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Intangible assets
3 Months Ended
Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible assets Intangible assets
Intangible assets, net consisted of the following:
Three Months EndedYear Ended
March 31, 2022December 31, 2021
Cost(in thousands)
Customer relationships$4,055,260 $4,056,642 
Order backlog527,451 528,022 
Trade names & brands204,648 204,685 
Patient database170,456 170,525 
Technology assets121,211 121,507 
Total cost5,079,026 5,081,381 
Accumulated amortization(486,439)(370,538)
 Net book value$4,592,587 $4,710,843 
The identifiable intangible assets are amortized over their estimated useful lives.