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Intangible assets | 9 Months Ended
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Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible assets | 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 |
The identifiable intangible assets are amortized over their estimated useful lives.

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- Definition The entire disclosure for all or part of the information related to intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -URI http://asc.fasb.org/topic&trid=2144416 + Details
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