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Intangible assets | 3 Months Ended
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Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
Intangible assets | Intangible assets Intangible assets, net consisted of the following:
| Three Months Ended | Year Ended
| March 31, 2023 | December 31, 2022
Cost | (in thousands)
Customer relationships | $ | 4,077,267 |  | $ | 4,076,435 |
Order backlog | 537,247 |  | 536,934 |
Trade names & brands | 204,640 |  | 204,621 |
Patient database | 170,298 |  | 170,238 |
Technology assets | 121,141 |  | 120,984 |
Total cost | 5,110,593 |  | 5,109,212 |
Accumulated amortization | (946,183) |  | (830,553) |
Net book value | $ | 4,164,410 |  | $ | 4,278,659 |
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://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -URI https://asc.fasb.org/subtopic&trid=2144471 + Details
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