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14. Segment Information Segment Profit Reconciliation (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Dec. 31, 2019
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Goodwill, Impairment Loss   $ 0 $ 282,000  
Income before income taxes   2,261,081 512,659 $ 97,805
Unrealized Gain on Securities $ 646,000 2,030,987 606,230 0
Operating Segments [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Income before income taxes   219,100 (116,800) 106,300
Segment Reconciling Items [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Unrealized Gain on Securities   2,031,000 606,200 0
Corporate, Non-Segment [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Income before income taxes   (12,900) (10,400) (10,100)
Foreign Currency Gain (Loss) [Member] | Segment Reconciling Items [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Income before income taxes   (2,200) (2,900) (9,100)
Other Nonoperating Income (Expense) [Member] | Segment Reconciling Items [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Income before income taxes   26,100 36,600 $ 10,700
Clinical Diagnostics [Member]        
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]        
Goodwill, Impairment Loss   $ 0 $ 276,100