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1. Significant Accounting Policies Property, Plant and Equipment (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Property, Plant and Equipment [Line Items]      
Restricted investments $ 5,560 $ 5,560  
Retained earnings 9,898,203 13,525,343  
Other assets 94,599 104,189  
Prepaid Taxes 7,800    
Income Tax Expense (Benefit) 1,076,738 (1,194,798) $ (1,103,778)
Intangible Assets, Net (Excluding Goodwill) $ 332,147 $ 253,939  
Property, Plant and Equipment
Property, Plant and Equipment

Property, plant and equipment are stated at cost, less accumulated depreciation and amortization. Additions and improvements are capitalized, and maintenance and repairs are expensed as incurred. Included in property, plant and equipment are buildings and equipment acquired under capital lease arrangements, reagent rental equipment and capitalized software, including costs for software developed or obtained for internal use.

Depreciation is computed on a straight-line basis over the estimated useful lives of the assets. The estimated useful lives of property, plant and equipment are generally as follows: buildings, 10-50 years; leasehold improvements, the life of the improvements or the term of the lease, whichever is shorter; reagent rental equipment, 1-5 years; equipment, 3-12 years; and computer software, 3-5 years.

When property and equipment is retired or otherwise disposed of, the cost and accumulated depreciation are relieved from the accounts and the net gain or loss is included in operating expenses.

Internal-Use Software Development Costs

Costs incurred in the development of internal use software during the application development stage are capitalized and included in Property, plant and equipment, net on the consolidated balance sheets. Such capitalized costs include costs directly associated with the development of the applications. Capitalization of such costs begins when the preliminary project stage is complete and ceases at the point the project is substantially complete and is ready for its intended purpose. Internal-use software is amortized on a straight-line basis over the estimated useful life of between 3-5 years. Costs incurred during the preliminary project stage, as well as maintenance and training costs, are expensed as incurred.
    
Minimum [Member] | Customer Relationships [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 4 years    
Minimum [Member] | Developed Technology Rights [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 2 years    
Minimum [Member] | License      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 12 years    
Minimum [Member] | Trade Names [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 6 years    
Minimum [Member] | Noncompete Agreements [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 3 years    
Minimum [Member] | Building and Building Improvements [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 10 years    
Minimum [Member] | Reagent Rental Equipment [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 1 year    
Minimum [Member] | Equipment [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 3 years    
Minimum [Member] | Software Development      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 3 years    
Maximum [Member] | Customer Relationships [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 16 years    
Maximum [Member] | Technology-Based Intangible Assets      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 14 years    
Maximum [Member] | Developed Technology Rights [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 20 years    
Maximum [Member] | License      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 13 years    
Maximum [Member] | Trade Names [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 10 years    
Maximum [Member] | Noncompete Agreements [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 10 years    
Maximum [Member] | Building and Building Improvements [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 50 years    
Maximum [Member] | Reagent Rental Equipment [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 5 years    
Maximum [Member] | Equipment [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 12 years    
Maximum [Member] | Software Development      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 5 years