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Revenue from Contract with Customer (Policies)
3 Months Ended
Mar. 31, 2023
Revenue from Contract with Customer [Abstract]  
Revenue REVENUES
The Company's revenues by segment and by payers/customer groups for the three months ended March 31, 2023, and 2022, were as follows:
For the Three Months Ended March 31, 2023For the Three Months Ended March 31, 2022
North AmericaEuropeOtherTotalNorth AmericaEuropeOtherTotal
Payer/Customer
Dx
   Clients17 %— %— %17 %17 %— %— %17 %
   Patients%— %— %%%— %— %%
   Medicare and Medicaid%— %— %%%— %— %%
   Third party31 %— %— %31 %35 %— %— %35 %
Total Dx revenues by payer63 %— %— %63 %63 %— %— %63 %
DD
Pharmaceutical, biotechnology and medical device companies18 %12 %%37 %17 %13 %%37 %
Total revenues81 %12 %%100 %80 %13 %%100 %
Revenues in the U.S. were $2,959.2 (78.3%) and $3,000.5 (76.9%) for the three months ended March 31, 2023, and 2022, respectively.
DD Contract costs
DD incurs costs to fulfill contracts with customers. Contract fulfillment costs include software implementation costs and setup costs for certain market access solutions.
March 31, 2023December 31, 2022
Sales commission assets$38.3 $38.2 
Deferred contract fulfillment costs14.3 15.0 
Total$52.6 $53.2 
Amortization related to sales commission assets and associated payroll taxes for the three months ended March 31, 2023, and 2022, was $8.4 and $7.2, respectively. Amortization related to deferred contract fulfillment costs for the three months ended March 31, 2023, and 2022, was $2.4 and $3.1, respectively.
Accounts Receivable, Unbilled Services and Unearned Revenue
The following table provides information about accounts receivable, unbilled services, and unearned revenue from contracts with customers:
March 31, 2023December 31, 2022
Dx accounts receivable$1,131.6 $1,046.9 
DD accounts receivable1,266.0 1,218.6 
Less DD allowance for doubtful accounts(52.8)(43.5)
Accounts receivable$2,344.8 $2,222.0 
Gross unbilled services$715.9 $805.9 
Less reserve for unbilled services(10.8)(10.5)
Unbilled services$705.1 $795.4 
Unearned revenue$586.7 $582.1 
Revenues recognized during the period that were included in the unearned revenue balance at the beginning of the period were $165.3 and $163.8 for the three months ended March 31, 2023, and 2022, respectively.
Credit Loss Rollforward
The Company estimates future expected losses on accounts receivable, unbilled services and notes receivable over the remaining collection period of the instrument. The rollforward for the allowance for credit losses for the three months ended March 31, 2023, is as follows:
Accounts ReceivableUnbilled ServicesNote and Other ReceivablesTotal
Balance as of December 31, 2022$43.5 $10.5 $0.7 $54.7 
Plus, credit loss expense11.1 — — 11.1 
Less, write offs(1.8)0.3 — (1.5)
Balance as of March 31, 2023$52.8 $10.8 $0.7 $64.3 
The credit loss expense in the first quarter primarily related to the the collection risk from several biotech receivable balances.
Performance Obligations Under Long-Term Contracts
Long-term contracts at the Company consist primarily of fully managed clinical studies within DD. The amount of existing performance obligations unsatisfied under such long-term contracts were $4,720.0 as of March 31, 2023. DD expects to recognize approximately 30.0% of the remaining performance obligations as of March 31, 2023, as revenue over the next 12 months. DD's long-term contracts generally range from 1 to 8 years.
Within DD, revenues of $10.4 and $31.7 were recognized during the three months ended March 31, 2023 and 2022, respectively, from performance obligations that were satisfied in previous periods. This revenue primarily relates to adjustments related to changes in scope in full service clinical studies, and to a lesser extent, changes in estimates.