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Income Taxes Effective tax rate (Details) - USD ($) $ in Thousands | 3 Months Ended
--- | ---
Mar. 31, 2023 | Mar. 31, 2022
Business Acquisition, Contingent Consideration [Line Items] |  |
Change in fair value of contingent earn-out | $ (700) | $ 0
Effective Income Tax Rate | 27.00% | 31.00%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent | 21.00% | 21.00%
Share-based Payment Arrangement, Expense, Tax Benefit | $ 700 | $ 2,600
contingent consideration, tax expense | 0 |
SmithsMedical |  |
Business Acquisition, Contingent Consideration [Line Items] |  |
Change in fair value of contingent earn-out | $ (700) |

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