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Goodwill and Intangible Assets (Tables)
 12 Months Ended
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