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Revenue (Notes)
12 Months Ended
Dec. 31, 2020
Revenue from Contract with Customer [Abstract]  
Revenue from Contract with Customer [Text Block] REVENUE
Revenue Recognition

    Our primary product lines are Infusion Consumables, Infusion Systems, IV Solutions and Critical Care. The vast majority of our sales of these products are made on a stand-alone basis to hospitals and distributors. Revenue is typically recognized upon transfer of control of the products, which we deem to be at point of shipment. Our software licenses and renewals are considered to be transferred to a customer at a point in time therefore revenue is recognized at the start of the license term.

    Payment is typically due in full within 30 days of delivery or the start of the contract term. Revenue is recorded in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services. We offer certain volume-based rebates to our distribution customers, which we record as variable consideration when calculating the transaction price. Rebates are offered on both a fixed and tiered/variable basis. In both cases, we use information available at the time and our historical experience with each customer to estimate the most likely rebate amount. We also provide chargebacks to distributors that sell to end-customers at prices determined under a contract between us and the end-customer. We use information available at the time, including our historical experience to estimate the expected value in recording provisions for chargebacks.

    We also warrant products against defects and have a policy permitting the return of defective products, for which we accrue and expense at the time of sale using information available at that time and our historical experience. We also provide for extended service-type warranties, which we consider to be separate performance obligations. We allocate a portion of the transaction price to the extended service-type warranty based on its estimated relative selling price, and recognize revenue over the period the warranty service is provided. Our revenues are recorded at the net sales price, which includes an estimate for variable consideration related to rebates, chargebacks and product returns.

Arrangements with Multiple Performance Obligations

    We also enter into arrangements which include multiple performance obligations, see Note 1, Basis of Presentation and Summary of Significant Accounting Policies.

    The most significant judgments related to these arrangements include:

Identifying the various performance obligations of these arrangements.
Estimating the relative standalone selling price of each performance obligation, typically using directly observable method or calculated on a cost plus margin basis method.

Revenue disaggregated

    The following table represents our revenues disaggregated by product line (in thousands) and our disaggregated product line revenue as a percentage of total revenue:
Year ended December 31,
202020192018
Product lineRevenue% of RevenueRevenue% of RevenueRevenue% of Revenue
Infusion Consumables$473,740 37 %$477,611 37 %$483,039 35 %
Infusion Systems359,691 28 %328,282 26 %355,484 25 %
IV Solutions388,971 31 %414,971 33 %507,985 36 %
Critical Care48,602 %45,344 %53,532 %
Total Revenues$1,271,004 100 %$1,266,208 100 %$1,400,040 100 %
    
    We report revenue on a "where sold" basis, which reflects the revenue within the country or region in which the ultimate sale is made to our external customer.    
    
    The following table represents our revenues disaggregated by geography (in thousands):
Year ended December 31,
Geography202020192018
Europe, the Middle East and Africa$132,763 $130,530 $134,363 
Other Foreign227,614 212,336 210,996 
Total Foreign360,377 342,866 345,359 
United States910,627 923,342 1,054,681 
Total Revenues$1,271,004 $1,266,208 $1,400,040 

Domestic sales accounted for 72%, 73% and 75% of total revenue in 2020, 2019 and 2018, respectively. International sales accounted for 28%, 27% and 25% of total revenue in 2020, 2019 and 2018, respectively.

Contract balances

    Our contract balances (deferred revenue) are recorded in accrued liabilities and other long-term liabilities in our consolidated balance sheet (see Note 10, Accrued Liabilities and Other Long-term liabilities). The following table presents our changes in the contract balances for the years ended December 31, 2020 and 2019, (in thousands):
Contract Liabilities
Beginning balance, January 1, 2019$(4,282)
Equipment revenue recognized8,807 
Equipment revenue deferred due to implementation(8,794)
Software revenue recognized3,953 
Software revenue deferred due to implementation(4,539)
Ending balance, December 31, 2019$(4,855)
Equipment revenue recognized14,408 
Equipment revenue deferred due to implementation(14,341)
Software revenue recognized5,721 
Software revenue deferred due to implementation(7,363)
Ending balance, December 31, 2020$(6,430)
    
    During 2020, we recognized $4.7 million in revenue that was included in the opening contract balances for the year ended December 31, 2019. As of December 31, 2020, revenue from remaining performance obligations related to implementation of software and equipment is $4.8 million. We expect to recognize substantially all of this revenue within the next three to six months. Revenue from remaining performance obligations related to annual software licenses is $1.7 million. We expect to recognize substantially all of this revenue over the next twelve months.

Costs to Obtain a Contract with a Customer

    As part of the cost to obtain a contract, we may pay incremental commissions to sales employees upon entering into a sales contract. Under ASC Topic 606, we have elected to expense these costs as incurred as the period of benefit is less than one year.
Practical expedients and exemptions

    In addition to the practical expedient applied to sales commissions, under ASC Topic 606, we elected to apply the practical expedient for shipping and handling costs incurred after the customer has obtained control of a good. We will continue to treat these costs as a fulfillment cost rather than as an additional promised service.