0001562762-22-000244 | 10-Q | XBRL Viewer

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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2022	May 06, 2022
Document and Entity Information [Abstract]
Document Quarterly Report	true
Document Transition Report	false
Document Type	10-Q
Document Period End Date	Mar. 31, 2022
Entity Registrant Name	GLOBUS MEDICAL, INC.
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Title of 12(b) Security	Class A Common Stock, par value $.001 per share
Trading Symbol	GMED
Security Exchange Name	NYSE
Entity File Number	001-35621
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-3744954
Entity Address, Address Line One	2560 General Armistead Avenue
Entity Address, City or Town	Audubon
Entity Address, State or Province	PA
Entity Address, Postal Zip Code	19403
City Area Code	610
Local Phone Number	930-1800
Amendment Flag	false
Entity Common Stock, Shares Outstanding		101,750,825
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001237831
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 229,789	$ 193,069
Short-term marketable securities	243,505	250,378
Accounts receivable, net of allowances of $4,186 and $4,962, respectively	166,222	164,436
Inventories	253,886	237,001
Prepaid expenses and other current assets	19,587	18,417
Income taxes receivable	3,609	1,215
Total current assets	916,598	864,516
Property and equipment, net of accumulated depreciation of $313,514 and $305,575, respectively	227,541	221,076
Long-term marketable securities	546,881	562,475
Intangible assets, net	64,385	68,660
Goodwill	179,045	179,708
Other assets	34,307	36,334
Deferred income taxes	29,937	24,494
Total assets	1,998,694	1,957,263
Current liabilities:
Accounts payable	26,093	21,955
Accrued expenses	75,531	91,168
Income taxes payable	16,525	1,046
Business acquisition liabilities	11,535	11,770
Deferred revenue	11,807	12,025
Payable to broker		2,200
Total current liabilities	141,491	140,164
Business acquisition liabilities, net of current portion	56,501	58,755
Deferred income taxes	3,811	4,314
Other liabilities	11,519	12,642
Total liabilities	213,322	215,875
Commitments and contingencies (Note 15)
Equity:
Additional paid-in capital	570,082	553,787
Accumulated other comprehensive income/(loss)	(17,167)	(6,772)
Retained earnings	1,232,356	1,194,272
Total equity	1,785,372	1,741,388
Total liabilities and equity	1,998,694	1,957,263
Common Class A [Member]
Equity:
Common stock	79	79
Common Class B [Member]
Equity:
Common stock	$ 22	$ 22

Condensed Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Accounts receivable, allowances	$ 4,186	$ 4,962
Property and equipment
Accumulated depreciation	$ 313,514	$ 305,575
Equity:
Common stock, shares authorized	775,000,000
Common Class A [Member]
Equity:
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	500,000,000	500,000,000
Common stock, shares issued	79,297,823	79,113,916
Common stock, shares outstanding	79,297,823	79,113,916
Common Class B [Member]
Equity:
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	275,000,000	275,000,000
Common stock, shares issued	22,430,097	22,430,097
Common stock, shares outstanding	22,430,097	22,430,097

Condensed Consolidated Statements of Operations and Comprehensive Income - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Condensed Consolidated Statements of Operations and Comprehensive Income [Abstract]
Net sales	$ 230,549	$ 227,344
Cost of goods sold	59,167	55,027
Gross profit	171,382	172,317
Operating expenses:
Research and development	17,412	14,924
Selling, general and administrative	100,748	97,891
Provision for litigation	2,341	(94)
Amortization of intangibles	4,512	4,774
Acquisition related costs	(76)	274
Total operating expenses	124,937	117,769
Operating income/(loss)	46,445	54,548
Other income/(expense), net:
Interest income/(expense), net	2,543	2,712
Foreign currency transaction gain/(loss)	(391)	(280)
Other income/(expense)	301	214
Total other income/(expense), net	2,453	2,646
Income/(loss) before income taxes	48,898	57,194
Income tax provision	10,814	11,865
Net income/(loss)	38,084	45,329
Other comprehensive income/(loss), net of tax:
Unrealized gain/(loss) on marketable securities	(8,828)	(1,666)
Foreign currency translation gain/(loss)	(1,567)	(4,113)
Total other comprehensive income/(loss), net of tax	(10,395)	(5,779)
Comprehensive income/(loss)	$ 27,689	$ 39,550
Earnings per share:
Basic	$ 0.37	$ 0.45
Diluted	$ 0.37	$ 0.44
Weighted average shares outstanding:
Basic	101,600	99,866
Diluted	104,077	102,420

Condensed Consolidated Statements of Equity - USD ($) shares in Thousands, $ in Thousands	Common Stock [Member] Common Class A [Member]	Common Stock [Member] Common Class B [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income/(Loss) [Member]	Retained Earnings [Member]	Total
Shares, Outstanding, Beginning Balance at Dec. 31, 2020	77,284	22,430
Total equity, beginning of period at Dec. 31, 2020	$ 77	$ 22	$ 457,161	$ 3,955	$ 1,045,082	$ 1,506,297
Stock-based compensation			7,883			7,883
Grant of restricted stock units			163			163
Exercise of stock options (shares)	303
Exercise of stock options	$ 1		9,100			9,101
Comprehensive income/(loss)				(5,779)	45,329	39,550
Total equity, end of period at Mar. 31, 2021	$ 78	$ 22	474,307	(1,824)	1,090,411	1,562,994
Shares, Outstanding, Ending Balance at Mar. 31, 2021	77,587	22,430
Shares, Outstanding, Beginning Balance at Dec. 31, 2021	79,114	22,430
Total equity, beginning of period at Dec. 31, 2021	$ 79	$ 22	553,787	(6,772)	1,194,272	1,741,388
Stock-based compensation			8,353			8,353
Grant of restricted stock units			196			$ 196
Exercise of stock options (shares)	184					184
Exercise of stock options			7,746			$ 7,746
Comprehensive income/(loss)				(10,395)	38,084	27,689
Total equity, end of period at Mar. 31, 2022	$ 79	$ 22	$ 570,082	$ (17,167)	$ 1,232,356	$ 1,785,372
Shares, Outstanding, Ending Balance at Mar. 31, 2022	79,298	22,430

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
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-Topic 825
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-Paragraph 28
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Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
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-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

+ Details

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net income	$ 38,084	$ 45,329
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	16,837	17,157
Amortization of premium (discount) on marketable securities	1,690	520
Write-down for excess and obsolete inventories, net	1,834	1,550
Stock-based compensation expense	8,152	7,698
Allowance for doubtful accounts	(728)	80
Change in fair value of business acquisition liabilities	(263)	258
Change in deferred income taxes	(2,994)	(808)
(Gain)/loss on disposal of assets, net	115	103
Payment of business acquisition related liabilities	(743)
(Increase)/decrease in:
Accounts receivable	(1,614)	(20,346)
Inventories	(17,939)	(3,997)
Prepaid expenses and other assets	547	4,516
Increase/(decrease) in:
Accounts payable	4,160	4,212
Accrued expenses and other liabilities	(15,428)	(4,783)
Income taxes payable/receivable	12,980	12,081
Net cash provided by/(used in) operating activities	44,690	63,570
Cash flows from investing activities:
Purchases of marketable securities	(142,145)	(185,110)
Maturities of marketable securities	106,549	39,850
Sales of marketable securities	42,673	33,818
Purchases of property and equipment	(19,971)	(13,672)
Acquisition of businesses, net of cash acquired, and purchases of intangible and other assets	(1,000)
Net cash provided by/(used in) investing activities	(13,894)	(125,114)
Cash flows from financing activities:
Payment of business acquisition liabilities	(1,699)	(1,537)
Proceeds from exercise of stock options	7,746	9,101
Net cash provided by/(used in) financing activities	6,047	7,564
Effect of foreign exchange rates on cash	(123)	(569)
Net increase in cash and cash equivalents	36,720	(54,549)
Cash and cash equivalents at beginning of period	193,069	239,397
Cash and cash equivalents at end of period	229,789	184,848
Supplemental disclosures of cash flow information:
Income taxes paid	572	570
Purchases of property and equipment included in accounts payable and accrued expenses	$ 4,105	$ 2,620

BACKGROUND	3 Months Ended
BACKGROUND	Mar. 31, 2022
BACKGROUND [Abstract]
Background	NOTE 1. BACKGROUND (a) The Company Globus Medical, Inc., together with its subsidiaries, is a medical device company that develops and commercializes healthcare solutions with a mission to improve the quality of life of patients with musculoskeletal disorders. We are primarily focused on implants that promote healing in patients with musculoskeletal disorders, including the use of a robotic guidance and navigation system and products to treat patients who have experienced orthopedic traumas. We are an engineering-driven company with a history of rapidly developing and commercializing advanced products and procedures to assist surgeons in effectively treating their patients and to address new treatment options. With over 220 products launched, we offer a comprehensive portfolio of innovative and differentiated technologies that address a variety of musculoskeletal pathologies, anatomies, and surgical approaches. We are headquartered in Audubon, Pennsylvania, and we market and sell our products through our exclusive sales force in the United States, as well as within North, Central & South America, Europe, Asia, Africa and Australia. Our sales force consists of direct sales representatives and distributor sales representatives employed by exclusive independent distributors. The terms the “Company,” “Globus,” “we,” “us” and “our” refer to Globus Medical, Inc. and, where applicable, our consolidated subsidiaries. (b) COVID-19 Pandemic Impact In March 2020, the World Health Organization declared the novel strain of coronavirus (“COVID-19”) a global pandemic and recommended containment and mitigation measures worldwide. COVID-19 has significantly impacted the economic conditions in the U.S. and globally as federal, state and local governments react to the public health crisis, creating significant uncertainties in the economy. Although the Company cannot reasonably estimate the length or severity of the impact that COVID-19 will have on its financial results, the Company may experience a material adverse impact on its sales, results of operations, and cash flows in 2022 should there be a resurgence impacting hospitals, surgical facilities, our internal operations, or our suppliers. In response to these developments, the Company will continue to monitor liquidity and cash flow. The Company has the ability to borrow from its existing credit facility, if needed, although we do not expect to do so due to our cash, cash equivalents and short-term marketable securities balances.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

3 Months Ended

Mar. 31, 2022

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES [Abstract]

Summary Of Significant Accounting Policies

NOTE 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

(a) Basis of Presentation

The accompanying interim unaudited condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in complete financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the consolidated financial statements and accompanying footnotes included in our Annual Report on Form 10-K for the year ended December 31, 2021.

In the opinion of management, these condensed consolidated financial statements include all adjustments necessary, which are of a normal and recurring nature, for the fair presentation of our financial position as of March 31, 2022, and results of operations for the three months ended March 31, 2022. The results of operations for any interim period may not be indicative of results for the full year.

(b) Principles of Consolidation

The accompanying unaudited condensed consolidated financial statements include the accounts of Globus and its wholly-owned subsidiaries. All intercompany balances and transactions are eliminated in consolidation.

The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We base our estimates, in part, on historical experience that management believes to be reasonable under the circumstances. Actual results could differ from those estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the condensed consolidated financial statements in the period they are determined to be necessary.

Significant areas that require estimates include revenue recognition, intangible assets, business acquisition liabilities, allowance for doubtful accounts, stock-based compensation, reserves for excess and obsolete inventory, useful lives of assets, the outcome of litigation, recoverability of intangible assets and income taxes. We are subject to risks and uncertainties due to changes in the healthcare environment, regulatory oversight, competition, and legislation that may cause actual results to differ from estimated results.

(d) Revenue Recognition

Revenue is recognized upon transfer of control of promised products or services to customers in an amount that reflects the consideration we expect to receive in exchange for those products or services. Sales and other taxes we collect concurrent with revenue-producing activities are excluded from revenue. For purposes of disclosure, we disaggregate our revenue into two categories, Musculoskeletal Solutions and Enabling Technologies. Our Musculoskeletal Solutions products consist primarily of the implantable devices, disposables, and unique instruments used in an expansive range of spine, orthopedic trauma, hip, knee and extremity procedures. The majority of our Musculoskeletal Solutions contracts have a single performance obligation and revenue is recognized at a point in time. Our Enabling Technologies products are advanced hardware and software systems, and related technologies that are designed to enhance a surgeon’s capabilities and streamline surgical procedures by making them less invasive, more accurate, and more reproducible to improve patient care. The majority of our Enabling Technologies product contracts contain multiple performance obligations, including maintenance and support, and revenue is recognized as we fulfill each performance obligation. When contracts have multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our policy is to classify shipping and handling costs billed to customers as sales and the related expenses as cost of goods sold.

Nature of Products and Services

A significant portion of our Musculoskeletal Solutions product revenue is generated from consigned inventory maintained at hospitals or with sales representatives. Revenue from the sale of consigned musculoskeletal products is recognized when we transfer control, which generally occurs at the time the product is used or implanted. For all other Musculoskeletal Solutions product transactions, we recognize revenue when we transfer title to the goods, provided there are no remaining performance obligations that can affect the customer’s final acceptance of the sale.

Revenue from the sale of Enabling Technologies products is generally recognized when control transfers to the customer which occurs at the time the product is shipped or delivered. Any revenue related to the provision of maintenance and support is recognized as we satisfy the performance obligation. We use an observable price to determine the stand-alone selling price for each separate performance obligation.

Contract Balances

Timing of revenue recognition may differ from the timing of invoicing to customers. We record a receivable when revenue is recognized prior to invoicing, or deferred revenue when revenue is recognized subsequent to invoicing.

Deferred revenue is comprised mainly of unearned revenue related to the sales of certain Enabling Technologies products, which includes maintenance and support services. Maintenance and support services are generally invoiced annually, at the beginning of each contract period, and revenue is recognized ratably over the maintenance period. For the three months ended March 31, 2022, there was an immaterial amount of revenue recognized from previously deferred revenue.

(e) Cash and Cash Equivalents

The Company considers all short-term, highly liquid investments with original maturities of 90 days or less at acquisition date to be cash equivalents. Cash equivalents, which consist of money market accounts, commercial paper and corporate debt securities are stated at fair value.

(f) Marketable Securities

Our marketable securities include municipal bonds, corporate debt securities, commercial paper, asset-backed securities, and securities of government, federal agency, and other sovereign obligations and are classified as available-for-sale as of March 31, 2022. Short-term and long-term marketable securities are recorded at fair value on our condensed consolidated balance sheets. Any change in fair value of our available-for-sale securities, that do not result in recognition or reversal of an allowance for credit loss or write-down, are recorded, net of taxes, as a component of accumulated other comprehensive income or loss on our condensed consolidated balance sheets. Premiums and discounts are recognized over the life of the related security as an adjustment to yield using the straight-line method. Realized gains or losses from the sale of marketable securities are determined on a specific identification basis. Realized gains and losses, interest income and the amortization/accretion of premiums/discounts are included in other income/(expense), net, on our condensed consolidated statements of operations and comprehensive income. Interest receivable is recorded in prepaid expenses and other current assets on our condensed consolidated balance sheets.

We invest in securities that meet or exceed standards as defined in our investment policy. Our policy also limits the amount of credit exposure to any one issue, issuer or type of security. We review declines in the fair value of our securities to determine whether they are resulting from expected credit losses or other factors. If the assessment indicates a credit loss exists, we recognize any measured impairment as an allowance for credit loss in our condensed consolidated statements of operations. Any other impairments not recorded through allowance for credit losses is recognized in our other comprehensive income.

(g) Fair Value Measurements

Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis

Fair value is defined as the price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or the liability in an orderly transaction between market participants on the measurement date. Additionally, a fair value hierarchy was established that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets and liabilities and the lowest priority to unobservable inputs. The level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement.

Our assets and liabilities measured at fair value on a recurring basis are classified and disclosed in one of the following three categories:

Level 1—quoted prices (unadjusted) in active markets for identical assets and liabilities;

Level 2—observable inputs other than quoted prices in active markets for identical assets and liabilities; and

Level 3—unobservable inputs in which there is little or no market data available, which require the reporting entity to use significant unobservable inputs or valuation techniques.

Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis

The purchase price of business acquisitions is primarily allocated to the tangible and identifiable intangible assets acquired and liabilities assumed based on their estimated fair values on the acquisition date, with the excess recorded as goodwill. We utilize Level 3 inputs in the determination of the initial fair value.

Contingent consideration represents contingent milestone, performance and revenue-sharing payment obligations related to acquisitions and is measured at fair value, based on significant inputs that are not observable in the market, which represents a Level 3 measurement within the fair value hierarchy. The valuation of contingent consideration uses assumptions we believe would be made by a market participant. We assess these assumptions on an ongoing basis as additional data impacting the assumptions is obtained. The fair value of contingent consideration recorded in business acquisition liabilities on our condensed consolidated balance sheets, and changes in the fair value of contingent consideration are recognized in acquisition related costs in the condensed consolidated statements of operations and comprehensive income. The fair value of contingent restricted stock unit (“RSU”) grants are recorded as additional paid-in capital in the consolidated balance sheet on the day of the grant due to the remote likelihood of forfeiture.

(h) Inventories

Inventories are stated at the lower of cost or net realizable value. Cost is determined on a first-in, first-out basis. The majority of our inventory is finished goods and we utilize both in-house manufacturing and third-party suppliers to produce our products. We periodically evaluate the carrying value of our inventories in relation to estimated forecasts of product demand, which takes into consideration the life cycle of product releases. When quantities on hand exceed estimated sales forecasts, we record a write-down for such excess inventories. Once inventory has been written down, it creates a new cost basis for inventory that is not subsequently written up.

(i) Goodwill and Intangible Assets

Goodwill represents the excess of purchase price over the fair values of the identifiable assets acquired less the liabilities assumed in the acquisition of a business. Goodwill is tested for impairment at least annually or whenever events or circumstances indicate that a carrying amount may not be recoverable. Goodwill is tested for impairment at the reporting unit level by comparing the reporting unit’s carrying amount to the estimated fair value of the reporting unit. Fair values are estimated using an income and discounted cash flow approach. We perform our annual impairment test of goodwill in the fourth quarter of each year. We consider qualitative indicators of the fair value of a reporting unit when it is unlikely that a reporting unit has impaired goodwill. During the three months ended March 31, 2022 and 2021, we did not record any impairment charges related to goodwill.

Intangible assets consist of purchased in-process research and development (“IPR&D”), developed technology, supplier network, patents, customer relationships, re-acquired rights, and non-compete agreements. Intangible assets with finite useful lives are amortized over the period of estimated benefit using the straight-line method and estimated useful lives ranging from one to sixteen years. Intangible assets with finite useful lives are tested whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If an impairment is indicated, we measure the amount of the impairment loss as the amount by which the carrying amount exceeds the fair value of the asset. Fair value is generally determined using a discounted future cash flow analysis. There were no impairments of finite-lived intangible assets during the three months ended March 31, 2022 or 2021.

IPR&D has an indefinite life and is not amortized until completion of the project at which time the IPR&D becomes an amortizable asset. Intangible assets with indefinite useful lives are tested for impairment annually or whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable If the related project is not completed in a timely manner, we may have an impairment related to the IPR&D, calculated as the excess of the asset’s carrying value over its fair value. There were no impairments of IPR&D during the three months ended March 31, 2022 or 2021.

(j) Stock-Based Compensation

The cost of employee and non-employee director awards is measured at the grant date fair value of the award and is recognized as expense over the requisite service period, which is generally the vesting period of the equity award. Compensation expense for awards includes the impact of forfeiture in the period when they occur.

We estimate the fair value of stock options utilizing the Black-Scholes option-pricing model. Inputs to the Black-Scholes model include our stock price, expected volatility, expected term, risk-free interest rate and expected dividends. Expected volatility is based on the historical volatility of the Company’s common stock over the most recent period commensurate with the estimated expected term of the Company’s stock options offering period which is derived from historical experience. The risk-free interest rate assumption is based on observed interest rates of U.S. Treasury securities appropriate for the expected terms of the stock options. The dividend yield assumption is based on the history and expectation of no dividend payouts. The fair value of restricted stock units is estimated on the date of the grant using the closing price of the Company’s common stock.

(k) Recently Issued Accounting Pronouncements

None applicable.

(l) Recently Adopted Accounting Pronouncements

On March 12, 2020, the FASB issued ASU No. 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU is effective for all entities as of March 12, 2020, and will apply through December 31, 2022. To date, we have had no impacts on our investment portfolio or our credit agreement with Citizens Bank, N.A. related to reference rate reform. We

will continue to evaluate the impact this guidance could have on our condensed consolidated financial statements and related disclosures.

ASSET ACQUISITIONS AND BUSINESS COMBINATIONS

3 Months Ended

Mar. 31, 2022

ASSET ACQUISITIONS AND BUSINESS COMBINATIONS [Abstract]

Asset Acquisitions And Business Combinations

NOTE 3. ASSET ACQUISITIONS AND BUSINESS COMBINATIONS

Asset Acquisitions

During the fourth quarter of 2021, the Company acquired substantially all the assets of Capstone Surgical Technologies, LLC (“Capstone”), which engages in the business of advanced drill and robotic surgery platforms. The purchase price consisted of $24.5 million of cash paid at closing, subject to net working capital and other post-closing adjustments, if applicable. The transaction also provides for additional consideration contingent upon the developed products obtaining approval from the U.S. Food and Drug Administration (the “FDA”) of up to $15.0 million, and additional consideration of up to $10.0 million contingent upon the achievement of certain performance milestones. Contingent consideration is not recorded in an asset acquisition until the milestone is met.

Also during the fourth quarter of 2021, the Company acquired substantially all the assets of a company that engages in the development of technology for use in robotic surgery platforms which was not considered material to the consolidated financial statements during the periods presented. The purchase price consisted of $10.0 million of cash paid at closing and also provides for additional consideration of $5.0 million contingent upon the achievement of certain performance milestones. Contingent consideration is not recorded in an asset acquisition until the milestone is met.

During the second quarter of 2020, the Company acquired Synoste Oy (“Synoste”), a Finnish engineering company that specializes in the research and development of a limb lengthening system. The fair value of the net assets acquired was $25.3 million, and the consideration consisted of approximately $22.8 million of cash paid at closing plus $2.5 million of a contractual holdback obligation payable eighteen months from the closing date of the transaction, subject to net working capital and other post-closing adjustments, if applicable. During the fourth quarter of 2021, the contractual holdback and net working capital and other post-closing adjustments were settled for $2.7 million. The transaction also provides for additional consideration of $8.0 million contingent upon the developed product obtaining approval from the U.S. Food and Drug Administration (the “FDA”) within the third anniversary, or $4.0 million if within the fourth anniversary of the acquisition closing date, respectively. Contingent consideration is not recorded in an asset acquisition until the milestone is met.

The Company accounted for each of these transactions as asset acquisitions because substantially all of the fair value of the assets acquired in each transaction was concentrated in a single identified asset, in-process research and development (“IPR&D”) of the acquired technology, thus satisfying the requirements of the screen test in ASU 2017-1. At the date of the acquisitions, the Company determined that the development of the projects underway had not yet reached technological feasibility and that the research in process had no alternative future use. Accordingly, the acquired IPR&D of $34.3 million and $24.4 million was charged to research and development expense in the condensed consolidated statements of operations and comprehensive income for years ended 2021 and 2020, respectively.

Business Combinations

During 2021, the Company completed three acquisitions that were not considered material, individually or collectively, to the condensed consolidated financial statements during the periods presented. Two acquisitions were completed in the third quarter, while the third acquisition was completed in the fourth quarter. These acquisitions have been included in the condensed consolidated financial statements from the date of acquisition. The purchase price of the acquisition in the fourth quarter consisted of approximately $0.3 million of cash paid at closing and $13.0 million of contingent consideration payments, resulting in goodwill of $13.3 million based on the estimated fair values. The combined purchase price of the two acquisitions in the third quarter consisted of approximately $12.6 million of contingent consideration payments. The Company recorded other intangible assets of $1.6 million, with a weighted average useful life of 3.8 years, and goodwill of $11.0 million based on their estimated fair values. The contingent payments for all three acquisitions are based upon achieving various performance milestones over a period of 10 years and are payable in a combination of cash and RSUs.

During the fourth quarter of 2020, the Company completed two acquisitions that were not considered material, individually or collectively, to the overall consolidated financial statements during the periods presented. These acquisitions have been included in the condensed consolidated financial statements from the date of acquisition. The combined purchase price consisted of approximately $1.5 million of cash paid at closing, plus $0.3 million of other liabilities and $33.2 million of contingent consideration payments. The contingent payments are based upon achieving various performance milestones over a period of 10 years and are payable in a combination of cash and RSUs. The Company recorded other intangible assets of $8.8 million, with a weighted average useful life of 4.2 years, and goodwill of $26.2 million based on their fair values.

NET SALES

3 Months Ended

Mar. 31, 2022

NET SALES [Abstract]

Net Sales

NOTE 4. NET SALES

The following table represents net sales by product category:



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Musculoskeletal Solutions	$	217,402	$	212,416
Enabling Technologies		13,147		14,928
Total net sales	$	230,549	$	227,344

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
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-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Paragraph 12
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
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-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=123351226&loc=SL49130554-203045

+ Details

MARKETABLE SECURITIES

3 Months Ended

Mar. 31, 2022

MARKETABLE SECURITIES [Abstract]

Marketable Securities

NOTE 5. MARKETABLE SECURITIES

The composition of our short-term and long-term marketable securities was as follows:



	March 31, 2022
(In thousands)	Amortized ‎Cost		Gross ‎Unrealized ‎Gains		Gross Unrealized Losses		Fair ‎Value
Short-term:
Municipal bonds	$	41,252	$	9	$	(110)	$	41,151
Corporate debt securities		147,401		57		(927)		146,531
Commercial paper		36,251		—		(42)		36,209
Asset-backed securities		6,603		11		—		6,614
Government, federal agency, and other sovereign obligations		13,070		—		(70)		13,000
Total short-term marketable securities	$	244,577	$	77	$	(1,149)	$	243,505

Long-term:
Municipal bonds	$	101,483	$	4	$	(2,255)	$	99,232
Corporate debt securities		341,254		76		(7,442)		333,888
Asset-backed securities		102,013		19		(1,926)		100,106
Government, federal agency, and other sovereign obligations		14,032		—		(377)		13,655
Total long-term marketable securities	$	558,782	$	99	$	(12,000)	$	546,881



	December 31, 2021
(In thousands)	Amortized ‎Cost		Gross ‎Unrealized ‎Gains		Gross ‎Unrealized ‎Losses		Fair ‎Value
Short-term:
Municipal bonds	$	66,379	$	99	$	(11)	$	66,467
Corporate debt securities		107,102		434		(65)		107,471
Commercial paper		38,252		2		(1)		38,253
Asset-backed securities		12,931		58		—		12,989
Government, federal agency, and other sovereign obligations		25,231		—		(33)		25,198
Total short-term marketable securities	$	249,895	$	593	$	(110)	$	250,378

Long-term:
Municipal bonds	$	91,185	$	4	$	(409)	$	90,780
Corporate debt securities		324,492		351		(1,318)		323,525
Asset-backed securities		128,139		101		(578)		127,662
Government, federal agency, and other sovereign obligations		20,539		—		(31)		20,508
Total long-term marketable securities	$	564,355	$	456	$	(2,336)	$	562,475

The short-term marketable securities have effective maturity dates of less than one year and the long-term marketable securities have effective maturity dates ranging from one to three years as of March 31, 2022 and December 31, 2021, respectively.

Purchases of marketable securities include amounts payable to brokers of $2.2 million as of December 31, 2021. Purchases of marketable securities included no amounts payable to brokers as of March 31, 2022.

FAIR VALUE MEASUREMENTS

3 Months Ended

Mar. 31, 2022

FAIR VALUE MEASUREMENTS [Abstract]

Fair Value Measurements

NOTE 6. FAIR VALUE MEASUREMENTS

Assets and liabilities measured at fair value on a recurring basis included the following:



(In thousands)	Balance at March 31, 2022		Level 1		Level 2		Level 3
Assets:
Cash equivalents	$	61,945	$	44,491	$	17,454	$	—
Municipal bonds		140,383		—		140,383		—
Corporate debt securities		480,419		—		480,419		—
Commercial paper		36,209		—		36,209		—
Asset-backed securities		106,720		—		106,720		—
Government, federal agency, and other sovereign obligations		26,655		—		26,655		—
Liabilities:
Business acquisition liabilities		68,036		—		—		68,036



(In thousands)	Balance at December 31, 2021		Level 1		Level 2		Level 3
Assets:
Cash equivalents	$	26,684	$	3,768	$	22,916	$	—
Municipal bonds		157,247		—		157,247		—
Corporate debt securities		430,996		—		430,996		—
Commercial paper		38,253		—		38,253		—
Asset-backed securities		140,651		—		140,651		—
Government, federal agency, and other sovereign obligations		45,706		—		45,706		—
Liabilities:
Business acquisition liabilities		70,525		—		—		70,525

Our marketable securities are classified as Level 2 within the fair value hierarchy, as we measure their fair value using market prices for similar instruments and inputs such as actual trade data, benchmark yields, broker/dealer quotes and other similar data obtained from quoted market prices or independent pricing vendors.

Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis

Fair value of the revenue-based business acquisition liabilities was determined using a discounted cash flow model and an option pricing model. The significant inputs of such models are not observable in the market, such as certain financial metric growth rates, volatility and discount rates, market price risk adjustment, projections associated with the applicable milestone, the interest rate, and the related probabilities and payment structure in the contingent consideration arrangement.

The following are the significant unobservable inputs used in the two valuation techniques:


Unobservable input	Range			Weighted Average*
Revenue risk premium	2.4%	-	4.9%	3.0%
Revenue volatility	14.0%	-	15.8%	14.8%
Discount rate	1.2%	-	8.5%	3.3%
Projected year of payment	2022	-	2031

* The weighted average rates were calculated based on the relative fair value of each business acquisition liability.

The change in the carrying value of the business acquisition liabilities during the three months ended March 31, 2022 and 2021, respectively included the following:



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Beginning balance	$	70,525	$	37,270
Contingent cash payments		(2,412)		(1,492)
Contingent RSU grants		(196)		(163)
Changes in fair value of business acquisition liabilities		(263)		258
Contractual payable reclassification		382		148
Ending balance	$	68,036	$	36,021

Changes in the fair value of business acquisition liabilities are driven by changes in market conditions and the achievement of certain performance conditions.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

INVENTORIES

3 Months Ended

Mar. 31, 2022

INVENTORIES [Abstract]

Inventories

NOTE 7. INVENTORIES

Inventories included the following:



	March 31,		December 31,
(In thousands)	2022		2021
Raw materials	$	48,894	$	41,819
Work in process		17,591		17,401
Finished goods		187,401		177,781
Total inventories	$	253,886	$	237,001

During the three months ended March 31, 2022 and 2021, net adjustments to cost of sales related to excess and obsolete inventory were $1.8 million and $1.6 million, respectively. The net adjustments for the three months ended March 31, 2022 and 2021 reflect a combination of additional expense for excess and obsolete related provisions ($3.4 million and $3.8 million, respectively) offset by sales and disposals ($1.6 million and $2.2 million, respectively) of inventory for which an excess and obsolete provision was provided previously through expense recognized in prior periods.

PROPERTY AND EQUIPMENT

3 Months Ended

Mar. 31, 2022

PROPERTY AND EQUIPMENT [Abstract]

PROPERTY AND EQUIPMENT

NOTE 8. PROPERTY AND EQUIPMENT

Property and equipment included the following:



	Useful	March 31,		December 31,
(In thousands)	Life	2022		2021
Land	—	$	8,286	$	8,296
Buildings and improvements	31.5		46,718		44,672
Equipment	5-15		117,052		113,301
Instruments	5		289,427		285,762
Modules and cases	5		45,047		44,185
Other property and equipment	3-5		34,525		30,435
			541,055		526,651
Less: accumulated depreciation			(313,514)		(305,575)
Total		$	227,541	$	221,076

Instruments are hand-held devices used by surgeons to install implants during surgery. Modules and cases are used to store and transport the instruments and implants.

Depreciation expense related to property and equipment was as follows:



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Depreciation	$	12,325	12,384

GOODWILL AND INTANGIBLE ASSETS

3 Months Ended

Mar. 31, 2022

GOODWILL AND INTANGIBLE ASSETS [Abstract]

Goodwill and Intangible Assets

NOTE 9. GOODWILL AND INTANGIBLE ASSETS

The change in the carrying amount of goodwill during the twelve months ended December 31, 2021 and the three months ended March 31, 2022, respectively included the following:



(In thousands)
December 31, 2020	$	156,716
Additions and adjustments		24,251
Foreign exchange		(1,259)
December 31, 2021		179,708
Foreign exchange		(663)
March 31, 2022	$	179,045

The composition of intangible assets was as follows:



		March 31, 2022
(In thousands)	Weighted Average Amortization Period (in years)	Gross ‎Carrying ‎Amount		Accumulated ‎Amortization		Intangible ‎Assets, ‎net
Supplier network	10.0	$	4,000	$	(2,967)	$	1,033
Customer relationships & other intangibles	6.4		53,971		(37,940)		16,031
Developed technology	8.0		72,584		(30,761)		41,823
Patents	16.1		8,863		(3,365)		5,498
Total intangible assets		$	139,418	$	(75,033)	$	64,385



		December 31, 2021
(In thousands)	Weighted Average Amortization Period (in years)	Gross ‎Carrying ‎Amount		Accumulated ‎Amortization		Intangible ‎Assets, ‎net
Supplier network	10.0	$	4,000	$	(2,867)	$	1,133
Customer relationships & other intangibles	6.4		56,264		(37,842)		18,422
Developed technology	8.0		71,947		(28,545)		43,402
Patents	16.1		8,938		(3,235)		5,703
Total intangible assets		$	141,149	$	(72,489)	$	68,660

The following table summarizes amortization of intangible assets for future periods as of March 31, 2022:


(In thousands)	Annual ‎Amortization
Remaining 2022	$	13,588
2023		16,061
2024		13,255
2025		8,969
2026		5,525
Thereafter		6,987
Total	$	64,385

ACCRUED EXPENSES

3 Months Ended

Mar. 31, 2022

ACCRUED EXPENSES [Abstract]

Accrued Expenses

NOTE 10. ACCRUED EXPENSES

Accrued expense included the following:



	March 31,		December 31,
(In thousands)	2022		2021
Compensation and other employee-related costs	$	40,802	$	52,407
Legal and other settlements and expenses		3,997		6,124
Accrued non-income taxes		6,791		6,415
Royalties		3,864		4,558
Rebates		8,920		8,725
Other		11,157		12,939
Total accrued expenses	$	75,531	$	91,168

DEBT

3 Months Ended

Mar. 31, 2022

DEBT [Abstract]

Debt

NOTE 11. DEBT

Line of Credit

In August 2020, we entered into a credit agreement with Citizens Bank, N.A. (the “Credit Agreement”) that provides a revolving credit facility permitting borrowings up to $125.0 million (as amended, the “Revolving Credit Facility”), and has a termination date of August 3, 2022. The Revolving Credit Facility includes up to a $25.0 million sub limit for letters of credit. Revolving loans under the Credit Agreement will bear interest, at the Company’s option, at either a base rate or the Adjusted LIBOR Rate (as defined in the Credit Agreement), plus, in each case, an applicable margin, as determined in accordance with the provisions of the Credit Agreement. The base rate will be the highest of: the rate of interest announced publicly by Citizens Bank, N.A. from time to time as its “prime rate”; the federal funds effective rate plus 1/2 of 1%; and the Adjusted LIBOR Rate for a one-month period plus 1%. The applicable margin is subject to adjustment as provided in the Credit Agreement. The Credit Agreement contains financial and other customary covenants, including a maximum leverage ratio. As of March 31, 2022, we have not borrowed under the Credit Agreement.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-URI http://asc.fasb.org/topic&trid=2208564

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

EQUITY

3 Months Ended

Mar. 31, 2022

EQUITY [Abstract]

Equity

NOTE 12. EQUITY

Stock Repurchases

In March 2020, the Company announced a stock repurchase plan, pursuant to which the Company was authorized to repurchase up to $200 million of the Company’s Class A common stock. In March 2022, the Company announced the expansion of the stock repurchase plan, pursuant to which the Company is authorized to repurchase an additional $200 million of the Company’s Class A common stock. The repurchase program has no time limit and may be suspended for periods or discontinued at any time. As of March 31, 2022, $295.3 million of this authorization is remaining. The timing and actual number of shares repurchased will depend on various factors including price, corporate and regulatory requirements, debt covenant requirements, alternative investment opportunities and other market conditions. Funding of share repurchases is expected to come from operating cash flows and excess cash.

Shares repurchased by the Company are accounted for under the constructive retirement method, in which the shares repurchased, are immediately retired, as there is no plan to reissue. The Company made an accounting policy election to charge the excess of repurchase price over par value entirely to retained earnings.

The following table summarizes the activity related to share repurchases:

(In thousands except for per share prices)


Period	Total number of shares repurchased	Average Price Paid per Share		Dollar amount of shares repurchased ⁽¹⁾		Approximate dollar value of shares that may yet be purchased under the plan
January 1, 2020 - March 31, 2020	1,920	$	38.49	$	73,902	$	126,098
April 1, 2020 - June 30, 2020	771		39.95		30,804		95,294
July 1, 2020 - September 30,2020	—		—		—		95,294
October 1, 2020 - December 31, 2020	—		—		—		95,294
January 1, 2021 - March 31, 2021	—		—		—		95,294
April 1, 2021 - June 30, 2021	—		—		—		95,294
July 1, 2021 - September 30, 2021	—		—		—		95,294
October 1, 2021 - December 31, 2021	—		—		—		95,294
January 1, 2022 - March 31, 2022	—		—		—	$	295,294
January 1, 2020 - March 31, 2022	2,691	$	38.91	$	104,706

⁽¹⁾ Inclusive of an immaterial amount of commission fees

Common Stock

Our amended and restated Certificate of Incorporation provides for a total of 775,000,000 authorized shares of common stock. Of the authorized number of shares of common stock, 500,000,000 shares are designated as Class A common stock (“Class A Common”), and 275,000,000 shares are designated as Class B common stock (“Class B Common”).

The holders of Class A Common are entitled to one vote for each share of Class A Common held. The holders of Class B Common are entitled to 10 votes for each share of Class B Common held. The holders of Class A Common and Class B Common vote together as one class of common stock on all matters submitted to a vote of stockholders, except as required by law or our amended and restated Certificate of Incorporation. Each share of our Class B common stock is convertible at any time at the option of the holder into one share of our Class A common stock. In addition, each share of our Class B common stock will convert automatically into one share of our Class A common stock upon any transfer, whether or not for value, except for permitted transfers. For more details relating to the conversion of our Class B common stock please see “Exhibit 4.2, Description of Securities of the Registrant” filed with our Annual Report on Form 10-K on February 17, 2022.

Accumulated Other Comprehensive Income (Loss)

The tables below present the changes in each component of accumulated other comprehensive income/(loss), including current period other comprehensive income/(loss) and reclassifications out of accumulated other comprehensive income/(loss) for the three months ended March 31, 2022 and 2021, respectively:


(In thousands)	Unrealized loss on marketable securities, net of tax		Foreign currency translation adjustments		Accumulated other comprehensive loss
Accumulated other comprehensive income/(loss), net of tax, at December 31, 2021	$	(1,053)	$	(5,719)	$	(6,772)
Other comprehensive income/(loss) before reclassifications		(11,596)		(1,567)		(13,163)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax		2,768		—		2,768
Other comprehensive income/(loss), net of tax		(8,828)		(1,567)		(10,395)
Accumulated other comprehensive income/(loss), net of tax, at March 31, 2022	$	(9,881)	$	(7,286)	$	(17,167)


(In thousands)	Unrealized loss on marketable securities, net of tax		Foreign currency translation adjustments		Accumulated other comprehensive loss
Accumulated other comprehensive income/(loss), net of tax, at December 31, 2020	$	5,001	$	(1,046)	$	3,955
Other comprehensive income/(loss) before reclassifications		(2,178)		(4,113)		(6,291)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax		512		—		512
Other comprehensive income/(loss), net of tax		(1,666)		(4,113)		(5,779)
Accumulated other comprehensive income/(loss), net of tax, at March 31, 2021	$	3,335	$	(5,159)	$	(1,824)

Amounts reclassified from accumulated other comprehensive loss, net of tax, related to unrealized gains/losses on marketable securities were released to other income, net in our condensed consolidated statements of operations and comprehensive income.

Earnings Per Common Share

The Company computes basic earnings per share using the weighted-average number of common shares outstanding during the period. Diluted earnings per share assumes the conversion, exercise or issuance of all potential common stock equivalents, unless the effect of inclusion would be anti-dilutive. For purposes of this calculation, common stock equivalents include the Company’s stock options and unvested RSUs. The contingently issuable shares are included in basic net income per share as of the date that all necessary conditions have been satisfied and are included in the denominator for dilutive calculation for the entire period if such shares would be issuable as of the end of the reporting period assuming the end of the reporting period was the end of the contingency period.

The following table sets forth the computation of basic and diluted earnings per share:


	Three Months Ended
	March 31,
(In thousands, except per share amounts)	2022		2021
Numerator:
Net income/(loss)	$	38,084	$	45,329
Denominator for basic and diluted net income per share:
Weighted average shares outstanding for basic		101,600		99,866
Dilutive stock options and RSUs		2,477		2,554
Weighted average shares outstanding for diluted		104,077		102,420
Earnings per share:
Basic	$	0.37	$	0.45
Diluted	$	0.37	$	0.44

Anti-dilutive stock options and RSUs excluded from the calculation		3,378		3,034

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

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+ Details

STOCK-BASED AWARDS

3 Months Ended

Mar. 31, 2022

STOCK-BASED AWARDS [Abstract]

Stock-Based Awards

NOTE 13. STOCK-BASED AWARDS

We have two stock plans: our 2012 Equity Incentive Plan (the “2012 Plan”) and our 2021 Equity Incentive Plan (the “2021 Plan”). The 2021 Plan is the only active stock plan. The purpose of the 2012 Plan was, and of the 2021 Plan is, to provide incentive to employees, directors, and consultants of Globus. The Plans are administered by the Board of Directors of Globus (the “Board”) or its delegates. The number, type of option, exercise price, and vesting terms are determined by the Board or its delegates in accordance with the terms of the Plans. The options granted expire on a date specified by the Board, which is generally not more than ten years from the grant date. Options granted to employees generally vest in varying installments over a four-year period.

The 2012 Plan was approved by our Board in March 2012, and by our stockholders in June 2012. The 2012 Plan terminated pursuant to its terms in 2022. Following the effectiveness of our 2021 Equity Incentive Plan, we have not issued any additional awards under the 2012 Plan; however, awards previously granted under the 2012 Plan remain outstanding and are administered by our Board of Directors under the terms and conditions of the 2012 Plan. Under the 2012 Plan, the aggregate number of shares of Class A Common stock that were able to be issued subject to options and other awards is equal to the sum of (i) 3,076,923 shares, (ii) any shares available for issuance under the 2008 Plan as of March 13, 2012, (iii) any shares underlying awards outstanding under the 2008 Plan as of March 13, 2012 that, on or after that date, are forfeited, terminated, expired or lapse for any reason, or are settled for cash without delivery of shares and (iv) starting January 1, 2013, an annual increase in the number of shares available under the 2012 Plan equal to up to 3% of the number of shares of our common and preferred stock outstanding at the end of the previous year, as determined by our Board. The number of shares that were able to be issued or transferred pursuant to incentive stock options under the 2012 Plan was limited to 10,769,230 shares. The shares of Class A Common stock covered by the 2012 Plan included authorized but unissued shares, treasury shares or shares of common stock purchased on the open market.

The 2021 Plan was approved by our Board in March 2021, and by our stockholders in June 2021. Under the 2021 Plan, the aggregate number of shares of Class A Common stock that were able to be issued subject to options and other awards is equal to the sum of (i) 2,000,000 shares, (ii) any shares available for issuance under the 2012 Plan as of June 3, 2021 and (iii) any shares underlying awards outstanding under the 2012 Plan or 2021 Plan as of June 3, 2021 that, on or after that date, are forfeited, terminated, expired or lapse for any reason, or are settled for cash without delivery of shares. The number of shares that may be issued or transferred pursuant to incentive stock options under the 2021 Plan is limited to 2,000,000 shares. The shares of Class A Common stock covered by the 2021 Plan include authorized but unissued shares, treasury shares or shares of common stock purchased on the open market.

As of March 31, 2022, pursuant to the 2021 Plan, there were 3,247,276 shares of Class A Common stock reserved and 1,333,253 shares of Class A Common stock available for future grants.

Stock Options

Stock option activity during the three months ended March 31, 2022 is summarized as follows:



	Option ‎Shares (thousands)	Weighted ‎average ‎exercise ‎price		Weighted ‎average ‎remaining ‎contractual ‎life (years)	Aggregate ‎intrinsic ‎value ‎(thousands)
Outstanding at December 31, 2021	9,462	$	48.01
Granted	1,339		64.24
Exercised	(184)		44.57
Forfeited	(138)		56.51
Outstanding at March 31, 2022	10,479	$	50.05	7.1	$	251,187
Exercisable at March 31, 2022	5,260	$	41.60	5.9	$	169,290
Expected to vest at March 31, 2022	5,219	$	58.57	8.4	$	81,897

The total intrinsic value of stock options exercised was $4.7 million and $10.1 million during the three months ended March 31, 2022, and 2021, respectively.

The fair value of the options was estimated on the date of the grant using a Black-Scholes option pricing model with the following assumptions:



	Three Months Ended
	March 31,
	2022			2021
Risk-free interest rate	1.46%	-	1.95%	0.40%	-	0.81%
Expected term (years)	4.8			4.8
Expected volatility		34.0%			34.0%
Expected dividend yield		—%			—%

The weighted average grant date fair value of stock options granted during the three months ended March 31, 2022, and 2021 was $20.48 and $19.26 per share, respectively.

Restricted Stock Units

Restricted stock unit activity during the three months ended March 31, 2022 is summarized as follows:


	Restricted Stock ‎Units (thousands)	Weighted ‎average ‎grant date fair value ‎per share		Weighted ‎average ‎remaining ‎contractual ‎life (years)
Outstanding at December 31, 2021	29	$	72.54
Granted	2		70.94
Vested	—		—
Forfeited	—		—
Outstanding at March 31, 2022	31	$	72.40	8.5

Stock-Based Compensation

Compensation expense related to stock options granted to employees and non-employees under the Plans was as follows:



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Stock-based compensation expense	$	8,152	$	7,698
Net stock-based compensation capitalized into inventory		201		185
Total stock-based compensation cost	$	8,353	$	7,883

As of March 31, 2022, there was $78.8 million of unrecognized compensation expense related to unvested employee stock options that are expected to vest over a weighted average period of approximately three years.

INCOME TAXES

3 Months Ended

Mar. 31, 2022

INCOME TAXES [Abstract]

Income Taxes

NOTE 14. INCOME TAXES

In computing our income tax provision, we make certain estimates and judgments, such as estimated annual taxable income or loss, annual effective tax rate, the nature and timing of permanent and temporary differences between taxable income for financial reporting and tax reporting, and the recoverability of deferred tax assets. Our estimates and assumptions may change as new events occur, additional information is obtained, or as the tax environment changes. Should facts and circumstances change during a quarter causing a material change to the estimated effective income tax rate, a cumulative adjustment is recorded.

The following table provides a summary of our effective tax rate for the three months ended March 31, 2022 and 2021, respectively:


	Three Months Ended
	March 31,
	2022	2021
Effective income tax rate	22.1%	20.7%

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

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+ Details

COMMITMENTS AND CONTINGENCIES

3 Months Ended

Mar. 31, 2022

COMMITMENTS AND CONTINGENCIES [Abstract]

Commitments and Contingencies

NOTE 15. COMMITMENTS AND CONTINGENCIES

We are involved in a number of proceedings, legal actions, and claims arising in the ordinary course of business. Such matters are subject to many uncertainties, and the outcomes of these matters are not within our control and may not be known for prolonged periods of time. In some actions, the claimants seek damages, as well as other relief, including injunctions prohibiting us from engaging in certain activities, which, if granted, could require significant expenditures and/or result in lost revenues. We record a liability in the condensed consolidated financial statements for these actions when a loss is considered probable and the amount can be reasonably estimated. If the reasonable estimate of a probable loss is a range, and no amount in the range is a better estimate than any other, the minimum amount of the range is accrued. If a loss is reasonably possible, but not probable, and the amount can be reasonably estimated, the estimated loss or range of loss is disclosed. In most cases, significant judgment is required to estimate the amount and timing of a loss. While it is not possible to predict the outcome for most of the matters discussed, we believe it is possible that costs associated with them could have a material adverse impact on our consolidated earnings, financial position or cash flows.

Moskowitz Family LLC Litigation

On November 20, 2019, Moskowitz Family LLC filed suit against us in the U.S. District Court for the Western District of Texas for patent infringement. Moskowitz, a non-practicing entity, alleges that Globus willfully infringes one or more claims of six patents by making, using, offering for sale or selling the COALITION^®, COALITION MIS^®, COALITION AGX^®, CORBEL^®, MONUMENT^®, MAGNIFY^®-S, HEDRON IA^TM, HEDRON IC^®, INDEPENDENCE^®, INDEPENDENCE MIS^®, INDEPENDENCE MIS AGX^®, FORTIFY^®and XPAND^® families, SABLE^®, RISE^®, RISE^® INTRALIF, RISE^®-L, ELSA^®, ELSA^® ATP, ALTERA^®, ARIEL^®, CALIBER^® and CALIBER^®-L products. Moskowitz seeks monetary damages and injunctive relief. On July 2, 2020, this suit was transferred from the U.S. District Court for the Western District of Texas to the U.S. District Court for the Eastern District of Pennsylvania. The outcome of this litigation cannot be determined, nor can we estimate a range of potential loss, therefore, we have not recorded a liability related to this litigation as of March 31, 2022.

SEGMENT AND GEOGRAPHIC INFORMATION

3 Months Ended

Mar. 31, 2022

SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]

Segment and Geographic Information

NOTE 16. SEGMENT AND GEOGRAPHIC INFORMATION

Operating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. We manage our business globally within one operating segment, and segment information is consistent with how the chief operating decision makers review the business, makes investing and resource allocation decisions and assesses operating performance.

The following table represents total net sales by geographic area, based on the location of the customer:



	Three Months Ended
	March 31,
(In thousands)	2022		2021
United States	$	196,403	$	193,317
International		34,146		34,027
Total net sales	$	230,549	$	227,344

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policy)	3 Months Ended
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policy)	Mar. 31, 2022
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim unaudited condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial statements and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, certain information and footnote disclosures normally included in complete financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”). As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the consolidated financial statements and accompanying footnotes included in our Annual Report on Form 10-K for the year ended December 31, 2021. In the opinion of management, these condensed consolidated financial statements include all adjustments necessary, which are of a normal and recurring nature, for the fair presentation of our financial position as of March 31, 2022, and results of operations for the three months ended March 31, 2022. The results of operations for any interim period may not be indicative of results for the full year.
Principles of Consolidation	Principles of Consolidation The accompanying unaudited condensed consolidated financial statements include the accounts of Globus and its wholly-owned subsidiaries. All intercompany balances and transactions are eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. We base our estimates, in part, on historical experience that management believes to be reasonable under the circumstances. Actual results could differ from those estimates. Estimates and assumptions are periodically reviewed and the effects of revisions are reflected in the condensed consolidated financial statements in the period they are determined to be necessary. Significant areas that require estimates include revenue recognition, intangible assets, business acquisition liabilities, allowance for doubtful accounts, stock-based compensation, reserves for excess and obsolete inventory, useful lives of assets, the outcome of litigation, recoverability of intangible assets and income taxes. We are subject to risks and uncertainties due to changes in the healthcare environment, regulatory oversight, competition, and legislation that may cause actual results to differ from estimated results.
Revenue Recognition	Revenue Recognition Revenue is recognized upon transfer of control of promised products or services to customers in an amount that reflects the consideration we expect to receive in exchange for those products or services. Sales and other taxes we collect concurrent with revenue-producing activities are excluded from revenue. For purposes of disclosure, we disaggregate our revenue into two categories, Musculoskeletal Solutions and Enabling Technologies. Our Musculoskeletal Solutions products consist primarily of the implantable devices, disposables, and unique instruments used in an expansive range of spine, orthopedic trauma, hip, knee and extremity procedures. The majority of our Musculoskeletal Solutions contracts have a single performance obligation and revenue is recognized at a point in time. Our Enabling Technologies products are advanced hardware and software systems, and related technologies that are designed to enhance a surgeon’s capabilities and streamline surgical procedures by making them less invasive, more accurate, and more reproducible to improve patient care. The majority of our Enabling Technologies product contracts contain multiple performance obligations, including maintenance and support, and revenue is recognized as we fulfill each performance obligation. When contracts have multiple performance obligations, we allocate the contract’s transaction price to each performance obligation using our best estimate of the standalone selling price of each distinct good or service in the contract. Our policy is to classify shipping and handling costs billed to customers as sales and the related expenses as cost of goods sold. Nature of Products and Services A significant portion of our Musculoskeletal Solutions product revenue is generated from consigned inventory maintained at hospitals or with sales representatives. Revenue from the sale of consigned musculoskeletal products is recognized when we transfer control, which generally occurs at the time the product is used or implanted. For all other Musculoskeletal Solutions product transactions, we recognize revenue when we transfer title to the goods, provided there are no remaining performance obligations that can affect the customer’s final acceptance of the sale. Revenue from the sale of Enabling Technologies products is generally recognized when control transfers to the customer which occurs at the time the product is shipped or delivered. Any revenue related to the provision of maintenance and support is recognized as we satisfy the performance obligation. We use an observable price to determine the stand-alone selling price for each separate performance obligation. Contract Balances Timing of revenue recognition may differ from the timing of invoicing to customers. We record a receivable when revenue is recognized prior to invoicing, or deferred revenue when revenue is recognized subsequent to invoicing. Deferred revenue is comprised mainly of unearned revenue related to the sales of certain Enabling Technologies products, which includes maintenance and support services. Maintenance and support services are generally invoiced annually, at the beginning of each contract period, and revenue is recognized ratably over the maintenance period. For the three months ended March 31, 2022, there was an immaterial amount of revenue recognized from previously deferred revenue.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all short-term, highly liquid investments with original maturities of 90 days or less at acquisition date to be cash equivalents. Cash equivalents, which consist of money market accounts, commercial paper and corporate debt securities are stated at fair value.
Marketable Securities	Marketable Securities Our marketable securities include municipal bonds, corporate debt securities, commercial paper, asset-backed securities, and securities of government, federal agency, and other sovereign obligations and are classified as available-for-sale as of March 31, 2022. Short-term and long-term marketable securities are recorded at fair value on our condensed consolidated balance sheets. Any change in fair value of our available-for-sale securities, that do not result in recognition or reversal of an allowance for credit loss or write-down, are recorded, net of taxes, as a component of accumulated other comprehensive income or loss on our condensed consolidated balance sheets. Premiums and discounts are recognized over the life of the related security as an adjustment to yield using the straight-line method. Realized gains or losses from the sale of marketable securities are determined on a specific identification basis. Realized gains and losses, interest income and the amortization/accretion of premiums/discounts are included in other income/(expense), net, on our condensed consolidated statements of operations and comprehensive income. Interest receivable is recorded in prepaid expenses and other current assets on our condensed consolidated balance sheets. We invest in securities that meet or exceed standards as defined in our investment policy. Our policy also limits the amount of credit exposure to any one issue, issuer or type of security. We review declines in the fair value of our securities to determine whether they are resulting from expected credit losses or other factors. If the assessment indicates a credit loss exists, we recognize any measured impairment as an allowance for credit loss in our condensed consolidated statements of operations. Any other impairments not recorded through allowance for credit losses is recognized in our other comprehensive income.
Fair Value Measurements	Fair Value Measurements Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis Fair value is defined as the price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or the liability in an orderly transaction between market participants on the measurement date. Additionally, a fair value hierarchy was established that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets and liabilities and the lowest priority to unobservable inputs. The level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. Our assets and liabilities measured at fair value on a recurring basis are classified and disclosed in one of the following three categories: Level 1—quoted prices (unadjusted) in active markets for identical assets and liabilities; Level 2—observable inputs other than quoted prices in active markets for identical assets and liabilities; and Level 3—unobservable inputs in which there is little or no market data available, which require the reporting entity to use significant unobservable inputs or valuation techniques. Assets and Liabilities That Are Measured at Fair Value on a Nonrecurring Basis The purchase price of business acquisitions is primarily allocated to the tangible and identifiable intangible assets acquired and liabilities assumed based on their estimated fair values on the acquisition date, with the excess recorded as goodwill. We utilize Level 3 inputs in the determination of the initial fair value. Contingent consideration represents contingent milestone, performance and revenue-sharing payment obligations related to acquisitions and is measured at fair value, based on significant inputs that are not observable in the market, which represents a Level 3 measurement within the fair value hierarchy. The valuation of contingent consideration uses assumptions we believe would be made by a market participant. We assess these assumptions on an ongoing basis as additional data impacting the assumptions is obtained. The fair value of contingent consideration recorded in business acquisition liabilities on our condensed consolidated balance sheets, and changes in the fair value of contingent consideration are recognized in acquisition related costs in the condensed consolidated statements of operations and comprehensive income. The fair value of contingent restricted stock unit (“RSU”) grants are recorded as additional paid-in capital in the consolidated balance sheet on the day of the grant due to the remote likelihood of forfeiture.
Inventories	Inventories Inventories are stated at the lower of cost or net realizable value. Cost is determined on a first-in, first-out basis. The majority of our inventory is finished goods and we utilize both in-house manufacturing and third-party suppliers to produce our products. We periodically evaluate the carrying value of our inventories in relation to estimated forecasts of product demand, which takes into consideration the life cycle of product releases. When quantities on hand exceed estimated sales forecasts, we record a write-down for such excess inventories. Once inventory has been written down, it creates a new cost basis for inventory that is not subsequently written up.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill represents the excess of purchase price over the fair values of the identifiable assets acquired less the liabilities assumed in the acquisition of a business. Goodwill is tested for impairment at least annually or whenever events or circumstances indicate that a carrying amount may not be recoverable. Goodwill is tested for impairment at the reporting unit level by comparing the reporting unit’s carrying amount to the estimated fair value of the reporting unit. Fair values are estimated using an income and discounted cash flow approach. We perform our annual impairment test of goodwill in the fourth quarter of each year. We consider qualitative indicators of the fair value of a reporting unit when it is unlikely that a reporting unit has impaired goodwill. During the three months ended March 31, 2022 and 2021, we did not record any impairment charges related to goodwill. Intangible assets consist of purchased in-process research and development (“IPR&D”), developed technology, supplier network, patents, customer relationships, re-acquired rights, and non-compete agreements. Intangible assets with finite useful lives are amortized over the period of estimated benefit using the straight-line method and estimated useful lives ranging from one to sixteen years. Intangible assets with finite useful lives are tested whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable. If an impairment is indicated, we measure the amount of the impairment loss as the amount by which the carrying amount exceeds the fair value of the asset. Fair value is generally determined using a discounted future cash flow analysis. There were no impairments of finite-lived intangible assets during the three months ended March 31, 2022 or 2021. IPR&D has an indefinite life and is not amortized until completion of the project at which time the IPR&D becomes an amortizable asset. Intangible assets with indefinite useful lives are tested for impairment annually or whenever events or circumstances indicate that a carrying amount of an asset (asset group) may not be recoverable If the related project is not completed in a timely manner, we may have an impairment related to the IPR&D, calculated as the excess of the asset’s carrying value over its fair value. There were no impairments of IPR&D during the three months ended March 31, 2022 or 2021.
Stock-Based Compensation	Stock-Based Compensation The cost of employee and non-employee director awards is measured at the grant date fair value of the award and is recognized as expense over the requisite service period, which is generally the vesting period of the equity award. Compensation expense for awards includes the impact of forfeiture in the period when they occur. We estimate the fair value of stock options utilizing the Black-Scholes option-pricing model. Inputs to the Black-Scholes model include our stock price, expected volatility, expected term, risk-free interest rate and expected dividends. Expected volatility is based on the historical volatility of the Company’s common stock over the most recent period commensurate with the estimated expected term of the Company’s stock options offering period which is derived from historical experience. The risk-free interest rate assumption is based on observed interest rates of U.S. Treasury securities appropriate for the expected terms of the stock options. The dividend yield assumption is based on the history and expectation of no dividend payouts. The fair value of restricted stock units is estimated on the date of the grant using the closing price of the Company’s common stock.
Recently Issued Accounting Pronouncements & Recently Adopted Accounting Pronouncements	(k) Recently Issued Accounting Pronouncements None applicable. (l) Recently Adopted Accounting Pronouncements On March 12, 2020, the FASB issued ASU No. 2020-04, Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional expedients and exceptions for applying generally accepted accounting principles to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another reference rate expected to be discontinued. The ASU is effective for all entities as of March 12, 2020, and will apply through December 31, 2022. To date, we have had no impacts on our investment portfolio or our credit agreement with Citizens Bank, N.A. related to reference rate reform. We will continue to evaluate the impact this guidance could have on our condensed consolidated financial statements and related disclosures.

NET SALES (Tables)

3 Months Ended

Mar. 31, 2022

NET SALES [Abstract]

Schedule of Net Sales by Product Category



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Musculoskeletal Solutions	$	217,402	$	212,416
Enabling Technologies		13,147		14,928
Total net sales	$	230,549	$	227,344

MARKETABLE SECURITIES (Tables)

3 Months Ended

Mar. 31, 2022

MARKETABLE SECURITIES [Abstract]

Composition of Marketable Securities

The composition of our short-term and long-term marketable securities was as follows:



	March 31, 2022
(In thousands)	Amortized ‎Cost		Gross ‎Unrealized ‎Gains		Gross Unrealized Losses		Fair ‎Value
Short-term:
Municipal bonds	$	41,252	$	9	$	(110)	$	41,151
Corporate debt securities		147,401		57		(927)		146,531
Commercial paper		36,251		—		(42)		36,209
Asset-backed securities		6,603		11		—		6,614
Government, federal agency, and other sovereign obligations		13,070		—		(70)		13,000
Total short-term marketable securities	$	244,577	$	77	$	(1,149)	$	243,505

Long-term:
Municipal bonds	$	101,483	$	4	$	(2,255)	$	99,232
Corporate debt securities		341,254		76		(7,442)		333,888
Asset-backed securities		102,013		19		(1,926)		100,106
Government, federal agency, and other sovereign obligations		14,032		—		(377)		13,655
Total long-term marketable securities	$	558,782	$	99	$	(12,000)	$	546,881



	December 31, 2021
(In thousands)	Amortized ‎Cost		Gross ‎Unrealized ‎Gains		Gross ‎Unrealized ‎Losses		Fair ‎Value
Short-term:
Municipal bonds	$	66,379	$	99	$	(11)	$	66,467
Corporate debt securities		107,102		434		(65)		107,471
Commercial paper		38,252		2		(1)		38,253
Asset-backed securities		12,931		58		—		12,989
Government, federal agency, and other sovereign obligations		25,231		—		(33)		25,198
Total short-term marketable securities	$	249,895	$	593	$	(110)	$	250,378

Long-term:
Municipal bonds	$	91,185	$	4	$	(409)	$	90,780
Corporate debt securities		324,492		351		(1,318)		323,525
Asset-backed securities		128,139		101		(578)		127,662
Government, federal agency, and other sovereign obligations		20,539		—		(31)		20,508
Total long-term marketable securities	$	564,355	$	456	$	(2,336)	$	562,475

FAIR VALUE MEASUREMENTS (Tables)

3 Months Ended

Mar. 31, 2022

FAIR VALUE MEASUREMENTS [Abstract]

Fair Value of Assets and Liabilities Measured on Recurring Basis



(In thousands)	Balance at March 31, 2022		Level 1		Level 2		Level 3
Assets:
Cash equivalents	$	61,945	$	44,491	$	17,454	$	—
Municipal bonds		140,383		—		140,383		—
Corporate debt securities		480,419		—		480,419		—
Commercial paper		36,209		—		36,209		—
Asset-backed securities		106,720		—		106,720		—
Government, federal agency, and other sovereign obligations		26,655		—		26,655		—
Liabilities:
Business acquisition liabilities		68,036		—		—		68,036



(In thousands)	Balance at December 31, 2021		Level 1		Level 2		Level 3
Assets:
Cash equivalents	$	26,684	$	3,768	$	22,916	$	—
Municipal bonds		157,247		—		157,247		—
Corporate debt securities		430,996		—		430,996		—
Commercial paper		38,253		—		38,253		—
Asset-backed securities		140,651		—		140,651		—
Government, federal agency, and other sovereign obligations		45,706		—		45,706		—
Liabilities:
Business acquisition liabilities		70,525		—		—		70,525

Significant Unobservable Inputs in Valuation Techniques


Unobservable input	Range			Weighted Average*
Revenue risk premium	2.4%	-	4.9%	3.0%
Revenue volatility	14.0%	-	15.8%	14.8%
Discount rate	1.2%	-	8.5%	3.3%
Projected year of payment	2022	-	2031

* The weighted average rates were calculated based on the relative fair value of each business acquisition liability.

Changes in Carrying Value of Business Acquisition Liabilities



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Beginning balance	$	70,525	$	37,270
Contingent cash payments		(2,412)		(1,492)
Contingent RSU grants		(196)		(163)
Changes in fair value of business acquisition liabilities		(263)		258
Contractual payable reclassification		382		148
Ending balance	$	68,036	$	36,021

INVENTORIES (Tables)

3 Months Ended

Mar. 31, 2022

INVENTORIES [Abstract]

Schedule of Inventory



	March 31,		December 31,
(In thousands)	2022		2021
Raw materials	$	48,894	$	41,819
Work in process		17,591		17,401
Finished goods		187,401		177,781
Total inventories	$	253,886	$	237,001

PROPERTY AND EQUIPMENT (Tables)

3 Months Ended

Mar. 31, 2022

PROPERTY AND EQUIPMENT [Abstract]

Schedule of Property and Equipment



	Useful	March 31,		December 31,
(In thousands)	Life	2022		2021
Land	—	$	8,286	$	8,296
Buildings and improvements	31.5		46,718		44,672
Equipment	5-15		117,052		113,301
Instruments	5		289,427		285,762
Modules and cases	5		45,047		44,185
Other property and equipment	3-5		34,525		30,435
			541,055		526,651
Less: accumulated depreciation			(313,514)		(305,575)
Total		$	227,541	$	221,076

Schedule of Depreciation Related to Property and Equipment



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Depreciation	$	12,325	12,384

GOODWILL AND INTANGIBLE ASSETS (Tables)

3 Months Ended

Mar. 31, 2022

GOODWILL AND INTANGIBLE ASSETS [Abstract]

Summary of Goodwill



(In thousands)
December 31, 2020	$	156,716
Additions and adjustments		24,251
Foreign exchange		(1,259)
December 31, 2021		179,708
Foreign exchange		(663)
March 31, 2022	$	179,045

Summary of Intangible Assets



		March 31, 2022
(In thousands)	Weighted Average Amortization Period (in years)	Gross ‎Carrying ‎Amount		Accumulated ‎Amortization		Intangible ‎Assets, ‎net
Supplier network	10.0	$	4,000	$	(2,967)	$	1,033
Customer relationships & other intangibles	6.4		53,971		(37,940)		16,031
Developed technology	8.0		72,584		(30,761)		41,823
Patents	16.1		8,863		(3,365)		5,498
Total intangible assets		$	139,418	$	(75,033)	$	64,385



		December 31, 2021
(In thousands)	Weighted Average Amortization Period (in years)	Gross ‎Carrying ‎Amount		Accumulated ‎Amortization		Intangible ‎Assets, ‎net
Supplier network	10.0	$	4,000	$	(2,867)	$	1,133
Customer relationships & other intangibles	6.4		56,264		(37,842)		18,422
Developed technology	8.0		71,947		(28,545)		43,402
Patents	16.1		8,938		(3,235)		5,703
Total intangible assets		$	141,149	$	(72,489)	$	68,660

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense

The following table summarizes amortization of intangible assets for future periods as of March 31, 2022:


(In thousands)	Annual ‎Amortization
Remaining 2022	$	13,588
2023		16,061
2024		13,255
2025		8,969
2026		5,525
Thereafter		6,987
Total	$	64,385

ACCRUED EXPENSES (Tables)

3 Months Ended

Mar. 31, 2022

ACCRUED EXPENSES [Abstract]

Schedule of Accrued Expenses



	March 31,		December 31,
(In thousands)	2022		2021
Compensation and other employee-related costs	$	40,802	$	52,407
Legal and other settlements and expenses		3,997		6,124
Accrued non-income taxes		6,791		6,415
Royalties		3,864		4,558
Rebates		8,920		8,725
Other		11,157		12,939
Total accrued expenses	$	75,531	$	91,168

EQUITY (Tables)

3 Months Ended

Mar. 31, 2022

EQUITY [Abstract]

Schedule of Shares Repurchased


Period	Total number of shares repurchased	Average Price Paid per Share		Dollar amount of shares repurchased ⁽¹⁾		Approximate dollar value of shares that may yet be purchased under the plan
January 1, 2020 - March 31, 2020	1,920	$	38.49	$	73,902	$	126,098
April 1, 2020 - June 30, 2020	771		39.95		30,804		95,294
July 1, 2020 - September 30,2020	—		—		—		95,294
October 1, 2020 - December 31, 2020	—		—		—		95,294
January 1, 2021 - March 31, 2021	—		—		—		95,294
April 1, 2021 - June 30, 2021	—		—		—		95,294
July 1, 2021 - September 30, 2021	—		—		—		95,294
October 1, 2021 - December 31, 2021	—		—		—		95,294
January 1, 2022 - March 31, 2022	—		—		—	$	295,294
January 1, 2020 - March 31, 2022	2,691	$	38.91	$	104,706

Accumulated Other Comprehensive Income (Loss)


(In thousands)	Unrealized loss on marketable securities, net of tax		Foreign currency translation adjustments		Accumulated other comprehensive loss
Accumulated other comprehensive income/(loss), net of tax, at December 31, 2021	$	(1,053)	$	(5,719)	$	(6,772)
Other comprehensive income/(loss) before reclassifications		(11,596)		(1,567)		(13,163)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax		2,768		—		2,768
Other comprehensive income/(loss), net of tax		(8,828)		(1,567)		(10,395)
Accumulated other comprehensive income/(loss), net of tax, at March 31, 2022	$	(9,881)	$	(7,286)	$	(17,167)


(In thousands)	Unrealized loss on marketable securities, net of tax		Foreign currency translation adjustments		Accumulated other comprehensive loss
Accumulated other comprehensive income/(loss), net of tax, at December 31, 2020	$	5,001	$	(1,046)	$	3,955
Other comprehensive income/(loss) before reclassifications		(2,178)		(4,113)		(6,291)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax		512		—		512
Other comprehensive income/(loss), net of tax		(1,666)		(4,113)		(5,779)
Accumulated other comprehensive income/(loss), net of tax, at March 31, 2021	$	3,335	$	(5,159)	$	(1,824)

Schedule of Computation of Basic and Diluted Earnings


	Three Months Ended
	March 31,
(In thousands, except per share amounts)	2022		2021
Numerator:
Net income/(loss)	$	38,084	$	45,329
Denominator for basic and diluted net income per share:
Weighted average shares outstanding for basic		101,600		99,866
Dilutive stock options and RSUs		2,477		2,554
Weighted average shares outstanding for diluted		104,077		102,420
Earnings per share:
Basic	$	0.37	$	0.45
Diluted	$	0.37	$	0.44

Anti-dilutive stock options and RSUs excluded from the calculation		3,378		3,034

STOCK-BASED AWARDS (Tables)

3 Months Ended

Mar. 31, 2022

STOCK-BASED AWARDS [Abstract]

Summary of Stock Option Activity

Stock option activity during the three months ended March 31, 2022 is summarized as follows:



	Option ‎Shares (thousands)	Weighted ‎average ‎exercise ‎price		Weighted ‎average ‎remaining ‎contractual ‎life (years)	Aggregate ‎intrinsic ‎value ‎(thousands)
Outstanding at December 31, 2021	9,462	$	48.01
Granted	1,339		64.24
Exercised	(184)		44.57
Forfeited	(138)		56.51
Outstanding at March 31, 2022	10,479	$	50.05	7.1	$	251,187
Exercisable at March 31, 2022	5,260	$	41.60	5.9	$	169,290
Expected to vest at March 31, 2022	5,219	$	58.57	8.4	$	81,897

Fair Value of Options Using Black Scholes Option Pricing Model

The fair value of the options was estimated on the date of the grant using a Black-Scholes option pricing model with the following assumptions:



	Three Months Ended
	March 31,
	2022			2021
Risk-free interest rate	1.46%	-	1.95%	0.40%	-	0.81%
Expected term (years)	4.8			4.8
Expected volatility		34.0%			34.0%
Expected dividend yield		—%			—%

Summary of Restricted Stock Unit Activity


	Restricted Stock ‎Units (thousands)	Weighted ‎average ‎grant date fair value ‎per share		Weighted ‎average ‎remaining ‎contractual ‎life (years)
Outstanding at December 31, 2021	29	$	72.54
Granted	2		70.94
Vested	—		—
Forfeited	—		—
Outstanding at March 31, 2022	31	$	72.40	8.5

Stock-based Compensation Schedule



	Three Months Ended
	March 31,
(In thousands)	2022		2021
Stock-based compensation expense	$	8,152	$	7,698
Net stock-based compensation capitalized into inventory		201		185
Total stock-based compensation cost	$	8,353	$	7,883

INCOME TAXES (Tables)

3 Months Ended

Mar. 31, 2022

INCOME TAXES [Abstract]

Reconciliation of Statutory U.S. Federal Tax Rate to Effective Rate


	Three Months Ended
	March 31,
	2022	2021
Effective income tax rate	22.1%	20.7%

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)

3 Months Ended

Mar. 31, 2022

SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]

Schedule of Total Sales by Geographical Area



	Three Months Ended
	March 31,
(In thousands)	2022		2021
United States	$	196,403	$	193,317
International		34,146		34,027
Total net sales	$	230,549	$	227,344

BACKGROUND (Narrative) (Details)	Mar. 31, 2022 item
Minimum [Member]
Number of products launched	220

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Narrative) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES [Abstract]
Goodwill impairment	$ 0	$ 0
Impairment of finite-lived intangible assets	0	0
Impairment of intangible assets	$ 0	$ 0

ASSET ACQUISITIONS AND BUSINESS COMBINATIONS (Narrative) (Details) $ in Thousands	3 Months Ended				12 Months Ended
	Dec. 31, 2021 USD ($)	Sep. 30, 2021 USD ($) item	Dec. 31, 2020 USD ($) item	Jun. 30, 2020 USD ($)	Dec. 31, 2021 USD ($) item	Dec. 31, 2020 USD ($)	Mar. 31, 2022 USD ($)	Mar. 31, 2021 USD ($)
Business Acquisition [Line Items]
Contingent consideration liability	$ 70,525		$ 37,270		$ 70,525	$ 37,270	$ 68,036	$ 36,021
Goodwill	179,708		$ 156,716		179,708	156,716	179,045
Development Of Technology, Robotic Surgery Platforms [Member]
Business Acquisition [Line Items]
Purchase price of assets	10,000
Additional contingent consideration	5,000
Third Anniversary [Member]
Business Acquisition [Line Items]
Contingent consideration liability							8,000
Fourth Anniversary [Member]
Business Acquisition [Line Items]
Contingent consideration liability							$ 4,000
Capstone Surgical Technologies, LLC [Member]
Business Acquisition [Line Items]
Business combination, consideration transferred	24,500
Capstone Surgical Technologies, LLC [Member] \| Approval Of FDA [Member]
Business Acquisition [Line Items]
Contingent consideration liability	15,000				15,000
Capstone Surgical Technologies, LLC [Member] \| Achievement Of Certain Performance Obligation [Member]
Business Acquisition [Line Items]
Contingent consideration liability	10,000				10,000
Synoste Acquisition [Member]
Business Acquisition [Line Items]
Payments to Acquire Businesses, Gross				$ 22,800
Business combination, consideration transferred				25,300
Contingent consideration liability				$ 2,500
Contingent consideration payment	2,700
Acquired in-process research and development					$ 34,300	24,400
Series of Individually Immaterial Business Acquisitions [Member]
Business Acquisition [Line Items]
Number of acquisitions \| item		2	2		3
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Intangible Assets, Other than Goodwill		$ 1,600	$ 8,800			8,800
Weighted average amortization period		3 years 9 months 18 days	4 years 2 months 12 days
Payments to Acquire Businesses, Gross			$ 1,500		$ 300
Contingent consideration liability	13,000		33,200		13,000	33,200
Goodwill	$ 13,300	$ 11,000	$ 26,200		$ 13,300	$ 26,200
Contingent consideration payment		$ 12,600
Business Acquisitions, Contractual Holdback Obligation Payable Period		10 years	10 years
Liabilities incurred from acquisition			$ 300

NET SALES (Schedule of Net Sales by Product Category) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Disaggregation of Revenue [Line Items]
Net sales	$ 230,549	$ 227,344
Musculoskeletal Solutions [Member]
Disaggregation of Revenue [Line Items]
Net sales	217,402	212,416
Enabling Technologies [Member]
Disaggregation of Revenue [Line Items]
Net sales	$ 13,147	$ 14,928

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (SX 210.13-02(a)(4)(iii)(A))
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e9031-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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-Paragraph 1A
-Subparagraph (SX 210.13-01(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(i))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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-Paragraph 30
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Subparagraph (SX 210.13-02(a)(5))
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

+ Details

MARKETABLE SECURITIES (Narrative) (Details) - USD ($)	3 Months Ended	12 Months Ended
MARKETABLE SECURITIES (Narrative) (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Debt Securities, Available-for-sale [Line Items]
Payable to brokers	$ 0	$ 2,200,000
Short-term Investments [Member] \| Maximum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	1 year	1 year
Long-term Investments [Member] \| Minimum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	1 year	1 year
Long-term Investments [Member] \| Maximum [Member]
Debt Securities, Available-for-sale [Line Items]
Contractual Maturity	3 years	3 years

MARKETABLE SECURITIES (Composition of Marketable Securities) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Municipal Bonds [Member]
Debt Securities, Available-for-sale [Line Items]
Fair Value	$ 140,383	$ 157,247
Corporate Debt Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Fair Value	480,419	430,996
Commercial Paper [Member]
Debt Securities, Available-for-sale [Line Items]
Fair Value	36,209	38,253
Asset-backed Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Fair Value	106,720	140,651
U.S. Government And Agency Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Fair Value	26,655	45,706
Short-term Investments [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	244,577	249,895
Gross Unrealized Gains	77	593
Gross Unrealized Losses	(1,149)	(110)
Fair Value	243,505	250,378
Short-term Investments [Member] \| Municipal Bonds [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	41,252	66,379
Gross Unrealized Gains	9	99
Gross Unrealized Losses	(110)	(11)
Fair Value	41,151	66,467
Short-term Investments [Member] \| Corporate Debt Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	147,401	107,102
Gross Unrealized Gains	57	434
Gross Unrealized Losses	(927)	(65)
Fair Value	146,531	107,471
Short-term Investments [Member] \| Commercial Paper [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	36,251	38,252
Gross Unrealized Gains		2
Gross Unrealized Losses	(42)	(1)
Fair Value	36,209	38,253
Short-term Investments [Member] \| Asset-backed Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	6,603	12,931
Gross Unrealized Gains	11	58
Fair Value	6,614	12,989
Short-term Investments [Member] \| U.S. Government And Agency Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	13,070	25,231
Gross Unrealized Losses	(70)	(33)
Fair Value	13,000	25,198
Long-term Investments [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	558,782	564,355
Gross Unrealized Gains	99	456
Gross Unrealized Losses	(12,000)	(2,336)
Fair Value	546,881	562,475
Long-term Investments [Member] \| Municipal Bonds [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	101,483	91,185
Gross Unrealized Gains	4	4
Gross Unrealized Losses	(2,255)	(409)
Fair Value	99,232	90,780
Long-term Investments [Member] \| Corporate Debt Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	341,254	324,492
Gross Unrealized Gains	76	351
Gross Unrealized Losses	(7,442)	(1,318)
Fair Value	333,888	323,525
Long-term Investments [Member] \| Asset-backed Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	102,013	128,139
Gross Unrealized Gains	19	101
Gross Unrealized Losses	(1,926)	(578)
Fair Value	100,106	127,662
Long-term Investments [Member] \| U.S. Government And Agency Securities [Member]
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	14,032	20,539
Gross Unrealized Losses	(377)	(31)
Fair Value	$ 13,655	$ 20,508

FAIR VALUE MEASUREMENTS (Fair Value of Assets and Liabilities Measured on Recurring Basis) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	$ 61,945	$ 26,684
Business acquisition liabilities	68,036	70,525	$ 36,021	$ 37,270
Municipal Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	140,383	157,247
Corporate Debt Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	480,419	430,996
Commercial Paper [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	36,209	38,253
Asset-backed Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	106,720	140,651
U.S. Government And Agency Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	26,655	45,706
Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	44,491	3,768
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents	17,454	22,916
Fair Value, Inputs, Level 2 [Member] \| Municipal Bonds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	140,383	157,247
Fair Value, Inputs, Level 2 [Member] \| Corporate Debt Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	480,419	430,996
Fair Value, Inputs, Level 2 [Member] \| Commercial Paper [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	36,209	38,253
Fair Value, Inputs, Level 2 [Member] \| Asset-backed Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	106,720	140,651
Fair Value, Inputs, Level 2 [Member] \| U.S. Government And Agency Securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Securities	26,655	45,706
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition liabilities	$ 68,036	$ 70,525

FAIR VALUE MEASUREMENTS (Significant Unobservable Inputs in Valuation Techniques) (Details)

3 Months Ended

Mar. 31, 2022

item

Revenue Risk Premium [Member] | Maximum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

4.9

Revenue Risk Premium [Member] | Minimum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

2.4

Revenue Risk Premium [Member] | Weighted Average [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

3.0

^[1]

Revenue Volatility [Member] | Maximum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

15.8

Revenue Volatility [Member] | Minimum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

14.0

Revenue Volatility [Member] | Weighted Average [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

14.8

^[1]

Discount Rate [Member] | Maximum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

8.5

Discount Rate [Member] | Minimum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

1.2

Discount Rate [Member] | Weighted Average [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Business acquisition liabilities, measurement input

3.3

^[1]

Probability Of Payment [Member] | Maximum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Projected year of payment

2031

Probability Of Payment [Member] | Minimum [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Projected year of payment

2022

[1]	The weighted average rates were calculated based on the relative fair value of each business acquisition liability.

FAIR VALUE MEASUREMENTS (Changes in Carrying Value of Business Acquisition Liabilities) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, beginning balance	$ 70,525	$ 37,270
Contingent cash payments	(2,412)	(1,492)
Contingent RSU grants	(196)	(163)
Changes in fair value of business acquisition liabilities	(263)	258
Contractual payable reclassification	382	148
Fair value measurement, ending balance	68,036	$ 36,021
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value measurement, beginning balance	70,525
Fair value measurement, ending balance	$ 68,036

INVENTORIES (Narrative) (Details) - USD ($) $ in Millions	3 Months Ended
INVENTORIES (Narrative) (Details) - USD ($) $ in Millions	Mar. 31, 2022	Mar. 31, 2021
INVENTORIES [Abstract]
Net adjustment to cost of sales related to excess and obsolete inventory	$ 1.8	$ 1.6
Excess and obsolete related provisions	3.4	3.8
Inventory sales and disposals related provisions	$ 1.6	$ 2.2

INVENTORIES (Schedule of Inventory) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
INVENTORIES [Abstract]
Raw materials	$ 48,894	$ 41,819
Work in process	17,591	17,401
Finished goods	187,401	177,781
Total inventories	$ 253,886	$ 237,001

PROPERTY AND EQUIPMENT (Schedule of Property and Equipment) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Property and equipment	$ 541,055	$ 526,651
Less: accumulated depreciation	(313,514)	(305,575)
Total	227,541	221,076
Land [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	8,286	8,296
Building and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 46,718	44,672
Useful Life	31 years 6 months
Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 117,052	113,301
Instruments [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 289,427	285,762
Useful Life	5 years
Modules and cases [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 45,047	44,185
Useful Life	5 years
Other Property and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment	$ 34,525	$ 30,435
Maximum [Member] \| Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	15 years
Maximum [Member] \| Other Property and Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	5 years
Minimum [Member] \| Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	5 years
Minimum [Member] \| Other Property and Equipment [Member]
Property, Plant and Equipment [Line Items]
Useful Life	3 years

PROPERTY AND EQUIPMENT (Schedule of Depreciation Related to Property and Equipment) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
PROPERTY AND EQUIPMENT [Abstract]
Depreciation	$ 12,325	$ 12,384

GOODWILL AND INTANGIBLE ASSETS (Summary of Goodwill) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Goodwill, Beginning Balance	$ 179,708	$ 156,716
Additions and adjustments		24,251
Foreign exchange	(663)	(1,259)
Goodwill, Ending Balance	$ 179,045	$ 179,708

GOODWILL AND INTANGIBLE ASSETS (Summary of Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 139,418	$ 141,149
Accumulated amortization	(75,033)	(72,489)
Intangible Assets, net	$ 64,385	$ 68,660
Supplier Network [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	10 years	10 years
Gross Carrying Amount	$ 4,000	$ 4,000
Accumulated amortization	(2,967)	(2,867)
Intangible Assets, net	$ 1,033	$ 1,133
Customer Relationships & Other Intangibles [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	6 years 4 months 24 days	6 years 4 months 24 days
Gross Carrying Amount	$ 53,971	$ 56,264
Accumulated amortization	(37,940)	(37,842)
Intangible Assets, net	$ 16,031	$ 18,422
Developed Technology [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	8 years	8 years
Gross Carrying Amount	$ 72,584	$ 71,947
Accumulated amortization	(30,761)	(28,545)
Intangible Assets, net	$ 41,823	$ 43,402
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted average amortization period	16 years 1 month 6 days	16 years 1 month 6 days
Gross Carrying Amount	$ 8,863	$ 8,938
Accumulated amortization	(3,365)	(3,235)
Intangible Assets, net	$ 5,498	$ 5,703

GOODWILL AND INTANGIBLE ASSETS (Schedule of Finite-Lived Intangible Assets, Future Amortization Expense) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
GOODWILL AND INTANGIBLE ASSETS [Abstract]
Remaining 2022	$ 13,588
2023	16,061
2024	13,255
2025	8,969
2026	5,525
Thereafter	6,987
Intangible Assets, net	$ 64,385	$ 68,660

ACCRUED EXPENSES (Schedule of Accrued Expenses) (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
ACCRUED EXPENSES [Abstract]
Compensation and other employee-related costs	$ 40,802	$ 52,407
Legal and other settlements and expenses	3,997	6,124
Accrued non-income taxes	6,791	6,415
Royalties	3,864	4,558
Rebates	8,920	8,725
Other	11,157	12,939
Total accrued expenses	$ 75,531	$ 91,168

DEBT (Narrative) (Details) - USD ($)	1 Months Ended	3 Months Ended
DEBT (Narrative) (Details) - USD ($)	Aug. 31, 2020	Mar. 31, 2022
Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity		$ 125,000,000.0
Line of credit facility, expiration date		Aug. 03, 2022
Line of credit, borrowed amount		$ 0
Federal Funds Effective Rate [Member]
Debt Instrument [Line Items]
Credit facility, basis spread on variable rate	0.50%
LIBOR [Member] \| Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, basis spread on variable rate	1.00%
Letter of Credit [Member] \| Citizens Bank [Member]
Debt Instrument [Line Items]
Credit facility, maximum borrowing capacity		$ 25,000,000.0

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

EQUITY (Narrative) (Details) $ in Thousands	3 Months Ended
EQUITY (Narrative) (Details) $ in Thousands	Mar. 31, 2022 USD ($) item / shares item shares	Dec. 31, 2021 USD ($) shares	Sep. 30, 2021 USD ($)	Jun. 30, 2021 USD ($)	Mar. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Sep. 30, 2020 USD ($)	Jun. 30, 2020 USD ($)	Mar. 31, 2020 USD ($)
Class of Stock [Line Items]
Stock repurchase plan, authorized amount \| $									$ 200,000
Stock repurchase plan, remaining authorized amount \| $	$ 295,294	$ 95,294	$ 95,294	$ 95,294	$ 95,294	$ 95,294	$ 95,294	$ 95,294	$ 126,098
Common stock, shares authorized	775,000,000
Common Class A [Member]
Class of Stock [Line Items]
Additional stock repurchase plan, authorized amount \| $	$ 200,000
Common stock, shares authorized	500,000,000	500,000,000
Number of votes per share \| item / shares	1
Shares converted from other class	1
Common Class A And B [Member]
Class of Stock [Line Items]
Number of votes per share \| item	1
Common Class B [Member]
Class of Stock [Line Items]
Common stock, shares authorized	275,000,000	275,000,000
Number of votes per share \| item / shares	10

EQUITY (Schedule of Shares Repurchased) (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands

3 Months Ended

27 Months Ended

Jun. 30, 2020

Mar. 31, 2020

Mar. 31, 2022

Dec. 31, 2021

Sep. 30, 2021

Jun. 30, 2021

Mar. 31, 2021

Dec. 31, 2020

Sep. 30, 2020

EQUITY [Abstract]

Total number of shares repurchased

771

1,920

2,691

Average Price Paid per Share

$ 39.95

$ 38.49

$ 38.91

Dollar amount of shares repurchased

^[1]

$ 30,804

$ 73,902

$ 104,706

Approximate dollar value of shares that may yet be purchased under the plan

$ 95,294

$ 126,098

$ 295,294

$ 95,294

[1]	Inclusive of an immaterial amount of commission fees

EQUITY (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	$ 1,741,388	$ 1,506,297
Total other comprehensive income/(loss), net of tax	(10,395)	(5,779)
Total equity, end of period	1,785,372	1,562,994
Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	(6,772)	3,955
Other comprehensive (loss)/income before reclassifications	(13,163)	(6,291)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax	2,768	512
Total other comprehensive income/(loss), net of tax	(10,395)	(5,779)
Total equity, end of period	(17,167)	(1,824)
Unrealized Loss On Marketable Securities, Net Of Tax [Member] \| Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	(1,053)	5,001
Other comprehensive (loss)/income before reclassifications	(11,596)	(2,178)
Amounts reclassified from accumulated other comprehensive income/(loss), net of tax	2,768	512
Total other comprehensive income/(loss), net of tax	(8,828)	(1,666)
Total equity, end of period	(9,881)	3,335
Foreign Currency Translation Adjustments [Member] \| Accumulated Other Comprehensive Income/(Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Total equity, beginning of period	(5,719)	(1,046)
Other comprehensive (loss)/income before reclassifications	(1,567)	(4,113)
Total other comprehensive income/(loss), net of tax	(1,567)	(4,113)
Total equity, end of period	$ (7,286)	$ (5,159)

- Definition

+ References

+ Details

EQUITY (Schedule Of Computation of Basic and Diluted Earnings) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
EQUITY [Abstract]
Net income/(loss)	$ 38,084	$ 45,329
Weighted average shares outstanding for basic	101,600	99,866
Dilutive stock options	2,477	2,554
Weighted average shares outstanding for diluted	104,077	102,420
Basic	$ 0.37	$ 0.45
Diluted	$ 0.37	$ 0.44
Anti-dilutive stock options and RSUs excluded from the calculation	3,378	3,034

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
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Reference 29: http://www.xbrl.org/2003/role/disclosureRef
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Reference 30: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

STOCK-BASED AWARDS (Narrative) (Details) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2022 USD ($) ShareBasedCompensationPlan $ / shares shares	Mar. 31, 2021 USD ($) $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average period of recognition, unvested stock options	3 years
Number of stock plans \| ShareBasedCompensationPlan	2
Class A reserved under the 2012 Equity Incentive Plan	3,247,276
Class A number of shares available for grant under the 2012 Equity Incentive Plan	1,333,253
Intrinsic value of stock options exercised \| $	$ 4.7	$ 10.1
Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	4 years
Unrecognized compensation expense, unvested stock options \| $	$ 78.8
Maximum contractual term	10 years
Weighted average grant date fair value per share \| $ / shares	$ 20.48	$ 19.26
2012 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	3,076,923
2012 Plan [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares authorized	10,769,230
Annual percentage limit for incremental shares that may be issued	3.00%
2021 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	2,000,000
2021 Plan [Member] \| Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Base number of shares that may be issuable under stock plan	2,000,000

STOCK-BASED AWARDS (Summary of Stock Option Activity) (Details) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Option shares outstanding beginning balance \| shares	9,462
Option shares granted \| shares	1,339
Option shares exercised \| shares	(184)
Option shares forfeited \| shares	(138)
Option shares outstanding ending balance \| shares	10,479
Option shares exercisable \| shares	5,260
Option shares expected to vest \| shares	5,219
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price
Weighted average exercise price per share outstanding beginning balance \| $ / shares	$ 48.01
Weighted average exercise price per share granted \| $ / shares	64.24
Weighted average exercise price per share exercised \| $ / shares	44.57
Weighted average exercise price per share forfeited \| $ / shares	56.51
Weighted average exercise price per share outstanding ending balance \| $ / shares	50.05
Weighted average exercise price per share exercisable \| $ / shares	41.60
Weighted average exercise price per share expected to vest \| $ / shares	$ 58.57
Weighted average remaining contractual life outstanding	7 years 1 month 6 days
Weighted average remaining contractual life exercisable	5 years 10 months 24 days
Weighted average remaining contractual life expected to vest	8 years 4 months 24 days
Aggregate intrinsic value outstanding \| $	$ 251,187
Aggregate intrinsic value exercisable \| $	169,290
Aggregate intrinsic value expected to vest \| $	$ 81,897

STOCK-BASED AWARDS (Fair Value of Options Using Black Scholes Option Pricing Model) (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
STOCK-BASED AWARDS [Abstract]
Risk-free interest rate, minimum	1.46%	0.40%
Risk-free interest rate, maximum	1.95%	0.81%
Expected term (years)	4 years 9 months 18 days	4 years 9 months 18 days
Expected volatility	34.00%	34.00%
Expected dividend yield

STOCK-BASED AWARDS (Summary of Restricted Stock Unit Activity) (Details) - Restricted Stock Units (RSUs) [Member] shares in Thousands	3 Months Ended
	Mar. 31, 2022 $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding, Beginning Balance \| shares	29
Granted \| shares	2
Outstanding, Ending Balance \| shares	31
Weighted average grant date fair value per share, Beginning Balance \| $ / shares	$ 72.54
Weighted average grant date fair value per share, Granted \| $ / shares	70.94
Weighted average grant date fair value per share, Ending Balance \| $ / shares	$ 72.40
Weighted average remaining contractual life (years)	8 years 6 months

STOCK-BASED AWARDS (Stock-based Compensation Schedule) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
STOCK-BASED AWARDS [Abstract]
Stock-based compensation expense	$ 8,152	$ 7,698
Net stock-based compensation capitalized into inventory	201	185
Total stock-based compensation cost	$ 8,353	$ 7,883

INCOME TAXES (Reconciliation of Statutory U.S. Federal Tax Rate to Effective Rate) (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
INCOME TAXES [Abstract]
Effective income tax rate	22.10%	20.70%

COMMITMENTS AND CONTINGENCIES (Narrative) (Details)	Mar. 31, 2022 USD ($)
Moskowitz Family LLC Litigation [Member]
Estimated Litigation Liability	$ 0

SEGMENT AND GEOGRAPHIC INFORMATION (Narrative) (Details)	3 Months Ended
	Mar. 31, 2022 segment
SEGMENT AND GEOGRAPHIC INFORMATION [Abstract]
Number of operating segments	1

SEGMENT AND GEOGRAPHIC INFORMATION (Schedule of Total Sales by Geographical Area) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	$ 230,549	$ 227,344
United States [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	196,403	193,317
International [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total net sales	$ 34,146	$ 34,027

- Definition

+ References

+ Details