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Entity Wide Disclosures
 3 Months Ended
Mar. 31, 2026
Entity Wide Disclosures [Abstract]  
Segment Reporting Disclosure Segment Disclosures
Information about the one reportable segment, significant segment expenses and a reconciliation to condensed consolidated net income is as follows (in thousands):
Three Months Ended
March 31,
20262025
Revenue, net$706,604 $558,570 
Operating expenses:
Direct service costs, excluding depreciation and amortization - Employee compensation164,603 143,927 
Direct service costs, excluding depreciation and amortization - Other segment items (a)33,671 33,889 
Reimbursed out-of-pocket expenses312,004 202,404 
Total direct costs510,278 380,220 
Selling, general and administrative47,917 57,897 
Depreciation6,751 6,694 
Amortization155 236 
Total operating expenses565,101 445,047 
Income from operations141,503 113,523 
Other income, net:
Miscellaneous income (expense), net971 (1,816)
Interest income, net5,117 6,463 
Total other income, net6,088 4,647 
Income before income taxes147,591 118,170 
Income tax provision23,721 3,575 
Segment net income$123,870 $114,595 
Reconciliation of profit or loss
Adjustments and reconciling items— — 
Condensed consolidated net income$123,870 $114,595 
(a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs.
Revenue by Category
The following table disaggregates the Company’s revenue by major source (in thousands):
Three Months Ended
March 31,
20262025
Therapeutic Area
Metabolic$237,558 $148,015 
Oncology201,239 170,476 
Other93,318 95,836 
Central Nervous System80,207 54,901 
Cardiology56,261 58,279 
AVAI38,021 31,063 
Total revenue$706,604 $558,570