Stock-Based Compensation - Components of Stock-Based Compensation Expense (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	$ 920,307	$ 836,171	$ 685,053
Income tax benefit	228,639	193,143	165,673
Total stock-based compensation, net of tax	691,668	643,028	519,380
Cost of product sales
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	51,549	60,698	50,232
Cost of services
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	73,918	62,979	58,421
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	324,727	299,255	258,746
Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	470,113	413,239	317,654
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	262,508	326,041	327,622
Income tax benefit	66,780	73,293	75,771
Total stock-based compensation, net of tax	195,728	252,748	251,851
Stock Options | Cost of product sales
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	22,399	29,504	29,586
Stock Options | Cost of services
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	20,968	25,221	29,493
Stock Options | Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	88,495	106,556	112,484
Stock Options | Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	130,646	164,760	156,059
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	657,799	510,130	357,431
Income tax benefit	161,859	119,850	89,902
Total stock-based compensation, net of tax	495,940	390,280	267,529
Restricted Stock | Cost of product sales
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	29,150	31,194	20,646
Restricted Stock | Cost of services
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	52,950	37,758	28,928
Restricted Stock | Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	236,232	192,699	146,262
Restricted Stock | Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense before income taxes	$ 339,467	$ 248,479	$ 161,595