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Segment Information
 9 Months Ended
Sep. 30, 2022
Segment Reporting [Abstract]  
Segment Information Segment Information
We periodically evaluate our application of accounting guidance for reportable segments and disclose information about reportable segments based on the way management organizes the enterprise for making operating decisions and assessing performance. We report our business under two segments: Products & Healthcare Services and Patient Direct. The Products & Healthcare Services segment includes our United States distribution business (Medical Distribution), outsourced logistics and value-added services business, and Global Products which manufactures and sources medical surgical products through our production and kitting operations. The Patient Direct segment includes our home healthcare businesses (Byram and Apria).
We evaluate the performance of our segments based on their operating income excluding intangible amortization and acquisition-related and exit and realignment charges that, either as a result of their nature or size, would not be expected to occur as part of our normal business operations on a regular basis. Segment assets exclude inter-segment account balances as we believe their inclusion would be misleading and not meaningful.
The following tables present financial information by segment:
Three Months Ended
 September 30,		Nine Months Ended
 September 30,
2022202120222021
Net revenue:
Products & Healthcare Services$1,903,356 $2,256,295 $5,964,784 $6,621,560 
Patient Direct594,045 245,880 1,439,584 696,609 
Consolidated net revenue$2,497,401 $2,502,175 $7,404,368 $7,318,169 
Operating income:
Products & Healthcare Services$23,781 $64,415 $174,108 $316,062 
Patient Direct59,666 14,865 127,791 41,434 
Intangible amortization(14,302)(10,025)(55,459)(30,077)
Acquisition-related and exit and realignment charges(8,898)(6,380)(50,048)(20,967)
Consolidated operating income$60,247 $62,875 $196,392 $306,452 
Depreciation and amortization:
Products & Healthcare Services$19,121 $18,868 $57,325 $56,874 
Patient Direct39,030 3,774 98,113 11,268 
Consolidated depreciation and amortization$58,151 $22,642 $155,438 $68,142 
Capital expenditures:
Products & Healthcare Services$9,743 $13,498 $38,804 $31,768 
Patient Direct39,706 446 76,344 857 
Consolidated capital expenditures$49,449 $13,944 $115,148 $32,625 


September 30,
2022		December 31, 2021
Total assets:
Products & Healthcare Services$2,952,570 $3,012,303 
Patient Direct2,509,242 468,536 
Segment assets5,461,812 3,480,839 
Cash and cash equivalents76,770 55,712 
Consolidated total assets$5,538,582 $3,536,551 
The following table presents net revenue by geographic area, which were attributed based on the location from which we ship products or provide services:
Three Months Ended September 30,Nine Months Ended September 30,
2022202120222021
Net revenue:
United States$2,410,790 $2,380,794 $7,049,382 $6,900,222 
International86,611 121,381 354,986 417,947 
Consolidated net revenue$2,497,401 $2,502,175 $7,404,368 $7,318,169