Composition of Certain Financial Statement Captions (Details) - USD ($) $ in Thousands	Jun. 30, 2017	Dec. 31, 2016
Accounts receivable, net
Accounts receivable	$ 306,967	$ 256,552
Less: allowance for doubtful accounts	(55,220)	(36,268)
Accounts receivable, net	251,747	220,284
Inventories, net
Consumable supplies	21,113	23,448
Finished products	21,822	16,143
Work in-process	4,983	3,896
Raw materials	6,352	4,686
Less: inventory reserve	(5,977)	(945)
Inventory, net	48,293	47,228
Other current assets and prepaid expenses
Taxes recoverable	15,416	16,187
Other receivables	12,516	13,021
Prepaid supplies	8,565	6,952
Prepaid insurance	2,162	3,688
Other	3,287	7,508
Other current assets and prepaid expenses	41,946	47,356
Intangible assets, net:
Less: accumulated amortization	(160,138)	(123,207)
Intangible assets, net	731,134	763,976
Accrued expenses:
Deferred revenue	74,954	73,434
Employee benefits	48,631	43,792
Clinical trials	9,176	5,935
Taxes payable	5,879	4,430
Contingent consideration	5,081	259
Capital leases short-term	3,464	3,025
Milestone payment	4,966	4,865
Professional fees	4,067	4,035
Other	50,185	58,180
Accrued expenses	206,403	197,955
Other long-term liabilities:
Deferred revenue	53,537	89,016
Line of credit	69,700	38,809
Contingent consideration	46,434	44,817
Mortgages and other debts payable	1,560	717
Capital leases long-term	8,488	7,216
Other	22,124	21,908
Other long-term liabilities	201,843	202,483
Customer relationships
Intangible assets, net:
Intangible assets	446,368	443,560
Technologies
Intangible assets, net:
Intangible assets	340,721	340,397
Trade names
Intangible assets, net:
Intangible assets	50,478	50,442
Licenses
Intangible assets, net:
Intangible assets	23,500	23,506
Covenants not to compete
Intangible assets, net:
Intangible assets	16,368	16,348
Product registrations
Intangible assets, net:
Intangible assets	8,233	7,641
Other
Intangible assets, net:
Intangible assets	$ 5,604	$ 5,289