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Goodwill and Intangible Assets (Tables) | 12 Months Ended
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Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract] |
Summary of Intangible Assets, Net | Intangible assets, net, consist of the following (in thousands):
|  | December 31, 2018 |
|  | Gross Carrying Value |  |  | Accumulated Amortization |  |  | Net Carrying Value |
Physician and hospital agreements |  | $ | 376,871 |  |  | $ | (223,589) |  |  | $ | 153,282 |
Customer relationships |  |  | 443,300 |  |  |  | (71,870 | ) |  |  | 371,430 |
Trade names |  |  | 43,156 |  |  |  | (4,630 | ) |  |  | 38,526 |
Patented and other technology |  |  | 47,561 |  |  |  | (22,487 | ) |  |  | 25,074 |
|  | $ | 910,888 |  |  | $ | (322,576) |  |  | $ | 588,312 |
|  | December 31, 2017 |
|  | Gross Carrying Value |  |  | Accumulated Amortization |  |  | Net Carrying Value |
Physician and hospital agreements |  | $ | 381,635 |  |  | $ | (203,915) |  |  | $ | 177,720 |
Customer relationships |  |  | 443,300 |  |  |  | (48,837 | ) |  |  | 394,463 |
Trade names |  |  | 43,156 |  |  |  | (2,933 | ) |  |  | 40,223 |
Patented and other technology |  |  | 38,590 |  |  |  | (11,068 | ) |  |  | 27,522 |
|  | $ | 906,681 |  |  | $ | (266,753) |  |  | $ | 639,928 |
Amortization Expenses for Existing Intangible Assets for the Next Five Years | Amortization expense for existing intangible assets for the next five years is expected to be as follows (in thousands):
2019 |  | $ | 66,532 |
2020 |  |  | 59,969 |
2021 |  |  | 53,771 |
2022 |  |  | 46,249 |
2023 |  |  | 40,448 |

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- Definition Tabular disclosure of assets, excluding financial assets and goodwill, lacking physical substance with a finite life, by either major class or business segment. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16265-109275 + Details
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