Revenue (Notes)

12 Months Ended

Dec. 31, 2021

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. However, for purposes of revenue recognition for our software licenses and renewals, we consider the control of these products to be transferred to a customer at a certain point in time; therefore, we recognize revenue at the start of the applicable 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. Chargebacks are the difference between the prices we charge our distribution customers and the contracted prices we have with the end customer which are processed as credits to our distribution customers. In estimating the expected value of chargeback amounts in order to determine the transaction price, we use information available at the time, including our historical experience.

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 a 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,
	2021				2020				2019
Product line	Revenue		% of Revenue		Revenue		% of Revenue		Revenue		% of Revenue
Infusion Consumables	$	555,189	42	%	$	473,740	37	%	$	477,611	37	%
Infusion Systems	352,321		27	%	359,691		28	%	328,282		26	%
IV Solutions	359,477		27	%	388,971		31	%	414,971		33	%
Critical Care	49,321		4	%	48,602		4	%	45,344		4	%
Total Revenues	$	1,316,308	100	%	$	1,271,004	100	%	$	1,266,208	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,
Geography	2021		2020		2019
Europe, the Middle East and Africa	$	147,488	$	132,763	$	130,530
Other Foreign	227,011		227,614		212,336
Total Foreign	374,499		360,377		342,866
United States	941,809		910,627		923,342
Total Revenues	$	1,316,308	$	1,271,004	$	1,266,208

Domestic sales accounted for 72%, 72% and 73% of total revenue in 2021, 2020 and 2019, respectively. International sales accounted for 28%, 28% and 27% of total revenue in 2021, 2020 and 2019, 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 the changes in our contract balances for the years ended December 31, 2021 and 2020, (in thousands):

	Contract Liabilities
Beginning balance, January 1, 2020	$	(4,855)
Equipment revenue recognized	14,408
Equipment revenue deferred due to implementation	(14,341)
Software revenue recognized	5,721
Software revenue deferred due to implementation	(7,363)
Ending balance, December 31, 2020	$	(6,430)
Equipment revenue recognized	10,048
Equipment revenue deferred due to implementation	(13,725)
Software revenue recognized	7,261
Software revenue deferred due to implementation	(4,615)
Ending balance, December 31, 2021	$	(7,461)

During 2021, we recognized $5.1 million in revenue that was included in the opening contract balances as of December 31, 2020. As of December 31, 2021, revenue from remaining performance obligations related to implementation of software and equipment is $5.6 million. We expect to recognize substantially all of this revenue within the next three to six months dependent on implementation restrictions due to the novel coronavirus and its variants ("COVID-19"). Revenue from remaining performance obligations related to annual software licenses is $1.9 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.