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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2022
Sep. 30, 2021
CASH FLOWS FROM OPERATING ACTIVITIES:    
Net loss $ (130,013) $ (49,042)
Adjustments to reconcile net loss to cash flows from operating activities:    
Depreciation and amortization 58,185 57,510
Share-based compensation expense 67,771 68,603
Deferred income taxes (54,073) 2,015
Change in the fair value of contingent consideration 21,750 677
Loss on debt extinguishment   171
Other non-cash charges 3,746 1,803
Changes in assets and liabilities:    
Receivables 56,045 (13,991)
Contract assets 3,258 10,892
Inventory (15,646) (13,375)
Prepaid expenses and other assets 1,872 (1,507)
Right-of-use assets 12,470 12,891
Accounts payable and accrued expenses 4,810 15,546
Contract liabilities (9,191) (4,642)
Operating lease liabilities (13,411) (12,504)
Other long-term liabilities 12,424 (4,353)
Cash flows provided by operating activities 19,997 70,694
CASH FLOWS FROM INVESTING ACTIVITIES:    
Additions of property, plant and equipment (28,227) (19,359)
Proceeds from the sale of equipment   277
Proceeds from contingent consideration 1,273 7,908
Return of Fountain Healthcare Partners II, L.P. investment 485  
Payment made for licensed Intellectual Property ("IP")   (1,000)
Purchases of investments (256,806) (294,370)
Sales and maturities of investments 190,994 241,082
Cash flows used in investing activities (92,281) (65,462)
CASH FLOWS FROM FINANCING ACTIVITIES:    
Proceeds from the issuance of ordinary shares under share-based compensation arrangements 18,850 24,810
Employee taxes paid related to net share settlement of equity awards (17,903) (13,633)
Proceeds from the issuance of long-term debt   23,567
Payment made for debt extinguishment   (993)
Principal payments of long-term debt (2,250) (1,500)
Cash flows (used in) provided by financing activities (1,303) 32,251
NET (DECREASE) INCREASE IN CASH AND CASH EQUIVALENTS (73,587) 37,483
CASH AND CASH EQUIVALENTS—Beginning of period 337,544 272,961
CASH AND CASH EQUIVALENTS—End of period 263,957 310,444
Non-cash investing and financing activities:    
Purchased capital expenditures included in accounts payable and accrued expenses $ 2,690 $ 2,698