Acquisitions and Strategic Investments (Tables)

12 Months Ended

Dec. 31, 2024

Business Combinations [Abstract]

Schedule of Business Acquisitions, by Acquisition

The preliminary purchase prices were comprised of the amounts presented below:

(in millions)	Silk Road Medical		Axonics
Payment for acquisition, net of cash acquired	$	1,126	$	3,409
	$	1,126	$	3,409

We accounted for these transactions as business combinations in accordance with FASB ASC Topic 805. The final purchase prices were comprised of the amounts presented below:

(in millions)	Acotec(1)		Apollo		Relievant
Payment for acquisition, net of cash acquired (2)	$	381	$	636	$	794
Fair value of contingent consideration	—		—		273
	$	381	$	636	$	1,067

(1) Excludes approximately $140 million of cash on hand at the closing of the transaction

(2) Related to Acotec, represents our majority stake investment

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

(in millions)	Silk Road Medical		Axonics
Goodwill	$	569	$	2,147
Amortizable intangible assets	507		1,242
Other assets acquired	117		423
Liabilities assumed	(45)		(167)
Net deferred tax liabilities	(23)		(237)
	$	1,126	$	3,409

The final purchase price allocations were comprised of the components presented below, with the excess of the purchase price over the fair value of net identifiable assets acquired recorded to goodwill:

(in millions)	Acotec		Apollo		Relievant
Goodwill	$	337	$	378	$	731
Amortizable intangible assets	334		248		325
Other assets acquired	93		50		24
Liabilities assumed	(48)		(33)		(15)
Net deferred tax liabilities	(76)		(5)		1
Fair value of noncontrolling interest	(259)		—		—
	$	381	$	636	$	1,067

Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination

We allocated a portion of the purchase price to the specific intangible asset categories as follows:

	Amount Assigned (in millions)		Weighted Average Amortization Period (in years)	Risk-Adjusted Discount Rates used in Purchase Price Allocation
Silk Road Medical:
Amortizable intangible assets:
Technology-related	$	447	12	13%
Customer relationships	61		12	13%
	$	507
Axonics
Amortizable intangible assets:
Technology-related	$	1,157	12	10%
Customer relationships	85		12	10%
	$	1,242

We allocated a portion of the purchase price to the specific intangible asset categories as follows:

	Amount Assigned (in millions)		Weighted Average Amortization Period (in years)	Risk-Adjusted Discount Rates used in Purchase Price Allocation
Acotec:
Amortizable intangible assets:
Technology-related	$	308	11	14%
Customer relationships	15		11	14%
Other intangible assets	11		13	14%
	$	334
Apollo:
Amortizable intangible assets:
Technology-related	$	222	11	12%
Customer relationships	26		11	12%
	$	248
Relievant:
Amortizable intangible assets:
Technology-related	$	287	12	12%
Customer relationships	38		12	12%
	$	325

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

Changes in the fair value of our contingent consideration liability during 2024 and 2023 associated with current and prior period acquisitions were as follows:

(in millions)
Balance as of December 31, 2022	$	149
Amount recorded related to current year acquisitions	273
Contingent consideration net expense (benefit)	58
Contingent consideration payments	(76)
Balance as of December 31, 2023	$	404
Amount recorded related to current year acquisitions	29
Contingent consideration net expense (benefit)	(5)
Contingent consideration payments and other adjustments	(257)
Balance as of December 31, 2024	$	171

Fair Value Measurement Inputs and Valuation Techniques

The recurring Level 3 fair value measurements of our contingent consideration liability that we expect to be required to settle include the following significant unobservable inputs:

Contingent Consideration Liability	Fair Value as of December 31, 2024	Valuation Technique	Unobservable Input	Range				Weighted Average(1)
Revenue-based Payments and Commercialization Milestones	$171 million	Discounted Cash Flow	Discount Rate	6	%	-	15%	7%
			Probability of Payment	40%		-	100%	96%
			Projected Year of Payment	2025		-	2029	2027

(1) Unobservable inputs were weighted by the relative fair value of the contingent consideration liability. For projected year of payment, the amount represents the median of the inputs and is not a weighted average.

Investment

The aggregate carrying amount of our strategic investments was comprised of the following:

	As of December 31,
(in millions)	2024		2023
Equity method investments	$	278	$	219
Measurement alternative investments(1, 2)	277		194
	$	555	$	413

(1) Measurement alternative investments are privately-held equity securities without readily determinable fair values that are measured at cost less impairment, if any, adjusted to fair value for any observable price changes in orderly transactions for the identical or a similar investment of the same issuer, recognized in Other, net within our accompanying consolidated statements of operations.

(2) Includes publicly-held equity securities and convertible notes measured at fair value with changes in fair value recognized in Other, net within our consolidated statements of operations.