| Intangible Assets | 
 Note 7: Intangible Assets 
Intangible assets, net consisted of the following as of: 
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September 30, 2024 | 
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December 31, 2023 | 
 
 | 
Gross Carrying Amount | 
 | 
Accumulated Amortization | 
 | 
Net Carrying Amount | 
 | 
Gross Carrying Amount | 
 | 
Accumulated Amortization | 
 | 
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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  | 
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  | 
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  | 
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  | 
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  | 
 
| Customer relationships | 
671,818  | 
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(190,349) | 
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481,469  | 
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684,000  | 
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(142,500) | 
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541,500  | 
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| Trademarks | 
148,635  | 
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(42,748) | 
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105,887  | 
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148,635  | 
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(31,671) | 
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 | 
116,964  | 
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| Payor contracts | 
4,700  | 
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(1,293) | 
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 | 
3,407  | 
 | 
 | 
4,700  | 
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(940) | 
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 | 
3,760  | 
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| Provider network | 
4,734  | 
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(1,332) | 
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 | 
3,402  | 
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 | 
4,800  | 
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(991) | 
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 | 
3,809  | 
 | 
 
| Total | 
$ | 
830,587  | 
 | 
 | 
$ | 
(235,722) | 
 | 
 | 
$ | 
594,865  | 
 | 
 | 
$ | 
842,835  | 
 | 
 | 
$ | 
(176,102) | 
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$ | 
666,733  | 
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  Amortization of intangible assets was $21.0 million and $21.1 million during the three months ended September 30, 2024 and 2023, respectively, and $63.1 million and $63.2 million during the nine months ended September 30, 2024 and 2023, respectively
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