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Consolidated statement of cash flows

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January 1 to December 31, € in millions  Note 2022 2021
Operating activities
Net income  2,117 2,819
Adjustments to reconcile net income to cash and
cash equivalents provided by operating activities
Depreciation and amortization  18, 19, 20, 31 2,973 2,667
Change in deferred taxes  11 -115 84
Gain/loss on sale of fixed assets and of investments and divestitures 2 -116 42
Changes in assets and liabilities, net of amounts
from businesses acquired or disposed of
Trade accounts and other receivables 16 85 87
Inventories 17 -472 -105
Other current and non-current assets  18 -360 -320
Accounts receivable from / payable to related parties  -4 -10
Trade accounts payable, provisions and 
other short-term and long-term liabilities 
21, 22 140 -154
Liabilities for income taxes  -50 -32
Net cash provided by operating activities  4,198 5,078
Investing activities
Purchases of property, plant and equipment
and capitalized development costs
19 -1,917 -2,047
Proceeds from sales of property, plant and equipment  140 30
Acquisitions and investments
and purchases of intangible assets 
2, 34 -977 -999
Proceeds from sale of investments and divestitures  2 147 199
Net cash used in investing activities -2,607 -2,817

Consolidated statement of cash flows

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January 1 to December 31, € in millions Note 2022 2021
Financing activities
Proceeds from short-term debt 23 698 3,279
Repayments of short-term debt  23 -2,655 -688
Proceeds from long-term debt  23 654 458
Repayments of long-term debt  23 -633 -3,028
Repayments of lease liabilities 31 -975 -880
Proceeds from the issuance of bonds 24 3,044 2,714
Repayments of liabilities from bonds 24 -912 -2,253
Proceeds from the Accounts Receivable
Facility of Fresenius Medical Care 
23 95
Proceeds from the exercise of stock options  36 20 38
Dividends paid -890 -1,068
Change in noncontrolling interests, net 27 -50 -24
Net cash used in financing activities -1,604 -1,452
Effect of exchange rate changes on cash and cash equivalents  -2 118
Net decrease/increase in cash and cash equivalents -15 927
Cash and cash equivalents at the beginning of the reporting period 15 2,764 1,837
Cash and cash equivalents at the end of the reporting period  15 2,749 2,764

Additional information on payments that are included in net cash provided by operating activities

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January 1 to December 31, € in millions Note 2022 2021
Received interest  137 94
Paid interest -610 -517
Income taxes paid -850 -750
The following notes are an integral part of the consolidated financial statements.