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ENTITY WIDE DISCLOSURES (Tables)

12 Months Ended

Dec. 31, 2024

Entity Wide Disclosures [Abstract]

Summary of Property and Equipment, Net by Geographic Region

The following table summarizes property and equipment, net by geographic region and is further broken down to show countries which account for 10% or more of total as of December 31, if any (in thousands):

			2024						2023
Property and equipment, net:
United States			$	80,692					$	77,850
Europe
Belgium			18,557						18,190
Other			7,456						8,772
Total Europe			26,013						26,962
Asia-Pacific			14,552						14,472
Other			2,358						1,305
Total property and equipment, net			$	123,615					$	120,589

Summary of Revenue by Major Source

The following table disaggregates the Company’s revenue by major source (in thousands):

			Year Ended December 31,
			2024						2023						2022
Therapeutic Area
Oncology			$	651,237					$	587,097					$	467,796
Metabolic			457,542						376,842						244,682
Other			431,384						404,844						296,914
Cardiology			230,454						193,690						174,634
Central Nervous System			181,977						160,057						157,939
AVAI			156,460						163,312						118,031
Total revenue			$	2,109,054					$	1,885,842					$	1,459,996

Schedule of Segment Reporting Information, by Segment

Information about the reportable segment, significant segment expenses and a reconciliation to consolidated net income is as follows (in thousands):

			Year Ended December 31,
			2024						2023						2022
Revenue, net			$	2,109,054					$	1,885,842					$	1,459,996
Operating expenses:
Direct service costs, excluding depreciation and amortization - Employee compensation			545,417						499,528						410,511
Direct service costs, excluding depreciation and amortization - Other segment items (a)			136,678						138,721						124,376
Reimbursed out-of-pocket expenses			770,654						723,088						492,671
Total direct costs			1,452,749						1,361,337						1,027,558
Selling, general and administrative			180,184						161,352						131,400
Depreciation			27,808						24,129						18,989
Amortization			1,443						2,199						3,352
Total operating expenses			1,662,184						1,549,017						1,181,299
Income from operations			446,870						336,825						278,697
Other income (expense), net:
Miscellaneous income (expense), net			4,056						(655)						7,068
Interest income (expense), net			24,996						(488)						(2,905)
Total other income (expense), net			29,052						(1,143)						4,163
Income before income taxes			475,922						335,682						282,860
Income tax provision			71,536						52,872						37,492
Segment net income			$	404,386					$	282,810					$	245,368
Reconciliation of profit or loss
Adjustments and reconciling items			—						—						—
Consolidated net income			$	404,386					$	282,810					$	245,368

(a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs.

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Entity wide disclosures.

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No definition available.

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Tabular disclosure of disaggregation of revenue into categories depicting how nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factor.

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-Topic 606
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Tabular disclosure of the names of foreign countries in which material long-lived assets other than financial instruments, long-term customer relationships of a financial institution, mortgage and other servicing rights, deferred policy acquisition costs, and deferred tax assets are located, and amount of such long-lived assets located in that country or foreign geographic area.

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-Topic 280
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Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.

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