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Intangible assets (Tables) | 9 Months Ended
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Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract] |
Schedule of Finite-Lived Intangible Assets | Intangible assets, net consisted of the following:
| Nine Months Ended |  | Year Ended
| September 30, 2021 |  | December 31, 2020
Cost | (in thousands)
Customer relationships | $ | 4,047,002 |  |  | $ | 144,251 |
Order backlog | 527,324 |  |  | 39,269 |
Trade names & brands | 204,705 |  |  | 2,766 |
Patient database | 170,513 |  |  | 2,552 |
Technology assets | 121,672 |  |  | 11,173 |
Total cost | 5,071,216 |  |  | 200,011 |
Accumulated amortization | (256,032) |  |  | (133,551) |
Net book value | $ | 4,815,184 |  |  | $ | 66,460 |

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- Definition Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance with a finite life, by either major class or business segment. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16265-109275 + Details
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