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Goodwill and Intangible Assets (Tables) | 12 Months Ended
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Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract] |
Summary of Changes to Goodwill | A summary of changes to goodwill is as follows (in thousands):
|  | Goodwill |
|  | Pharmacy Solutions |  |  | Provider Services |  |  | Total |
Goodwill at January 1, 2024* |  | $ | 833,989 |  |  | $ | 1,466,783 |  |  | $ | 2,300,772 |
Goodwill added through acquisitions |  |  | 7,063 |  |  |  | 56,144 |  |  |  | 63,207 |
Measurement period adjustments |  |  | — |  |  |  | 237 |  |  |  | 237 |
Foreign currency adjustments |  |  | — |  |  |  | (332 | ) |  |  | (332 | )
Goodwill at December 31, 2024* |  | $ | 841,052 |  |  | $ | 1,522,832 |  |  | $ | 2,363,884 |
Goodwill added through acquisitions |  |  | — |  |  |  | 181,472 |  |  |  | 181,472 |
Measurement period adjustments |  |  | — |  |  |  | 128 |  |  |  | 128 |
Foreign currency adjustments |  |  | — |  |  |  | 189 |  |  |  | 189 |
Goodwill at December 31, 2025* |  | $ | 841,052 |  |  | $ | 1,704,621 |  |  | $ | 2,545,673 |
* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million, which were incurred in fiscal year 2022. |
Schedule of Intangible Assets | Intangible assets are as follows (in thousands):
|  | December 31, 2025 |  |  | December 31, 2024 |  |  |
|  | Gross |  |  | Accumulated Amortization |  |  | Net Carrying Value |  |  | Gross |  |  | Accumulated Amortization |  |  | Net Carrying Value |  |  | Life (Years)
Customer relationships |  | $ | 502,160 |  |  | $ | 356,146 |  |  | $ | 146,014 |  |  | $ | 542,137 |  |  | $ | 335,647 |  |  | $ | 206,490 |  |  | 5-20
Trade names |  |  | 318,768 |  |  |  | 154,601 |  |  |  | 164,167 |  |  |  | 332,977 |  |  |  | 140,020 |  |  |  | 192,957 |  |  | 2-20
Licenses |  |  | 67,395 |  |  |  | 18,886 |  |  |  | 48,509 |  |  |  | 68,425 |  |  |  | 17,528 |  |  |  | 50,897 |  |  | 10-20
Doctor/payor network |  |  | 5,650 |  |  |  | 4,987 |  |  |  | 663 |  |  |  | 12,730 |  |  |  | 10,965 |  |  |  | 1,765 |  |  | 5-8
Covenants not to compete |  |  | 6,654 |  |  |  | 4,717 |  |  |  | 1,937 |  |  |  | 8,790 |  |  |  | 5,886 |  |  |  | 2,904 |  |  | 2-7
Other intangible assets |  |  | 10,940 |  |  |  | 7,925 |  |  |  | 3,015 |  |  |  | 10,940 |  |  |  | 6,362 |  |  |  | 4,578 |  |  | 5-7
Total definite-lived assets |  | $ | 911,567 |  |  | $ | 547,262 |  |  | $ | 364,305 |  |  | $ | 975,999 |  |  | $ | 516,408 |  |  | $ | 459,591 |  |  |
Licenses |  |  | 193,250 |  |  |  | — |  |  |  | 193,250 |  |  |  | 135,633 |  |  |  | — |  |  |  | 135,633 |  |  | Indefinite
Total intangible assets |  | $ | 1,104,817 |  |  | $ | 547,262 |  |  | $ | 557,555 |  |  | $ | 1,111,632 |  |  | $ | 516,408 |  |  | $ | 595,224 |  |  |
Schedule of Definite-Lived Intangible Assets, Amortization Expense | As of December 31, 2025, total estimated amortization expense for the Company’s definite-lived intangible assets for the next five years and thereafter is as follows (in thousands):
2026 |  | $ | 79,888 |
2027 |  |  | 46,935 |
2028 |  |  | 39,876 |
2029 |  |  | 34,000 |
2030 |  |  | 33,108 |
Thereafter |  |  | 130,498 |
|  | $ | 364,305 |

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