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Segment Information
 12 Months Ended
Dec. 31, 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 our Global Products business 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, acquisition-related, exit and realignment charges, along with other adjustments, 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:
Year ended December 31,202220212020
Net revenue:
Products & Healthcare Services$7,898,397 $8,825,646 $7,662,429 
Patient Direct2,057,078 959,669 817,748 
Consolidated net revenue$9,955,475 $9,785,315 $8,480,177 
Operating income:
Products & Healthcare Services$175,309 $384,390 $215,698 
Patient Direct193,748 57,966 67,662 
Intangible amortization(78,847)(39,807)(41,490)
Acquisition-related and exit and realignment charges(55,022)(34,076)(37,752)
Inventory valuation adjustment(1)
(92,275)— — 
Consolidated operating income$142,913 $368,473 $204,118 
Depreciation and amortization:
Products & Healthcare Services$77,539 $75,548 $77,131 
Patient Direct151,128 15,073 16,205 
Consolidated depreciation and amortization$228,667 $90,621 $93,336 
Capital expenditures:
Products & Healthcare Services$49,824 $48,282 $55,110 
Patient Direct116,758 1,408 1,056 
Discontinued operations— — 3,027 
Consolidated capital expenditures$166,582 $49,690 $59,193 
(1) Relates to an inventory valuation adjustment in our Products & Healthcare Services segment, primarily associated with PPE inventory built up and a subsequent decline in demand as a result of the COVID-19 pandemic.
December 31,20222021
Total assets:
Products & Healthcare Services$2,809,600 $3,012,303 
Patient Direct2,507,216 468,536 
Segment assets5,316,816 3,480,839 
Cash and cash equivalents69,467 55,712 
Consolidated total assets$5,386,283 $3,536,551 
The following tables present information by geographic area. Net revenues were attributed to geographic areas based on the locations from which we ship products or provide services.

Year ended December 31,202220212020
Net revenue:
United States$9,526,037 $9,250,331 $8,130,411 
International429,438 534,984 349,766 
Consolidated net revenue$9,955,475 $9,785,315 $8,480,177 
December 31,20222021
Long-lived assets:
United States$1,226,108 $641,630 
International116,524 113,363 
Consolidated long-lived assets$1,342,632 $754,993