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Goodwill (Tables)
12 Months Ended
Dec. 31, 2021
Goodwill [Abstract]  
Changes in Carrying Amount of Goodwill

The changes in the carrying amount of goodwill as of December 31, 2021 and 2020 consisted of the following (in thousands):

 
Year Ended
December 31, 2021
   
Year Ended
December 31, 2020
 
             
Beginning balance
 
$
345,646
   
$
317,676
 
Goodwill acquired
   
89,746
     
28,540
 
Goodwill derecognition (write-off) related to closed clinics
   
-
     
(1,859
)
Goodwill adjustments for purchase price allocation of businesses acquired in prior year
   
(713
)
   
1,289
 
Ending balance
 
$
434,679
   
$
345,646