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Intangible assets (Tables) | 9 Months Ended
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Sep. 30, 2022
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, 2022 | December 31, 2021
Cost | (in thousands)
Customer relationships | $ | 4,072,988 |  | $ | 4,056,642 |
Order backlog | 535,557 |  | 528,022 |
Trade names & brands | 204,536 |  | 204,685 |
Patient database | 170,049 |  | 170,525 |
Technology assets | 120,283 |  | 121,507 |
Total cost | 5,103,413 |  | 5,081,381 |
Accumulated amortization | (711,714) |  | (370,538) |
Net book value | $ | 4,391,699 |  | $ | 4,710,843 |

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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 https://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 https://asc.fasb.org/extlink&oid=66006027&loc=d3e16265-109275 + Details
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