Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES:
Net Income	$ 103,135	$ 86,870	$ 101,035
Depreciation and amortization	89,698	85,631	76,916
Operatingleaserightofuseassetamortization	9,594	9,216	8,294
Provision for doubtful accounts	345	7,137	14,882
Provision for warranty and returns	831	(1,576)	(134)
Stock compensation	27,341	23,954	21,918
Gain (Loss) on Disposition of Property Plant Equipment	1,652	(1,789)	12,872
Bond premium amortization	655	231	135
Debt issuance cost amortization	240	288	288
Change in fair value of contingent earn-out	0	9,000	(47,400)
Production Related Impairments or Charges	3,380	2,626	0
Sparepartsusage	13,046	11,191	24,301
Other	2,582	6,939	447
Increase (Decrease) in Accounts Receivable	13,755	78,049	(23,684)
Increase (Decrease) in Inventories	20,815	19,196	(24,997)
Increase (Decrease) in Prepaid Expense and Other Assets	(7,973)	(4,311)	8,588
Increase (Decrease) in Other Operating Assets	(21,038)	(16,069)	(29,837)
Accounts payable	2,347	(46,415)	(2,697)
Accrued liabilities	6,259	(29,379)	(43,689)
Income taxes, including excess tax benefits and deferred income taxes	874	(18,037)	4,680
Net cash provided by operating activities	267,538	222,752	101,918
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property and equipment	(68,542)	(92,005)	(97,312)
Proceeds from Sale of Other Property, Plant, and Equipment	218	6,176	33
Intangible asset additions	(12,627)	(8,385)	(8,728)
Business acquisitions, net of cash acquired	(14,452)	0	(76,133)
Payments to Acquire Equity Method Investments	(3,250)	0	0
Purchases of investment securities	(10,034)	(32,825)	(26,040)
Proceeds from sale of investment securities	18,000	28,900	41,292
Net cash (used in) provided by investing activities	(90,687)	(98,139)	(166,888)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from Long-term Lines of Credit	0	150,000	0
Repayments of Long-term obligations	0	(150,000)	0
Proceeds from exercise of stock options	9,372	13,193	7,732
Finance Lease, Principal Payments	(607)	(357)	0
Payment for Contingent Consideration Liability, Financing Activities	(17,300)	0	0
Purchase of treasury stock	(8,335)	(12,876)	(18,639)
Net cash (used in) provided by financing activities	(16,870)	(40)	(10,907)
Effect of Exchange Rate on Cash [Abstract]
Effect of exchange rate changes on cash	(3,251)	2,854	(234)
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect, Total	156,730	127,427	(76,111)
CASH AND CASH EQUIVALENTS, beginning of period	396,097	268,670	344,781
CASH AND CASH EQUIVALENTS, end of period	552,827	396,097	268,670
SUPPLEMENTAL DISCLSOURE OF CASH FLOW INFORMATION
Cash paid during the year for income taxes	19,562	31,628	9,675
Interest Paid, Excluding Capitalized Interest, Operating Activities	858	1,753	549
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Accounts payable for property and equipment	9,338	2,211	13,912
Goodwill, Acquired During Period	10,626		20,026
International Distributor
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Liabilities Assumed	2,589	$ 0	0
Pursuit Vascular LLC
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Goodwill, Acquired During Period			19,100
Foreign Infusion System Supplier
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Fair value of assets acquired	4,592
Cash paid for acquisitions, net of cash acquired	(14,452)
Contingent consideration	0
Goodwill, Period Increase (Decrease)	10,626
Goodwill, Acquired During Period	10,600
Liabilities Assumed	$ 766
Total Acquisitions
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Fair value of assets acquired			91,019
Cash paid for acquisitions, net of cash acquired			(76,133)
Contingent consideration			(17,300)
Goodwill, Acquired During Period			20,026
Liabilities Assumed			$ 17,612