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Intangible Assets (Tables) | 12 Months Ended
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Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract] |
Schedule of Finite-Lived Intangible Assets | Intangible assets are amortized on a straight-line basis over their estimated useful lives, as set forth in the table below:
| Estimated Useful Life
Customer relationships | 16 - 23 years
Order backlog | 3 years
Trade names | 3 years
Patient database | 7 years
Technology assets | 5 years
The carrying amount of Intangible Assets for the years ended December 31, 2023 and 2022 is as follows:
| December 31, 2023 | December 31, 2022
Cost | (in thousands)
Customer relationships | $ | 4,090,393 |  | $ | 4,076,435 |
Order backlog | 541,302 |  | 536,934 |
Trade names & brands | 204,653 |  | 204,621 |
Patient database | 170,366 |  | 170,238 |
Technology assets | 141,257 |  | 120,984 |
Total cost | 5,147,971 |  | 5,109,212 |
Accumulated amortization | (1,292,106) |  | (830,553) |
Net book value | $ | 3,855,865 |  | $ | 4,278,659 |
Schedule of Future Intangible Asset Amortization Expense | Future intangible asset amortization expense for the years ended December 31, 2024 to December 31, 2028 is as follows:
| (in thousands)
2024 | $ | 344,518 |
2025 | 229,106 |
2026 | 214,869 |
2027 | 202,539 |
2028 | 189,539 |
Total | $ | 1,180,571 |

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