7Baggers
Quarterly
Annual
    Unit: USD2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2014-03-31 2013-12-31 2013-09-30 2013-06-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-12-31 2011-09-30 2011-06-30 2011-03-31 2010-12-31 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2009-09-30 2009-06-30 2009-03-31 2008-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2001-03-31 
      
                                                                                
      operating activities:
                                                                                
      net income
    -5,404,000 -484,073,000 -25,293,000 19,435,000 -10,696,000 -12,402,000 -3,281,000 19,834,000 19,497,000 4,184,000 24,226,000 52,946,000 49,915,000 44,788,000 32,901,000 45,384,000 43,229,000 35,068,000 45,394,000 92,744,000 32,337,000 -369,000 9,180,000 15,319,000 -27,610,000 29,736,000 32,756,000 25,138,000 13,295,000 11,376,000 10,992,000  3,158,000 10,836,000 6,394,000  20,143,000 14,525,000 11,648,000  -31,881,000 4,998,000 8,384,000  9,807,000 4,825,000 2,206,000  -28,550,000 3,440,000 -4,050,000  13,211,000 8,514,000 6,693,000 4,560,000 11,243,000 699,000 11,487,000 18,807,000 16,483,000 15,157,000 15,222,000 15,731,000 14,432,000 11,225,000 9,567,000 24,845,000 -15,291,000 13,814,000 11,565,000 5,382,000 9,673,000 9,342,000 9,074,000 1,996,000 
      adjustments to reconcile net income to net cash from operating activities:
                                                                                
      depreciation and amortization
    38,522,000 37,692,000 37,188,000 37,589,000 35,961,000 36,777,000 30,566,000 30,985,000 30,558,000 30,826,000 31,143,000 29,496,000 29,467,000 29,612,000 29,724,000 30,746,000 30,122,000 29,754,000 29,214,000 26,178,000 31,027,000 29,675,000 29,151,000 27,878,000 27,599,000 26,892,000 27,093,000 27,677,000 29,051,000 26,906,000 27,096,000  20,969,000 21,595,000 19,717,000  18,086,000 18,014,000 18,253,000  9,437,000 15,745,000 15,414,000  15,941,000 15,203,000 13,961,000  11,670,000 12,636,000 11,389,000  13,314,000 13,232,000 12,576,000 12,869,000 12,852,000 14,493,000 9,958,000 10,504,000 9,714,000 9,523,000 9,431,000 12,572,000 9,973,000 8,467,000 8,676,000 8,773,000 7,900,000 6,971,000 7,073,000 6,418,000 6,013,000 7,532,000 5,664,000 1,431,000 
      non-cash impairment charges
      36,000 29,000 5,080,000 7,064,000         2,754,000                    409,000  600,000                              
      deferred income tax benefit
    -8,653,000 -44,831,000 -1,832,000 -6,988,000            10,743,000 -8,591,000 -3,673,000 -1,234,000                              -6,838,000 655,000 -1,055,000      759,000 -3,228,000 -1,981,000  -1,289,000 -6,000 -369,000     -17,852,000 -8,716,000   -7,478,000 -2,242,000    
      share-based compensation
    5,580,000 5,295,000 1,870,000 7,152,000 4,382,000 7,244,000 5,599,000 5,793,000 5,459,000 5,271,000 3,620,000 5,731,000 8,967,000 6,736,000 6,291,000 6,432,000 7,745,000 15,699,000 6,334,000 5,257,000 5,411,000 5,172,000 3,750,000 5,511,000 5,885,000 5,776,000 4,083,000 4,993,000 5,572,000 5,483,000 4,731,000  5,309,000 5,687,000 5,363,000  4,876,000 4,651,000 3,246,000  6,172,000 3,239,000 2,377,000  3,386,000 5,831,000 2,471,000  2,830,000 2,692,000 2,072,000  2,277,000 2,285,000 2,070,000 7,908,000 3,034,000 11,829,000 4,034,000 5,756,000 3,933,000 3,677,000 3,843,000 4,059,000 3,790,000 3,971,000 3,760,000 3,910,000 21,647,000 3,600,000 3,478,000 4,432,000 3,780,000 3,826,000 3,356,000  
      amortization of debt issuance costs and expenses associated with debt refinancing
    1,315,000 1,890,000 1,385,000 1,400,000 1,335,000 1,460,000 1,398,000 1,433,000 1,417,000 1,424,000 1,890,000 1,703,000 1,750,000 1,668,000 1,724,000 1,722,000 1,739,000 1,848,000 1,721,000 1,577,000 4,948,000 1,305,000 4,246,000                                                      
      non-cash lease expense
    -307,000 -345,000 -254,000 964,000 -825,000 547,000 149,000 69,000 369,000 491,000 1,260,000 -224,000 1,647,000 1,410,000 -17,000 735,000 571,000 1,006,000 1,522,000 783,000 412,000                                                        
      loss on disposal of property and equipment
    -4,000 -1,000 495,000          182,000 20,000 712,000  1,943,000 88,000 -2,000  42,000 143,000 374,000 977,000 233,000 244,000 367,000 416,000 842,000 -19,000 146,000  -9,000 104,000 348,000  -138,000    86,000    127,000    -15,000 -34,000 1,865,000  376,000        -284,000 293,000 154,000              
      change in fair value of contingent consideration and others
    -14,441,000 -41,000 -162,000 -5,472,000 -2,123,000 1,348,000 456,000 4,610,000 2,197,000 1,382,000 4,699,000 -823,000 -13,682,000 -5,034,000 -765,000 -1,618,000 -159,000 -666,000 281,000 996,000 663,000 343,000 -1,051,000                                                      
      changes in assets and liabilities:
                                                                                
      accounts receivable
    22,507,000 -27,991,000 21,451,000 -31,463,000 28,750,000 -6,716,000 16,827,000 -457,000 224,000 -5,215,000 10,041,000 -10,035,000 -14,238,000 -6,516,000 -3,116,000 -10,172,000 6,635,000 -5,954,000 16,756,000 -5,758,000 -37,430,000 66,992,000 28,301,000 8,091,000 12,837,000 -16,651,000 -13,705,000 -18,201,000 9,600,000 9,980,000 -18,400,000  1,442,000 -10,714,000 -589,000  5,425,000 4,915,000 -18,440,000  -4,726,000 -6,580,000 2,100,000  -3,953,000 -5,565,000 5,671,000  2,185,000 -2,854,000 2,109,000  -3,585,000 -2,548,000 4,800,000 -1,101,000 -76,000 -1,797,000 1,096,000 474,000 -6,944,000 -591,000 3,278,000 -1,856,000 1,758,000 765,000 9,141,000 -2,097,000 649,000 -646,000 -2,616,000 -3,015,000 4,243,000 -3,529,000 -540,000 393,000 
      inventories
    -23,345,000 -6,378,000 -13,696,000 -570,000 -10,301,000 1,743,000 -19,021,000 -16,423,000 -15,795,000 -2,132,000 -25,423,000 -4,681,000 -6,867,000 -6,015,000 -11,561,000 8,972,000 -6,491,000 5,225,000 -2,332,000 -2,817,000 1,510,000 -20,805,000 -26,236,000 -12,755,000 -8,995,000 -9,510,000 -12,048,000 11,741,000 155,000 -4,893,000 1,297,000  4,602,000 -257,000 -5,207,000  -1,699,000 742,000 -8,104,000  1,870,000 -7,086,000 -2,789,000  -9,281,000 -8,851,000 -8,516,000  -10,889,000 -15,081,000 -8,885,000  3,235,000 -1,302,000 -853,000 8,490,000 2,762,000 -4,780,000 -4,770,000 1,029,000 -649,000 -5,555,000 -2,199,000 2,650,000 518,000 3,544,000 2,693,000 11,502,000 4,758,000 -5,616,000 179,000 -1,270,000 -7,489,000 -9,662,000 -170,000 -2,212,000 
      prepaid expenses and other current assets
    16,222,000 -3,665,000 -17,551,000 26,214,000 -17,628,000 -14,097,000 -2,676,000 24,352,000 -11,188,000 -8,348,000 -2,164,000 6,983,000 5,749,000 926,000 -5,046,000 -9,447,000 -3,635,000 -4,487,000 -3,574,000 2,497,000 -3,056,000 -2,492,000 4,683,000 21,233,000 6,644,000 -1,857,000 -12,949,000 501,000 5,391,000 -14,122,000 12,163,000  -5,455,000 -7,248,000 -1,988,000  -3,311,000 2,346,000 2,016,000  14,737,000 -13,317,000 6,003,000  9,460,000 -1,250,000 -1,582,000  342,000 -3,496,000 2,872,000  484,000 6,045,000 1,619,000 151,000 -1,738,000 -1,679,000 2,871,000 -10,556,000 7,981,000 -3,056,000 -821,000 -9,602,000 -3,199,000 1,240,000 7,247,000 34,791,000 -17,430,000 -11,488,000 -1,899,000 -5,110,000 3,800,000 -679,000 2,605,000 -99,000 
      other non-current assets
    1,001,000 824,000 1,510,000 -1,097,000 -11,266,000 9,182,000 339,000 239,000 -590,000 -2,175,000 -6,009,000 -11,757,000 2,837,000 4,455,000 2,283,000 1,975,000 1,833,000 -6,352,000 10,419,000 2,867,000 4,719,000 3,149,000 3,000,000 6,506,000 3,804,000 3,474,000 -628,000 2,449,000 -961,000 -775,000 339,000  -166,000 -1,490,000 -321,000  19,000 30,000 -601,000  3,030,000 -76,000 -1,730,000  1,409,000 -1,719,000 -127,000  -147,000 -253,000 -115,000  -1,000 -724,000 -152,000 436,000 64,000 -210,000 85,000 30,000 -411,000 6,000 196,000 -2,327,000 -2,686,000 4,514,000 910,000 -408,000 1,491,000 -650,000 -535,000 -340,000 -3,494,000 -2,211,000 6,409,000  
      accounts payable, accrued expenses and other current liabilities
    5,782,000 15,922,000 -18,000,000 -5,360,000 6,826,000 15,070,000 -19,210,000 1,912,000 -6,242,000 -10,915,000 -4,984,000 18,146,000 13,753,000 -4,802,000 -9,754,000 -984,000 6,581,000 12,828,000 14,449,000 9,666,000 21,493,000 -48,436,000 -40,235,000 14,300,000 -16,044,000 11,023,000 5,387,000 -5,830,000 12,823,000 -6,379,000 2,974,000  3,734,000 11,349,000 8,938,000  3,594,000 -5,769,000 8,006,000  -10,265,000 21,498,000 -1,885,000  3,946,000 9,286,000 -4,438,000  11,292,000 3,408,000 -515,000  -850,000 5,257,000 2,121,000 -7,657,000 -8,609,000 7,221,000 -2,797,000 -5,613,000 6,308,000 2,845,000 3,196,000 9,718,000 3,763,000 -3,511,000 -5,420,000 -18,346,000 5,140,000 -1,881,000 -2,171,000      
      contract liabilities
    371,000 2,100,000 244,000 1,718,000 -347,000 3,667,000 -1,498,000 -13,000 -583,000   1,750,000 1,750,000      -83,000 511,000 89,000 -975,000 338,000 788,000 576,000                                                    
      other non-current liabilities
    1,760,000 1,156,000 1,388,000 -1,429,000 7,359,000 -7,911,000 1,888,000 483,000 110,000 13,070,000 -14,073,000 9,850,000 -6,170,000 -5,542,000 -2,576,000 -15,619,000 1,027,000 10,144,000 -9,662,000 2,528,000 -2,006,000 -1,127,000 -2,284,000 -2,656,000 -489,000 -3,522,000 4,608,000 -155,000 -4,246,000 4,861,000 -69,000  9,227,000 -1,100,000 -5,685,000  829,000 -690,000 -386,000  -687,000 -932,000 1,547,000  -2,358,000 -643,000 -2,309,000  -726,000 -174,000 -364,000  -1,695,000 33,000 399,000  -1,001,000 -79,000 -198,000  -7,312,000 2,280,000 -2,836,000  184,000 -280,000 402,000    1,051,000    -4,477,000  
      net cash from operating activities
    40,906,000 8,919,000 -11,257,000 50,740,000 22,485,000 40,401,000 15,756,000 58,750,000 26,770,000 28,279,000 26,156,000 85,334,000 68,313,000 66,478,000 44,344,000 69,277,000 82,779,000 91,290,000 69,081,000 80,262,000 69,639,000 33,117,000 20,814,000 89,184,000 64,241,000 48,524,000 29,484,000 42,688,000 79,251,000 36,213,000 41,531,000 11,549,000 45,242,000 28,871,000 28,882,000 6,529,000 46,767,000 43,938,000 19,171,000 37,601,000 19,349,000 18,123,000 31,619,000 20,757,000 31,075,000 16,377,000 11,254,000 11,696,000 30,808,000 2,918,000 7,846,000 -3,788,000 27,909,000 2,276,000 32,318,000 34,695,000 23,795,000 24,583,000 21,255,000 28,430,000 29,646,000 19,358,000 28,137,000 47,044,000 28,366,000 30,638,000 37,187,000 27,091,000 27,128,000 -1,975,000 20,346,000 14,593,000 10,672,000 6,479,000 15,282,000 4,550,000 
      capex
    -15,156,000 -20,146,000 -28,920,000 -29,600,000 -29,646,000 -29,707,000 -15,465,000 -24,535,000 -13,078,000 -15,548,000 -13,704,000 -14,456,000 -9,155,000 -9,407,000 -9,325,000 -27,427,000 -7,286,000 -6,634,000 -6,675,000 -8,427,000 -6,727,000 -7,217,000 -16,519,000 -22,194,000 -13,593,000 -17,664,000 -16,086,000 -25,685,000 -16,669,000 -20,000,000 -15,387,000 -7,796,000 -12,819,000 -9,191,000 -6,974,000 -8,267,000 -10,895,000 1,699,000 -13,112,000 -8,901,000 -8,775,000 -9,356,000 -11,335,000 -13,247,000 -13,622,000 -10,853,000 -19,717,000 -14,230,000 -10,412,000 -13,044,000 -12,243,000 -7,216,000 -5,922,000 -18,241,000 -7,206,000 -5,747,000 -5,944,000 -11,287,000 -5,682,000 -5,223,000 -3,046,000 -4,108,000 -3,190,000 -3,259,000 -2,844,000 -5,327,000 -6,179,000 -7,217,000 -3,849,000 -396,000 
      free cash flows
    25,750,000 -11,227,000 -40,177,000 21,140,000 -7,161,000 10,694,000 291,000 34,215,000 13,692,000 12,731,000 12,452,000 70,878,000 59,158,000 57,071,000 35,019,000 41,850,000 75,493,000 84,656,000 62,406,000 71,835,000 62,912,000 25,900,000 4,295,000 66,990,000 50,648,000 30,860,000 13,398,000 17,003,000 62,582,000 16,213,000 26,144,000 11,549,000 37,446,000 16,052,000 19,691,000 6,529,000 39,793,000 35,671,000 8,276,000 37,601,000 21,048,000 5,011,000 22,718,000 20,757,000 22,300,000 7,021,000 -81,000 11,696,000 17,561,000 -10,704,000 -3,007,000 -3,788,000 8,192,000 -11,954,000 21,906,000 21,651,000 11,552,000 17,367,000 15,333,000 10,189,000 22,440,000 13,611,000 22,193,000 35,757,000 22,684,000 25,415,000 34,141,000 22,983,000 23,938,000 -5,234,000 17,502,000 9,266,000 4,493,000 -738,000 11,433,000 4,154,000 
      investing activities:
                                                                                
      purchases of property and equipment
    -15,156,000 -20,146,000 -28,920,000 -29,600,000 -29,646,000 -29,707,000 -15,465,000 -24,535,000 -13,078,000 -15,548,000 -13,704,000 -14,456,000 -9,155,000 -9,407,000 -9,325,000 -27,427,000 -7,286,000 -6,634,000 -6,675,000 -8,427,000 -6,727,000 -7,217,000 -16,519,000 -22,194,000 -13,593,000 -17,664,000 -16,086,000 -25,685,000 -16,669,000 -20,000,000 -15,387,000  -7,796,000 -12,819,000 -9,191,000  -6,974,000 -8,267,000 -10,895,000  1,699,000 -13,112,000 -8,901,000  -8,775,000 -9,356,000 -11,335,000  -13,247,000 -13,622,000 -10,853,000  -19,717,000 -14,230,000 -10,412,000 -13,044,000 -12,243,000 -7,216,000 -5,922,000 -18,241,000 -7,206,000 -5,747,000 -5,944,000 -11,287,000 -5,682,000 -5,223,000 -3,046,000 -4,108,000 -3,190,000 -3,259,000 -2,844,000 -5,327,000 -6,179,000 -7,217,000 -3,849,000 -396,000 
      cash paid for business acquisitions, net of cash acquired
                                                                               
      purchases of short-term investments
                                                        -14,659,000 -53,248,000                      
      proceeds from maturities of short-term investments
                                                                                
      net payments from swaps designated as net investment hedges
                                                                                
      net cash from investing activities
    -15,588,000 -21,648,000 -35,920,000 -4,249,000 -10,396,000 -322,198,000 -53,965,000 -57,229,000 -7,697,000 -15,548,000 -13,704,000 -54,820,000 14,805,000 -4,498,000 -14,067,000 -27,485,000 -8,475,000 -7,917,000 -117,566,000 -35,921,000 -6,718,000 -3,949,000 -21,485,000 -20,609,000 -108,839,000 -17,414,000 -15,806,000 -25,330,000 -16,343,000 1,266,000 -9,298,000 -983,568,000 -7,107,000 -37,517,000 -193,143,000 -21,142,000 -6,707,000 -8,043,000 -6,730,000 -30,758,000 -315,448,000 -13,112,000 -5,632,000 -98,851,000 -8,775,000 -9,356,000 -246,335,000 -10,127,000 -13,394,000 -13,688,000 -13,087,000 -29,773,000 19,855,000 -5,523,000 -63,835,000 -15,575,000 -80,864,000   -19,248,000 -8,956,000 -8,168,000 -5,944,000 -67,284,000 -8,658,000   -13,138,000 -81,001,000    -6,515,000   -3,287,000 
      financing activities:
                                                                                
      proceeds from borrowings of long-term indebtedness
    603,700,000 12,900,000 54,400,000 35,400,000 21,800,000 58,800,000 370,500,000 18,200,000 131,700,000 5,000,000 10,200,000 6,500,000 11,250,000 11,750,000 11,250,000 12,050,000 11,250,000 1,600,000 600,000 20,200,000 23,600,000 14,500,000 113,200,000 21,100,000 114,600,000 34,000,000 67,200,000                                                  
      payments on debt
    -38,688,000 -15,887,000 -15,244,000 -39,943,000 -41,544,000 -90,544,000 -15,100,000 -24,700,000 -56,800,000 -16,700,000 -12,400,000 -107,800,000 -17,750,000 -11,250,000 -11,750,000 -11,250,000 -12,050,000 -100,000,000 -2,200,000 -52,500,000 -44,300,000 -344,200,000 -102,850,000 -38,250,000 -47,600,000 -57,400,000                                                  
      repayments of convertible debt
                                                                                
      payment of debt issuance costs
    -75,000       -301,000 -7,578,000       -4,083,000 -20,264,000      -167,000                    -40,000                            
      purchases of treasury stock
          -125,000,000 -150,000,000  -125,000,000      -100,000,000                                 -14,452,000 -12,002,000 -52,689,000 -4,320,000            -20,465,000 -74,994,000 -11,075,000  
      payments for contingent considerations
    -13,851,000 -2,600,000                                                                          
      proceeds from exercised stock options
    957,000 6,398,000 225,000 655,000 1,111,000 2,326,000 3,873,000 353,000 1,239,000 236,000 2,985,000 1,381,000 2,222,000 1,411,000 223,000 1,295,000 2,303,000 4,735,000 463,000 1,750,000 153,000 5,512,000 65,000 3,662,000  8,607,000 1,167,000  665,000 8,222,000 1,038,000  7,114,000 231,000  562,000 7,755,000  186,000 234,000  446,000   153,000 247,000   10,444,000 1,069,000    2,038,000 569,000 23,000  5,565,000 2,515,000 1,113,000  4,778,000 4,366,000 7,471,000  
      cash taxes paid in net equity settlement
    -199,000 -225,000 -2,136,000 -136,000 -171,000 -81,000 -3,122,000 -314,000 -214,000 -104,000 -5,231,000 -272,000 -1,142,000 -14,000,000 -9,204,000 -515,000 -442,000 -207,000 -3,637,000 -389,000 -289,000 -49,000 -4,348,000 -242,000 -60,000 -55,000 -6,157,000 -406,000 -175,000 -464,000 -6,776,000  -265,000 -370,000 -6,128,000  -298,000                                        
      net cash from financing activities
    -10,245,000 -21,139,000 35,377,000 -7,150,000 -19,915,000 -93,748,000 358,676,000 -6,890,000 -49,659,000 -10,693,000 -162,683,000 -97,699,000 -7,642,000 -13,147,000 -133,465,000     21,222,000 -33,049,000 -28,553,000 162,005,000   -13,192,000 5,393,000 -84,055,000 -39,839,000 -36,092,000 -20,886,000  286,370,000 33,324,000 185,039,000 13,763,000 -19,797,000 -24,893,000 15,811,000 -17,512,000 245,575,000 44,276,000 -13,826,000 11,740,000 -13,192,000 1,062,000 243,174,000 -488,000 184,000 19,066,000 257,000 3,202,000 460,000 21,033,000 -12,560,000 -27,107,000 36,377,000 95,322,000 -44,455,000 38,674,000 -37,004,000 6,220,000 -9,464,000 -13,109,000 -54,013,000 -76,263,000 -27,957,000 62,539,000 86,268,000 -116,272,000 121,001,000 -17,794,000 4,444,000 125,199,000 -3,364,000 39,000 
      effect of exchange rate changes on cash and cash equivalents
    -801,000 12,678,000 4,529,000 -8,123,000 7,747,000 -1,125,000 -4,963,000 8,039,000 -4,874,000 -213,000 937,000 11,909,000 -10,691,000 -8,773,000 -3,168,000 904,000 -3,230,000 2,540,000 -9,690,000 8,324,000 5,426,000 2,654,000 -2,533,000 4,347,000 -4,530,000 1,141,000 -884,000 -456,000 -849,000 -7,012,000 3,114,000  2,838,000 5,809,000 1,280,000  532,000 -1,285,000 702,000  -1,201,000 2,138,000 -4,284,000  -6,037,000 39,000 331,000  2,634,000 649,000 -2,263,000  2,024,000 -958,000 1,911,000 -2,196,000 -5,596,000 1,035,000 4,713,000 -1,925,000 5,528,000 -5,466,000 -2,946,000 -1,507,000 2,335,000 4,073,000 -97,000 -2,285,000 -394,000 -142,000 3,177,000 748,000 59,000 408,000 887,000  
      net decrease in cash and cash equivalents
       31,218,000     -35,460,000 1,825,000 -149,294,000  64,785,000 40,060,000 -106,356,000                                        -42,166,000                      
      cash and cash equivalents at beginning of period
    246,375,000 276,402,000 456,661,000 513,448,000 470,166,000 198,911,000 138,838,000 174,935,000  102,055,000  48,132,000  -260,000 71,994,000  120,614,000  96,938,000  100,808,000 128,763,000 71,891,000 183,546,000 57,339,000 22,697,000 14,086,000 
      cash and cash equivalents at end of period
    14,272,000 -21,190,000 239,104,000 31,218,000 -79,000 -376,670,000 591,906,000 2,670,000 -35,460,000 1,825,000 307,367,000 -55,276,000 64,785,000 40,060,000 407,092,000 43,217,000 72,817,000 -11,562,000 408,976,000 73,887,000 35,298,000 3,269,000 357,712,000 -9,070,000 31,897,000 19,059,000 157,025,000 -67,153,000 22,220,000 -5,625,000 189,396,000  327,343,000 30,487,000 124,113,000  20,795,000 9,717,000 77,086,000  -51,985,000 51,425,000 79,871,000  3,071,000 8,122,000 129,038,000  20,232,000 8,945,000 89,691,000  50,248,000 16,828,000 58,642,000 -10,183,000 -26,288,000 32,925,000 104,354,000 45,931,000 -10,786,000 11,944,000 81,674,000 -34,856,000 -31,970,000 -46,913,000 185,630,000 74,207,000 32,001,000 -121,675,000 199,013,000 -72,159,000 8,660,000 91,509,000 29,329,000 15,392,000 
      purchases of short term investments
     -1,502,000 -7,000,000                                                                         
      net decrease increase in cash and cash equivalents
                                                                                
      net increase in cash and cash equivalents
      -7,271,000    315,504,000         43,217,000 72,817,000 -11,562,000 -61,190,000 73,887,000 35,298,000 3,269,000 158,801,000 -9,070,000 31,897,000 19,059,000 18,187,000 -67,153,000 22,220,000 -5,625,000 14,461,000 -307,008,000 327,343,000 30,487,000 22,058,000 -5,543,000 20,795,000 9,717,000 28,954,000                            2,084,000    141,674,000    6,632,000 1,306,000 
      lease incentive
                                                                                
      gain on disposal of property and equipment and construction in-progress
                                                                                
      gain from the sale of businesses
                                                                               
      purchases of intangible assets
                                                                                
      proceeds from sale of business
                                                                                
      acquired in-process research and development and intangibles
                                                                                
      proceeds from sales of property and equipment
                                                                                
      net proceeds on swaps designated as net investment hedges
                                                                                
      purchase of treasury stock
                                                                                
      gain on disposal of property and equipment
        72,000 1,253,000 12,000  100,000 -81,000 -23,000                            61,000    -19,000                                  
      cash (paid) for business acquisitions, net of cash acquired
                                                                               
      proceeds from maturities of short term investments
                                                                                
      net proceeds from swaps designated as net investment hedges
                                                                               
      payments for contingent consideration
                                                                               
      deferred income tax provision
         -1,844,000 -2,856,000  1,237,000 -227,000 1,953,000  -6,103,000 3,998,000 3,544,000                               -2,066,000 1,563,000      -630,000 -1,571,000 -983,000                -1,852,000    -1,024,000  
      purchases of investments
         -10,497,000 -38,500,000                                                                      
      net (decrease) in cash and cash equivalents
                                                                                
      gain from the sale of business
                   169,000 230,000 679,000 -42,876,000                                                          
      acquired in-process research and development milestone
                -4,742,000                                                             
      non-cash in-process research and development expense
                           5,027,000                                                     
      accretion of bond issuance discount
                       4,340,000 4,295,000 4,251,000 2,529,000                                                      
      net proceeds (payments) on swaps designated as net investment hedges
                                                                                
      purchase of option hedge on convertible notes
                       -104,248,000                                                    
      proceeds from convertible notes issuance
                       575,000,000                                                      
      proceeds from sale of stock purchase warrants
                       1,000 44,562,000                                                    
      proceeds from sale of property and equipment
                        9,000 3,268,000 34,000  1,000 35,000  93,000 57,000 148,000  14,000                                            
      proceeds from sale of businesses
                                                                                
      proceeds from sale of extremity orthopedics business
                   -1,268,000 191,736,000                                                          
      loss on disposal of property and equipment and construction in-progress
                                                                                
      proceeds from note receivable
                           257,000 250,000 245,000 231,000 233,000 225,000 221,000                                              
      acquired in-process research and development
                          -5,000,000                                                     
      net cash (used) provided by financing activities
                    1,743,000 -97,475,000 -3,015,000                                                          
      cash (paid) provided for business acquisitions, net of cash acquired
                     -1,283,000 -302,627,000                                                          
      income tax expense
                       -68,922,000                                                         
      cash from business acquisitions, net of cash acquired
                                                               -1,007,000                 
      net proceeds(payments) on swaps designated as net investment hedges
                                                                                
      net cash paid for contingent consideration
                                                                                
      proceeds from the issuance of common stock, net of issuance costs
                               -9,000                                                
      deferred income tax benefit/provision
                          5,068,000                                                      
      amortization of debt issuance costs
                           1,306,000 1,371,000 1,356,000 1,357,000 1,317,000 1,296,000 2,138,000 1,519,000  394,000 391,000 393,000  387,000 620,000 616,000  585,000 530,000 530,000  817,000 635,000 608,000  613,000 549,000 545,000  623,000 720,000 760,000 757,000 792,000   425,000                 
      realized loss on sale of short-term investments
                                                                                
      gain on divestiture of business
                                                                                
      proceeds from sale of short-term investments
                                    6,975,000 9,976,000                                          
      proceeds from divestiture of business
                                                                                
      debt issuance costs
                                                           -59,000                   
      deferred income tax
                            -1,459,000 -2,234,000 -6,843,000  1,212,000 1,213,000 -1,636,000  203,000 -1,145,000 7,000  -2,277,000 -1,584,000 942,000  30,930,000 464,000 1,184,000                       -1,431,000 -419,000          
      change in fair value of contingent consideration and other
                            -184,000 194,000  300,000 535,000 379,000  -778,000 -2,256,000 261,000                                          
      changes in assets and liabilities, net of business acquisitions:
                                                                                
      net cash paid for financing liabilities from business acquisitions
                                                                               
      net cash (used in) / provided by financing activities
                                                                                
      cash from business acquisitions
                                                                               
      deferred revenue
                              -188,000 1,615,000 -20,000    -678,000 832,000 1,251,000  -1,129,000 983,000 1,527,000  620,000 -36,000 -769,000  881,000 167,000 21,000  708,000 -113,000 391,000  -624,000 245,000 -534,000 920,000 292,000 -480,000 -628,000 110,000 148,000 -259,000 -456,000 -309,000 364,000 -153,000 -191,000 -799,000 562,000 -891,000 756,000 -2,125,000 596,000 -609,000 -933,000 19,000 
      non-cash interest expense
                                        2,132,000 2,104,000 2,064,000  2,130,000 1,885,000 1,859,000  1,823,000 1,767,000 1,666,000  1,633,000 1,622,000 1,610,000  1,788,000 2,968,000 3,528,000 3,472,000 3,487,000 1,998,000 1,634,000 1,606,000 1,578,000 1,888,000 2,053,000 2,038,000 2,334,000 2,765,000 2,762,000          
      payment of accreted interest
                                                                -1,396,000 -1,273,000 -1,178,000 -1,544,000          
      change in restricted cash
                                        4,165,000                                      
      payment of liability component of convertible notes
                                                                                
      payment of capital lease obligation
                                                                                
      realized loss on sale of short-term investment
                                                                               
      borrowings under senior credit facility
                                25,000,000 25,000,000  326,383,000 35,000,000 210,000,000  15,000,000  510,000,000    150,000,000 235,000,000  10,000,000      10,000,000 50,000,000   30,000,000       60,000,000 80,000,000 120,000,000 36,000,000 39,000,000  
      repayments under senior credit facility
                                -45,000,000 -380,000,000 -35,000,000  -35,000,000 -10,000,000 -20,000,000  -20,000,000 -26,875,000 -1,875,000  -433,750,000 -15,000,000          1,000 -12,813,000 -22,812,000 -1,875,000 -146,875,000 -41,875,000 -1,875,000 -15,000,000 -40,000,000            
      cash from business acquisition
                                  5,720,000                      690,000 -2,692,000 -175,000                      
      net cash paid for financing liability from business acquisition
                                  -7,772,000                                              
      net cash provided (used in) by financing activities
                                                                                
      effect of exchange rate fluctuations on cash
                                                                                
      cash from business acquisition, net of cash acquired
                                    192,000 -31,816,000 -193,928,000          -235,000,000  -150,000 -64,000 -2,766,000      -68,621,000        -645,000 -138,000 -4,003,000  -77,811,000 -27,000 -6,000  -368,000 -33,731,000 -2,324,000  
      cash received from business acquisition purchase price adjustment
                                        1,000                                        
      principal payments under capital lease obligations
                                        -164,000 -163,000 -160,000  -157,000 -218,000 -178,000  -125,000 -123,000 -122,000                              
      net cash received for contingent consideration
                                                                                
      income from discontinued operations, net of tax
                                                                                
      change in fair value of contingent consideration
                                        -170,000 120,000 131,000  120,000 114,000 125,000                                  
      net cash from operating activities of continuing operations
                                        46,767,000 43,938,000 19,171,000                                      
      net cash from operating activities of discontinued operations
                                                                                
      sale of property and equipment
                                            1,438,000                                  
      net cash from investing activities of continuing operations
                                        -6,707,000 -8,043,000 -6,730,000                                      
      net cash from investing activities of discontinued operations
                                                                                
      repayment of 2016 convertible notes
                                                                                
      distribution to seaspine
                                                                                
      excess tax benefits from stock-based compensation arrangements
                                          -1,808,000  -177,000 -2,380,000 -1,121,000  -43,000 -623,000 -541,000  -38,000 -79,000 -23,000  -14,000 -415,000 -3,000 -4,000 -66,000 -725,000 -53,000 -105,000 -1,000 -562,000 -2,912,000 -6,000 -7,000 1,000 -8,000 -228,000 -703,000 -593,000 -66,000 -430,000 -405,000 -135,000 -254,000  
      loss (income) from discontinued operations, net of tax
                                                                                
      proceeds from working capital purchase price adjustment
                                             1,831,000                                  
      net change in cash and cash equivalents
                                             51,425,000 7,877,000  3,071,000 8,122,000 8,424,000  20,232,000 8,945,000 -7,247,000  50,248,000    -26,288,000 32,925,000 -24,409,000  -10,786,000 11,944,000 9,783,000  -31,970,000    32,001,000    8,660,000    
      (gain) from change in fair value of contingent consideration
                                                120,000                                
      sales of property and equipment
                                                    3,000 -2,000 532,000                          
      maturities of short-term investments
                                                                                
      other
                                                          277,000             18,000 238,000 325,000   -11,000 
      proceeds from liability component of convertible notes
                                                                               
      proceeds from equity component of convertible notes
                                                                               
      sales of short-term investments
                                                                                
      proceeds from liability component of convertible notes issuance
                                                                                
      proceeds from equity component of convertible notes issuance
                                                                                
      repurchase of liability component of convertible notes
                                                                 -17,128,000 -16,058,000 -16,831,000 -27,988,000          
      proceeds from exercise of stock options
                                                          250,000    1,687,000    2,624,000              
      in-process research and development
                                                                              
      gain on convertible note repurchases
                                                                                
      other liabilities
                                                                                
      proceeds from the sale of stock purchase warrants
                                                                               
      amortization of bond issuance costs
                                                              517,000   317,000 357,000 447,000 519,000 610,000 824,000 605,000 608,000 608,000 610,000 590,000 585,000 146,000 91,000  
      refundable income taxes
                                                                                
      gain on bond repurchases
                                                                    207,000            
      purchase of intangible assets
                                                                                
      gain on sale of assets/investments
                                                                                
      income taxes payable
                                                                          4,755,000 11,068,000 -8,955,000 -2,750,000 1,872,000  
      proceeds from issuance of convertible notes
                                                                              
      purchase option hedge on convertible notes
                                                                              
      convertible note issuance and other financing costs
                                                                           -2,000     
      proceeds from exercised stock options and warrants
                                                                               1,434,000 
      cash paid during the year for interest
                                                                                
      cash paid during the year for income taxes
                                                                                
      supplemental non-cash disclosure:
                                                                                
      acquisition fees included in liabilities
                                                                                
      property and equipment purchases included in liabilities
                                                                                
      repayment of loans
                                                                          -178,000    -39,014,000  
      gain on bond repurchase
                                                                      -1,213,000          
      net cash (used in) investing activities
                                                                      -7,049,000    -2,850,000    -6,173,000  
      (gain) loss on sale of assets/investments
                                                                           52,000     
      amortization of discount/premium on investments
                                                                                
      proceeds from the sales of investments
                                                                                
      purchases of available for sale investments
                                                                                
      cash from acquisitions, net of cash acquired
                                                                                
      repayment of convertible notes and credit facility
                                                                                
      gain on sale of assets
                                                                                
      proceeds from sale of assets
                                                                            32,000    
      repayment of loans and credit facility
                                                                          77,000 -69,000    
      convertible note issuance costs
                                                                                
      derivative loss
                                                                                
      accounts payable
                                                                                
      other accrued expenses and current liabilities
                                                                                
      deferred tax liabilities
                                                                                
      proceeds from sales/maturities of investments
                                                                                
      purchases of available-for-sale investments
                                                                               -2,891,000 
      (gain) loss on sale of assets
                                                                                
      impairment of fixed assets
                                                                                
      derivative gain
                                                                              168,000  
      accounts payable accrued expenses and other liabilities
                                                                              -6,559,000  
      proceeds from sales/maturities of available-for-sale investments
                                                                                
      loss on sale of assets/investments
                                                                                
      accounts payable, accrued expenses and other liabilities
                                                                               342,000 
      net cash (used in)/provided by investing activities
                                                                                
      fees paid in connection with bank line of credit
                                                                                
      repayment of bank loans
                                                                                
      gain on sale of product line and investments
                                                                                
      non-current assets
                                                                               301,000 
      customer advances and deposits
                                                                               2,390,000 
      proceeds from sale of product line and other assets
                                                                                
      proceeds from sale/maturity of investments
                                                                                
      net proceeds from revolving credit facility
                                                                               770,000 
      repayment of term loan
                                                                               -625,000 
      repayment of note payable
                                                                               -1,540,000 
      proceeds from sale of preferred stock
                                                                                
      preferred dividends paid
                                                                                
      effect of exchange rate changes on cash
                                                                               4,000 
      non-cash investing activities:
                                                                                
      note issued in a business acquisition
                                                                                
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