New annual financial documents for large health care companies are rolling in with a familiar tune: executives took home large paydays in 2019 that mostly came from large stock gains.

The bottom line: The health care system is a firehose of spending, and a good chunk of that money always makes its way to the top.

By the numbers: 10 major health care companies have filed preliminary or final disclosures outlining executive pay in 2019. The CEOs at those firms made more than $300 million collectively, according to our updated tracker of health care executive compensation.

Ari Bousbib, CEO of pharmaceutical data and clinical trial firm IQVIA, made more than $104 million last year, based on the actual realized gains of his stock holdings.

Right behind were Intuitive Surgical CEO Gary Guthart at $50.5 million and Eli Lilly CEO David Ricks at $30.8 million.

What we're watching: Filings will continue to be released over the next two months. Follow along.

Go deeper: What health care executives made in 2018