Income Taxes Effective tax rate (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ 4,016	$ (27,194)	$ 3,316	$ (27,194)
Share-based Payment Arrangement, Expense, Tax Benefit	900	$ 0	$ 200	2,600
contingent consideration, tax expense	$ 0			$ 0
Effective Income Tax Rate	57.00%	56.00%	46.00%	36.00%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21.00%	21.00%
Share-based Payment Arrangement, Expense, Tax Benefit	$ 900	$ 0	$ 200	$ 2,600
contingent consideration, tax expense	0			$ 0
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	6,000		6,000
SmithsMedical
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value of contingent earn-out	$ 4,000		$ 3,300

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Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

No definition available.

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Amount of increase (decrease) in the value of a contingent consideration liability, including, but not limited to, differences arising upon settlement.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 230
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Subparagraph (a)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 805
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-Section 50
-Paragraph 4
-Subparagraph (a)(1)
-Publisher FASB
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- Definition

Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-12

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Percentage of domestic federal statutory tax rate applicable to pretax income (loss).

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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
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Amount of tax benefit for recognition of expense of award under share-based payment arrangement.

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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (h)(1)(i)
-Publisher FASB
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Amount of decrease in unrecognized tax benefits resulting from lapses of applicable statutes of limitations.

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Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
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