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Entity Wide Disclosures (Details)
$ in Thousands
 3 Months Ended
Mar. 31, 2026
USD ($)
segment
Mar. 31, 2025
USD ($)
Segment Reporting Information [Line Items]    
Total revenue $ 706,604 $ 558,570
Total direct costs 510,278 380,220
Selling, general and administrative 47,917 57,897
Depreciation 6,751 6,694
Amortization 155 236
Costs and Expenses 565,101 445,047
Operating Income (Loss) 141,503 113,523
Miscellaneous income (expense), net 971 (1,816)
Interest income, net 5,117 6,463
Nonoperating Income (Expense) 6,088 4,647
Income (Loss) from Continuing Operations before Income Taxes, Noncontrolling Interest 147,591 118,170
Income tax provision 23,721 3,575
Net income $ 123,870 114,595
Number of Reportable Segments | segment 1  
Direct Costs    
Segment Reporting Information [Line Items]    
Total direct costs $ 198,274 177,816
Reimbursed out-of-pocket expenses    
Segment Reporting Information [Line Items]    
Total direct costs 312,004 202,404
Metabolic    
Segment Reporting Information [Line Items]    
Total revenue 201,239 170,476
Oncology    
Segment Reporting Information [Line Items]    
Total revenue 237,558 148,015
Other    
Segment Reporting Information [Line Items]    
Total revenue 93,318 95,836
Central Nervous System    
Segment Reporting Information [Line Items]    
Total revenue 56,261 58,279
Cardiology    
Segment Reporting Information [Line Items]    
Total revenue 80,207 54,901
AVAI    
Segment Reporting Information [Line Items]    
Total revenue 38,021 31,063
Operating Segments | Reportable Segment    
Segment Reporting Information [Line Items]    
Total revenue 706,604 558,570
Total direct costs 510,278 380,220
Selling, general and administrative 47,917 57,897
Depreciation 6,751 6,694
Amortization 155 236
Costs and Expenses 565,101 445,047
Operating Income (Loss) 141,503 113,523
Miscellaneous income (expense), net 971 (1,816)
Interest income, net 5,117 6,463
Nonoperating Income (Expense) 6,088 4,647
Income (Loss) from Continuing Operations before Income Taxes, Noncontrolling Interest 147,591 118,170
Income tax provision 23,721 3,575
Net income 123,870 114,595
Operating Segments | Reportable Segment | Direct Costs    
Segment Reporting Information [Line Items]    
Segment Reporting, Other Segment Item, Amount 33,671 33,889
Labor and Related Expense $ 164,603 143,927
Segment Reporting, Other Segment Item, Composition, Description (a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs.  
Operating Segments | Reportable Segment | Reimbursed out-of-pocket expenses    
Segment Reporting Information [Line Items]    
Total direct costs $ 312,004 202,404
Eliminations and Reconciling Items    
Segment Reporting Information [Line Items]    
Net income $ 0 $ 0