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Revenue from Contract with Customer (Policies) | 3 Months Ended
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Sep. 30, 2024
Revenue from Contract with Customer [Abstract] |
Revenue | REVENUES The Company's revenues by segment and by payers/customer groups for the three and nine months ended September 30, 2024, and 2023, were as follows:
| For the Three Months Ended September 30, 2024 |  | For the Three Months Ended September 30, 2023
| North America |  | Europe |  | Other |  | Total |  | North America |  | Europe |  | Other |  | Total
Payer/Customer |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Dx |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Clients | 24 | % |  | — | % |  | — | % |  | 24 | % |  | 24 | % |  | — | % |  | — | % |  | 24 | %
Patients | 10 | % |  | — | % |  | — | % |  | 10 | % |  | 9 | % |  | — | % |  | — | % |  | 9 | %
Medicare and Medicaid | 8 | % |  | — | % |  | — | % |  | 8 | % |  | 8 | % |  | — | % |  | — | % |  | 8 | %
Third party | 36 | % |  | — | % |  | — | % |  | 36 | % |  | 36 | % |  | — | % |  | — | % |  | 36 | %
Total Dx revenues by payer | 78 | % |  | — | % |  | — | % |  | 78 | % |  | 77 | % |  | — | % |  | — | % |  | 77 | %
BLS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Pharmaceutical, biotechnology, and medical device companies | 9 | % |  | 9 | % |  | 4 | % |  | 22 | % |  | 10 | % |  | 9 | % |  | 4 | % |  | 23 | %
Total revenues | 87 | % |  | 9 | % |  | 4 | % |  | 100 | % |  | 87 | % |  | 9 | % |  | 4 | % |  | 100 | %
| For the Nine Months Ended September 30, 2024 |  | For the Nine Months Ended September 30, 2023
| North America |  | Europe |  | Other |  | Total |  | North America |  | Europe |  | Other |  | Total
Payer/Customer |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Dx |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Clients | 24 | % |  | — | % |  | — | % |  | 24 | % |  | 24 | % |  | — | % |  | — | % |  | 24 | %
Patients | 10 | % |  | — | % |  | — | % |  | 10 | % |  | 9 | % |  | — | % |  | — | % |  | 9 | %
Medicare and Medicaid | 8 | % |  | — | % |  | — | % |  | 8 | % |  | 8 | % |  | — | % |  | — | % |  | 8 | %
Third party | 36 | % |  | — | % |  | — | % |  | 36 | % |  | 36 | % |  | — | % |  | — | % |  | 36 | %
Total Dx revenues by payer | 78 | % |  | — | % |  | — | % |  | 78 | % |  | 77 | % |  | — | % |  | — | % |  | 77 | %
BLS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Pharmaceutical, biotechnology, and medical device companies | 9 | % |  | 9 | % |  | 4 | % |  | 22 | % |  | 10 | % |  | 9 | % |  | 4 | % |  | 23 | %
Total revenues | 87 | % |  | 9 | % |  | 4 | % |  | 100 | % |  | 87 | % |  | 9 | % |  | 4 | % |  | 100 | %
Revenues in the United States were $2,738.4 (83.4%) and $2,550.6 (83.4%) for the three months ended September 30, 2024 and 2023, respectively, and were $8,091.8 (83.6%) and $7,645.0 (83.8%) for the nine months ended September 30, 2024 and 2023, respectively. Accounts Receivable, Unbilled Services and Unearned Revenue The following table provides information about accounts receivable, unbilled services, and unearned revenue from contracts with customers as of September 30, 2024 and December 31, 2023:
| September 30, 2024 |  | December 31, 2023
Dx accounts receivable | $ | 1,323.7 |  |  | $ | 1,135.2 |
BLS accounts receivable | 773.7 |  |  | 810.8 |
Less BLS allowance for doubtful accounts | (38.9) |  |  | (32.7) |
Accounts receivable | $ | 2,058.5 |  |  | $ | 1,913.3 |
Gross unbilled services | $ | 167.9 |  |  | $ | 192.9 |
Less reserve for unbilled services | (1.6) |  |  | (7.5) |
Unbilled services | $ | 166.3 |  |  | $ | 185.4 |
Unearned revenue | $ | 403.1 |  |  | $ | 421.7 |
Revenues recognized during the period that were included in the unearned revenue balance at the beginning of the period were $20.2 and $6.3 for the three months ended September 30, 2024 and 2023, respectively, and $98.0 and $79.1 for the nine months ended September 30, 2024 and 2023, respectively. Credit Loss Rollforward The Company estimates future expected losses on accounts receivable, unbilled services and notes receivable over the remaining collection period of the instrument. The rollforward for the allowance for credit losses for the nine months ended September 30, 2024, was as follows:
| Accounts Receivable |  | Unbilled Services |  | Note and Other Receivables |  | Total
Balance as of December 31, 2023 | $ | 32.7 |  |  | $ | 7.5 |  |  | $ | 0.7 |  |  | $ | 40.9 |
Plus, credit loss expense | 7.7 |  |  | — |  |  | — |  |  | 7.7 |
Less, write offs | 1.5 |  |  | 5.9 |  |  | — |  |  | 7.4 |
Balance as of September 30, 2024 | $ | 38.9 |  |  | $ | 1.6 |  |  | $ | 0.7 |  |  | $ | 41.2 |
The credit loss expense in the first nine months was primarily related to the collection risk from several biotech receivable balances.

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