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Intangible assets
6 Months Ended
Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible assets Intangible assets
Intangible assets, net consisted of the following:
Six Months EndedYear Ended
June 30, 2023December 31, 2022
Cost(in thousands)
Customer relationships$4,077,225 $4,076,435 
Order backlog537,182 536,934 
Trade names & brands204,636 204,621 
Patient database170,342 170,238 
Technology assets121,110 120,984 
Total cost5,110,495 5,109,212 
Accumulated amortization(1,060,702)(830,553)
 Net book value$4,049,793 $4,278,659 
The identifiable intangible assets are amortized over their estimated useful lives.