v3.24.3
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flows from operating activities:    
Net income $ 76,479 $ 107,839
Adjustments to reconcile net income to net cash provided by operating activities:    
Acquired in-process research and development 12,613  
Depreciation and amortization 185,796 73,571
Amortization of premiums on marketable securities (119) 730
Provision for excess and obsolete inventory 16,194 6,700
Amortization of inventory fair value step up 168,097 19,065
Amortization of 2025 Note fair value step up 19,973  
Stock-based compensation expense 42,284 40,297
Allowance for expected credit losses 15,667 4,284
Change in fair value of business acquisition liabilities 8,608 4,431
Change in deferred income taxes (92,723) (45,990)
(Gain)/loss on disposal of assets, net 2,687 1,466
Payment of business acquisition-related liabilities (18,084) (2,370)
Net (gain)/loss from foreign currency adjustment (2,354)  
(Increase) decrease in:    
Accounts receivable (100,545) (36,953)
Inventories (17,973) (58,978)
Prepaid expenses and other assets (3,108) (1,280)
Increase (decrease) in:    
Accounts payable 1,294 (7,952)
Accrued expenses and other liabilities 389 20,579
Income taxes payable/receivable (4,876) 13,386
Net cash provided by/(used in) operating activities 310,299 138,825
Cash flows from investing activities:    
Purchases of marketable securities (13,366) (100,643)
Maturities of marketable securities 47,746 214,430
Sales of marketable securities 9,644 219,987
Purchases of property and equipment (98,318) (55,393)
Acquisition of businesses, net of cash acquired and purchases of intangible and other assets (17,635) (296,028)
Net cash provided by/(used in) investing activities (71,929) (17,647)
Cash flows from financing activities:    
Payment of business acquisition-related liabilities (37,003) (5,908)
Net proceeds from exercise of stock options 41,156 11,357
Payments related to tax withholdings for share-based compensation (6,795)  
Repurchase of common stock (84,787)  
Net cash provided by/(used in) financing activities (87,429) 5,449
Effect of foreign exchange rates on cash 4,533 2,527
Net increase/(decrease) in cash and cash equivalents 155,474 129,154
Cash and cash equivalents at beginning of period 467,292 150,466
Cash and cash equivalents at end of period 622,766 279,620
Supplemental disclosures of cash flow information:    
Income taxes paid, net 117,474 65,171
Non-cash investing and financing activities:    
Equity issued in conjunction with the NuVasive Merger   2,153,860
Accrued purchases of property and equipment $ 4,802 $ 5,971