| Intangible Assets | 
 Note 7: Intangible Assets 
Intangible assets, net consisted of the following: 
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September 30, 2023 | 
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December 31, 2022 | 
 
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Gross Carrying Amount | 
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Accumulated Amortization | 
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Net Carrying Amount | 
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Gross Carrying Amount | 
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Accumulated Amortization | 
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Net Carrying Amount | 
 
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(in thousands) | 
 
| Indefinite lived intangible assets: | 
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| Medical licenses | 
$ | 
700  | 
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$ | 
—  | 
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$ | 
700  | 
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$ | 
700  | 
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$ | 
—  | 
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$ | 
700  | 
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| Definite lived intangible assets: | 
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| Customer relationships | 
684,000  | 
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(125,400) | 
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558,600  | 
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684,000  | 
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(74,100) | 
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609,900  | 
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| Trademarks | 
148,635  | 
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(27,866) | 
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120,769  | 
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148,635  | 
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(16,704) | 
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131,931  | 
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| Payor contracts | 
4,700  | 
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(823) | 
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3,877  | 
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4,700  | 
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(470) | 
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4,230  | 
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| Provider network | 
4,800  | 
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(871) | 
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3,929  | 
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4,800  | 
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(511) | 
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4,289  | 
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| Total | 
$ | 
842,835  | 
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$ | 
(154,960) | 
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$ | 
687,875  | 
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$ | 
842,835  | 
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$ | 
(91,785) | 
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$ | 
751,050  | 
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  Amortization of intangible assets was $21.1 million for each of the three months ended September 30, 2023 and 2022 and $63.2 million and $63.4 million for the nine months ended September 30, 2023 and 2022, respectively.
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