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Intangible Assets - Narrative (Details) - USD ($) $ in Thousands |  |  | 3 Months Ended | 12 Months Ended | 30 Months Ended
--- | --- | --- | --- | --- | ---
Oct. 02, 2023 | Jul. 01, 2021 | Dec. 31, 2023 | Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2023
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization of intangible assets |  |  |  | $ 459,900 | $ 463,100 | $ 239,500 |
Fair value of cash consideration |  |  |  | $ 71,766 | $ 0 | $ 5,914,475 |
Customer relationships | Minimum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 16 years | 16 years |  |  | 16 years
Customer relationships | Maximum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 23 years | 23 years |  |  | 23 years
Order backlog |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 3 years | 3 years |  |  | 3 years
Trade names & brands |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 3 years | 3 years |  |  | 3 years
Patient database |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 7 years | 7 years |  |  | 7 years
Technology assets |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  |  | 5 years | 5 years |  |  | 5 years
Biotel Research LLC |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization of intangible assets |  |  | $ 1,500 |  |  |  |
Fair value of cash consideration | $ 68,100 |  |  |  |  |  |
Value of intangible assets acquired | $ 36,400 |  |  |  |  |  |
Biotel Research LLC | Minimum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period | 3 years |  |  |  |  |  |
Biotel Research LLC | Maximum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period | 16 years |  |  |  |  |  |
Biotel Research LLC | Customer relationships |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired | $ 12,500 |  |  |  |  |  |
Biotel Research LLC | Order backlog |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired | 3,900 |  |  |  |  |  |
Biotel Research LLC | Technology assets |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired | $ 20,000 |  |  |  |  |  |
PRA Health Sciences, Inc |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization of intangible assets |  |  |  | $ 451,400 |  |  | $ 1,128,500
Fair value of cash consideration |  | $ 5,308,646 |  |  |  |  |
Value of intangible assets acquired |  | $ 4,919,000 |  |  |  |  |
PRA Health Sciences, Inc | Minimum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  | 3 years |  |  |  |  |
PRA Health Sciences, Inc | Maximum |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Amortization period |  | 23 years |  |  |  |  |
PRA Health Sciences, Inc | Customer relationships |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired |  | $ 3,938,000 |  |  |  |  |
PRA Health Sciences, Inc | Order backlog |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired |  | 500,000 |  |  |  |  |
PRA Health Sciences, Inc | Trade names & brands |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired |  | 202,000 |  |  |  |  |
PRA Health Sciences, Inc | Patient database |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired |  | 168,000 |  |  |  |  |
PRA Health Sciences, Inc | Technology assets |  |  |  |  |  |  |
Indefinite-lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Value of intangible assets acquired |  | $ 111,000 |  |  |  |  |

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