consolidated totals:

      In millions

      Health Care

      Benefits


      Health

      Services (a)


      Pharmacy &

      Consumer

      Wellness


      Corporate/

      Other


      Intersegment

      Eliminations (b)


      Consolidated

      Totals

      Three Months Ended












      March 31, 2023












      Total revenues

      $     25,877


      $   44,591


      $         27,922


      $        188


      $        (13,300)


      $      85,278

      Adjusted operating income (loss) (1)

      1,824


      1,680


      1,134


      (268)


      —


      4,370

      March 31, 2022












      Total revenues, as previously reported

      $     23,109


      $   39,461


      $         25,418


      $        126


      $        (11,288)


      $      76,826

      Adjustments

      (15)


      154


      480


      —


      (619)


      —

      Total revenues, as adjusted

      $     23,094


      $   39,615


      $         25,898


      $        126


      $        (11,907)


      $      76,826

      Adjusted operating income (loss), as previously reported (1)

      $       1,751


      $     1,636


      $           1,605


      $       (305)


      $             (204)


      $        4,483

      Adjustments

      110


      (165)


      (32)


      7


      204


      124

      Adjusted operating income (loss), as adjusted

      $       1,861


      $     1,471


      $           1,573


      $      (298)


      $                 —


      $        4,607








      (a) 

      Total revenues of the Health Services segment include approximately $4.1 billion and $3.8 billion of retail co-payments for the three months ended March 31, 2023 and 2022, respectively.

      (b) 

      Intersegment revenue eliminations relate to intersegment revenue generating activities that occur between the Health Care Benefits segment, the Health Services segment, and/or the Pharmacy & Consumer Wellness segment. Prior to January 1, 2023, intersegment adjusted operating income eliminations occurred when members of the Health Services segment's clients enrolled in Maintenance Choice elected to pick up maintenance prescriptions at one of the Company's retail pharmacies instead of receiving them through the mail. When this occurred, both the Health Services and Pharmacy & Consumer Wellness segments recorded the adjusted operating income on a stand-alone basis. Effective January 1, 2023, the adjusted operating income associated with such transactions is reported only in the Pharmacy & Consumer Wellness segment, therefore no adjusted operating income elimination is required.

      Supplemental Information

      (Unaudited)


      Health Care Benefits Segment


      The following table summarizes the Health Care Benefits segment's performance for the respective periods:



      Three Months Ended

      March 31,


      Change

      In millions, except percentages and basis points ("bps")

      2023


      2022


      $


      %

      Revenues:








      Premiums

      $  24,339


      $  21,614


      $   2,725


      12.6 %

      Services

      1,374


      1,391


      (17)


      (1.2) %

      Net investment income

      164


      89


      75


      84.3 %

      Total revenues

      25,877


      23,094


      2,783


      12.1 %

      Benefit costs

      20,595


      18,019


      2,576


      14.3 %

      MBR (Benefit costs as a % of premium revenues) (4)

      84.6 %


      83.4 %


      120

      bps

      Loss on assets held for sale

      $         —


      $         41


      $    (41)


      (100.0) %

      Operating expenses

      3,874


      3,567


      307


      8.6 %

      Operating expenses as a % of total revenues

      15.0 %


      15.4 %





      Operating income

      $    1,408


      $    1,467


      $      (59)


      (4.0) %

      Operating income as a % of total revenues

      5.4 %


      6.4 %





      Adjusted operating income (1)

      $    1,824


      $    1,861


      $      (37)


      (2.0) %

      Adjusted operating income as a % of total revenues

      7.0 %


      8.1 %





      Premium revenues (by business):








      Government

      $  17,528


      $  16,195


      $   1,333


      8.2 %

      Commercial

      6,811


      5,419


      1,392


      25.7 %

      The following table summarizes the Health Care Benefits segment's medical membership for the respective periods:



      March 31, 2023


      December 31, 2022


      March 31, 2022

      In thousands

      Insured


      ASC


      Total


      Insured


      ASC


      Total


      Insured


      ASC


      Total

      Medical membership: (5)


















      Commercial

      3,949


      14,039


      17,988


      3,136


      13,896


      17,032


      3,285


      13,924


      17,209

      Medicare Advantage

      3,387


      —


      3,387


      3,270


      —


      3,270


      3,169


      —


      3,169

      Medicare Supplement

      1,344


      —


      1,344


      1,363


      —


      1,363


      1,292


      —


      1,292

      Medicaid

      2,293


      501


      2,794


      2,234


      497


      2,731


      2,375


      477


      2,852

      Total medical membership

      10,973


      14,540


      25,513


      10,003


      14,393


      24,396


      10,121


      14,401


      24,522



















      Supplemental membership information:















      Medicare Prescription Drug Plan (standalone)

      6,112






      6,128






      6,022

      Supplemental Information

      (Unaudited)


      The following table shows the components of the change in health care costs payable during the three months ended March 31, 2023 and 2022:



      Three Months Ended

      March 31,

      In millions

      2023


      2022

      Health care costs payable, beginning of period

      $       10,142


      $         8,678

      Less: Reinsurance recoverables

      5


      8

      Less: Impact of discount rate on long-duration insurance reserves (a)

      8


      —

      Health care costs payable, beginning of period, net

      10,129


      8,670

      Add: Components of incurred health care costs




      Current year

      21,068


      18,504

      Prior years (b)

      (693)


      (676)

      Total incurred health care costs (c)

      20,375


      17,828

      Less: Claims paid




      Current year

      11,957


      10,225

      Prior years

      7,645


      6,183

      Total claims paid

      19,602


      16,408

      Add: Premium deficiency reserve

      —


      13

      Other (d)

      —


      (13)

      Health care costs payable, end of period, net

      10,902


      10,090

      Add: Reinsurance recoverables

      5


      8

      Add: Impact of discount rate on long-duration insurance reserves (a)

      (12)


      7

      Health care costs payable, end of period

      $       10,895


      $       10,105








      (a) 

      Reflects the difference between the current discount rate and the locked-in discount rate on long-duration insurance reserves which is recorded within accumulated other comprehensive loss on the unaudited condensed consolidated balance sheets. Refer to Note 1 ''Significant Accounting Policies'' in the Company's Quarterly Report on Form 10-Q for the period ended March 31, 2023 for further information related to the adoption of the long-duration insurance contracts accounting standard. 

      (b) 

      Negative amounts reported for incurred health care costs related to prior years result from claims being settled for amounts less than originally estimated.

      (c) 

      Total incurred health care costs for the three months ended March 31, 2023 and 2022 in the table above exclude $22 million and $21 million, respectively, of benefit costs recorded in the Health Care Benefits segment that are included in other insurance liabilities on the  unaudited condensed consolidated balance sheets and $51 million and $61 million, respectively, of benefit costs recorded in the Corporate/Other segment that are included in other insurance liabilities on the unaudited condensed consolidated balance sheets. The incurred health care costs for the three months ended March 31, 2022 also exclude $13 million for premium deficiency reserves related to the Company's Medicaid products.

      (d) 

      As a result of the divestiture of the Thailand business, the net assets associated with this business were accounted for as assets held for sale and the associated health care costs payable balance was reclassified to accrued expenses on the unaudited condensed consolidated balance sheet at March 31, 2022.

      The following table summarizes the Health Care Benefits segment's days claims payable for the respective periods:



      March 31, 2023


      December 31, 2022


      March 31, 2022

      Days Claims Payable (10)

      48.1


      51.3


      51.0

      Supplemental Information

      (Unaudited)


      Health Services Segment (formerly Pharmacy Services Segment)


      The following table summarizes the Health Services segment's performance for the respective periods:



      Three Months Ended

      March 31,


      Change

      In millions, except percentages

      2023


      2022


      $


      %

      Revenues:








      Products

      $   43,671


      $  38,899


      $  4,772


      12.3 %

      Services

      920


      716


      204


      28.5 %

      Total revenues

      44,591


      39,615


      4,976


      12.6 %

      Cost of products sold

      42,416


      37,622


      4,794


      12.7 %

      Gross profit (11)

      2,175


      1,993


      182


      9.1 %

      Gross margin (Gross profit as a % of total revenues) (11)

      4.9 %


      5.0 %





      Operating expenses

      $        537


      $      566


      $      (29)


      (5.1) %

      Operating expenses as a % of total revenues

      1.2 %


      1.4 %





      Operating income

      $     1,638


      $    1,427


      $     211


      14.8 %

      Operating income as a % of total revenues

      3.7 %


      3.6 %





      Adjusted operating income (1)

      $     1,680


      $    1,471


      $     209


      14.2 %

      Adjusted operating income as a % of total revenues

      3.8 %


      3.7 %





      Revenues (by distribution channel):








      Pharmacy network (8)

      $   27,592


      $  24,128


      $   3,464


      14.4 %

      Mail & specialty (9)

      16,145


      14,668


      1,477


      10.1 %

      Other

      854


      819


      35


      4.3 %

      Pharmacy claims processed (6) (7) (a)

      587.3


      566.5


      20.8


      3.7 %

      Generic dispensing rate (7) (12) (b)

      88.4 %


      87.7 %












      (a) 

      Excluding the impact of COVID-19 vaccinations, pharmacy claims processed increased 4.8% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year.

      (b) 

      Excluding the impact of COVID-19 vaccinations, the Health Services segment's generic dispensing rate was 88.5% and 88.8% in the three months ended March 31, 2023 and 2022, respectively.

      Supplemental Information

      (Unaudited)


      Pharmacy & Consumer Wellness Segment (formerly Retail/LTC Segment)


      The following table summarizes the Pharmacy & Consumer Wellness segment's performance for the respective periods:



      Three Months Ended

      March 31,


      Change

      In millions, except percentages

      2023


      2022


      $


      %

      Revenues:








      Products

      $  27,258


      $  24,904


      $   2,354


      9.5 %

      Services

      667


      1,010


      (343)


      (34.0) %

      Net investment income (loss)

      (3)


      (16)


      13


      81.3 %

      Total revenues

      27,922


      25,898


      2,024


      7.8 %

      Cost of products sold

      21,876


      19,382


      2,494


      12.9 %

      Gross profit (10)

      6,046


      6,516


      (470)


      (7.2) %

      Gross margin (Gross profit as a % of total revenues) (11)

      21.7 %


      25.2 %





      Loss on assets held for sale

      $       349


      $      —


      $     349


      100.0 %

      Operating expenses

      $    4,980


      $    5,081


      $    (101)


      (2.0) %

      Operating expenses as a % of total revenues

      17.8 %


      19.6 %





      Operating income

      $       717


      $    1,435


      $    (718)


      (50.0) %

      Operating income as a % of total revenues

      2.6 %


      5.5 %





      Adjusted operating income (1)

      $    1,134


      $    1,573


      $    (439)


      (27.9) %

      Adjusted operating income as a % of total revenues

      4.1 %


      6.1 %





      Revenues (by major goods/service lines):








      Pharmacy

      $  21,495


      $  19,532


      $   1,963


      10.1 %

      Front Store

      5,597


      5,313


      284


      5.3 %

      Other

      833


      1,069


      (236)


      (22.1) %

      Net investment income (loss)

      (3)


      (16)


      13


      81.3 %

      Prescriptions filled (6) (7) (a)

      404.8


      395.1


      9.7


      2.5 %

      Same store sales increase: (13)








      Total

      11.6 %


      10.9 %





      Pharmacy

      12.7 %


      10.1 %





      Front Store

      7.7 %


      13.9 %





      Prescription volume (7)

      5.0 %


      6.1 %





      Generic dispensing rate (7) (12) (b)

      89.4 %


      87.5 %












      (a) 

      Excluding the impact of COVID-19 vaccinations, prescriptions filled increased 4.5% on a 30-day equivalent basis for the three months ended March 31, 2023 compared to the prior year.

      (b) 

      Excluding the impact of COVID-19 vaccinations, the Pharmacy & Consumer Wellness segment's generic dispensing rate was 89.7% in both the three months ended March 31, 2023 and 2022.

      Supplemental Information

      (Unaudited)


      Corporate/Other Segment


      The following table summarizes the Corporate/Other segment's performance for the respective periods:



      Three Months Ended

      March 31,


      Change

      In millions, except percentages

      2023


      2022


      $


      %

      Revenues:








      Premiums

      $         13


      $          17


      $        (4)


      (23.5) %

      Services

      2


      14


      (12)


      (85.7) %

      Net investment income

      173


      95


      78


      82.1 %

      Total revenues

      188


      126


      62


      49.2 %

      Cost of products sold

      1


      10


      (9)


      (90.0) %

      Benefit costs

      52


      61


      (9)


      (14.8) %

      Opioid litigation charge

      —


      484


      (484)


      (100.0) %

      Operating expenses

      452


      355


      97


      27.3 %

      Operating loss

      (317)


      (784)


      467


      59.6 %

      Adjusted operating loss (1)

      (268)


      (298)


      30


      10.1 %

      Adjusted Earnings Per Share Guidance
      (Unaudited)

      The following reconciliations of projected net income attributable to CVS Health to projected adjusted income attributable to CVS Health and calculations of projected GAAP diluted EPS and projected Adjusted EPS contain forward-looking information. All forward-looking information involves risks and uncertainties. Actual results may differ materially from those contemplated by the forward-looking information for a number of reasons as described in our SEC filings, including those set forth in the Risk Factors section and under the heading "Cautionary Statement Concerning Forward-Looking Statements" in our most recently filed Annual Report on Form 10-K and our Quarterly Report on Form 10-Q for the quarterly period ended March 31, 2023. See "Non-GAAP Financial Information" earlier in this press release and endnote (2) later in this press release for more information on how we calculate Adjusted EPS.


      Year Ending December 31, 2023


      Low


      High

      In millions, except per share amounts

      Total
      Company


      Per
      Common
      Share


      Total
      Company


      Per
      Common
      Share

      Net income attributable to CVS Health (GAAP measure)

      $     8,923


      $       6.90


      $     9,211


      $       7.12

      Non-GAAP adjustments:








      Amortization of intangible assets

      1,862


      1.44


      1,842


      1.42

      Net realized capital losses

      105


      0.08


      105


      0.08

      Loss on assets held for sale

      349


      0.27


      349


      0.27

      Acquisition-related transaction and integration costs

      350


      0.27


      330


      0.26

      Office real estate optimization charges

      60


      0.05


      60


      0.05

      Tax impact of non-GAAP adjustments

      (659)


      (0.51)


      (648)


      (0.50)

      Adjusted income attributable to CVS Health (2)

      $   10,990


      $       8.50


      $   11,249


      $       8.70









      Weighted average diluted shares outstanding



      1,293




      1,293

      Endnotes

      (1)  The Company defines adjusted operating income as operating income (GAAP measure) excluding the impact of amortization of intangible assets, net realized capital gains or losses and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance, such as losses on assets held for sale, acquisition-related transaction and integration costs, office real estate optimization charges and opioid litigation charges. The Company uses adjusted operating income as its principal measure of segment performance as it enhances the Company's ability to compare past financial performance with current performance and analyze underlying business performance and trends. The consolidated measure is not determined in accordance with GAAP and should not be considered a substitute for, or superior to, the most directly comparable GAAP measure, consolidated operating income. See "Non-GAAP Financial Information" earlier in this press release for additional information regarding the items excluded from consolidated operating income in determining consolidated adjusted operating income.

      (2)  Adjusted EPS is calculated by dividing adjusted income attributable to CVS Health by the Company's weighted average diluted shares outstanding. The Company defines adjusted income attributable to CVS Health as net income attributable to CVS Health (GAAP measure) excluding the impact of amortization of intangible assets, net realized capital gains or losses and other items, if any, that neither relate to the ordinary course of the Company's business nor reflect the Company's underlying business performance, such as losses on assets held for sale, acquisition-related transaction and integration costs, office real estate optimization charges, opioid litigation charges, as well as the corresponding income tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health and certain discrete tax items. See "Non-GAAP Financial Information" earlier in this press release for additional information regarding the items excluded from net income attributable to CVS Health in determining adjusted income attributable to CVS Health.

      (3)  The Company defines the adjusted effective income tax rate as the effective income tax rate (GAAP measure) excluding the corresponding tax benefit or expense related to the items excluded from adjusted income attributable to CVS Health above. The nature of each non-GAAP adjustment is evaluated to determine whether a discrete adjustment should be made to the adjusted effective income tax rate. During the three months ended March 31, 2022, the Company's adjusted effective income tax rate also excludes the impact of certain discrete tax items concluded in the first quarter of 2022.

      (4)  Medical benefit ratio is calculated as benefit costs divided by premium revenues and represents the percentage of premium revenues spent on medical benefits for the Company's insured members. Management uses MBR to assess the underlying business performance and underwriting of its insurance products, understand variances between actual results and expected results and identify trends in period-over-period results. MBR provides management and investors with information useful in assessing the operating results of the Company's insured Health Care Benefits products.

      (5)  Medical membership represents the number of members covered by the Company's insured and ASC medical products and related services at a specified point in time. Management uses this metric to understand variances between actual medical membership and expected amounts as well as trends in period-over-period results. This metric provides management and investors with information useful in understanding the impact of medical membership on segment total revenues and operating results.

      (6)  Pharmacy claims processed represents the number of prescription claims processed through the Company's pharmacy benefits manager and dispensed by either its retail network pharmacies or the Company's mail and specialty pharmacies. Prescriptions filled represents the number of prescriptions dispensed through the Pharmacy & Consumer Wellness segment's retail and long-term care pharmacies and infusion services operations. Management uses these metrics to understand variances between actual claims processed and prescriptions dispensed, respectively, and expected amounts as well as trends in period-over-period results. These metrics provide management and investors with information useful in understanding the impact of pharmacy claim volume and prescription volume, respectively, on segment total revenues and operating results.

      (7)  Includes an adjustment to convert 90-day prescriptions to the equivalent of three 30-day prescriptions. This adjustment reflects the fact that these prescriptions include approximately three times the amount of product days supplied compared to a normal prescription. 

      (8)  Health Services pharmacy network revenues relate to claims filled at retail and specialty retail pharmacies, including the Company's retail pharmacies and LTC pharmacies. Effective January 1, 2023, pharmacy network revenues also include activity associated with Maintenance Choice, which permits eligible client plan members to fill their maintenance prescriptions through mail order delivery or at a CVS pharmacy retail store for the same price as mail order. Maintenance Choice activity was previously reflected in mail & specialty revenues. Prior period financial information has been revised to conform with current period presentation.

      (9)  Health Services mail & specialty revenues relate to specialty mail claims inclusive of Specialty Connect® claims picked up at a retail pharmacy, as well as mail order and specialty claims fulfilled by the Pharmacy & Consumer Wellness segment. Effective January 1, 2023, mail & specialty revenues exclude Maintenance Choice activity, which is now reflected within pharmacy network revenues. Prior period financial information has been revised to conform with current period presentation. 

      (10)  Days claims payable is calculated by dividing the health care costs payable at the end of each quarter by the average health care costs per day during such quarter. Management and investors use this metric as an indicator of the adequacy of the Company's health care costs payable liability at the end of each quarter and as an indicator of changes in such adequacy over time.

      (11)  Gross profit is calculated as the segment's total revenues less its cost of products sold. Gross margin is calculated by dividing the segment's gross profit by its total revenues and represents the percentage of total revenues that remains after incurring direct costs associated with the segment's products sold and services provided. Gross margin provides investors with information that may be useful in assessing the operating results of the Company's Health Services and Pharmacy & Consumer Wellness segments.

      (12)  Generic dispensing rate is calculated by dividing the segment's generic drug claims processed or prescriptions filled by its total claims processed or prescriptions filled. Management uses this metric to evaluate the effectiveness of the business at encouraging the use of generic drugs when they are available and clinically appropriate, which aids in decreasing costs for client members and retail customers. This metric provides management and investors with information useful in understanding trends in segment total revenues and operating results.  

      (13)  Same store sales and prescription volume represent the change in revenues and prescriptions filled in the Company's retail pharmacy stores that have been operating for greater than one year, expressed as a percentage that indicates the increase or decrease relative to the comparable prior period. Same store metrics exclude revenues and prescriptions from LTC and infusion services operations. Effective January 1, 2023, same store sales also include digital sales initiated online or through mobile applications and fulfilled through the Company's distribution centers. Prior period financial information has been revised to conform with current period presentation. Management uses these metrics to evaluate the performance of existing stores on a comparable basis and to inform future decisions regarding existing stores and new locations. Same-store metrics provide management and investors with information useful in understanding the portion of current revenues and prescriptions resulting from organic growth in existing locations versus the portion resulting from opening new stores.

      SOURCE CVS Health Corporation

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