A summary of changes to goodwill, by reportable segment, is as follows (in thousands):


	Goodwill
	Pharmacy Solutions		Provider Services		Total
Goodwill at January 1, 2025*	$	841,052	$	1,522,832	$	2,363,884
Goodwill added through acquisitions		—		6,430		6,430
Measurement period adjustments		—		128		128
Foreign currency adjustments		—		124		124
Goodwill at September 30, 2025*	$	841,052	$	1,529,514	$	2,370,566

* For the periods presented, the carrying amount of goodwill is presented net of accumulated impairment losses of $40.9 million.

Intangible assets are as follows (in thousands):


	September 30, 2025						December 31, 2024
	Gross		Accumulated Amortization		Net Carrying Value		Gross		Accumulated Amortization		Net Carrying Value		Life (Years)
Customer relationships	$	517,753	$	354,982	$	162,771	$	542,137	$	335,647	$	206,490	5-20
Trade names		328,968		156,431		172,537		332,977		140,020		192,957	2-20
Licenses		60,515		17,970		42,545		68,425		17,528		50,897	10-20
Doctor/payor network		5,650		4,800		850		12,730		10,965		1,765	5-8
Covenants not to compete		6,874		4,605		2,269		8,790		5,886		2,904	2-7
Other intangible assets		10,940		7,535		3,405		10,940		6,362		4,578	5-7
Total definite-lived assets	$	930,700	$	546,323	$	384,377	$	975,999	$	516,408	$	459,591
Licenses		137,233		—		137,233		135,633		—		135,633	Indefinite
Total intangible assets	$	1,067,933	$	546,323	$	521,610	$	1,111,632	$	516,408	$	595,224

Amortization expense for the three and nine months ended September 30, 2025 was $22.7 million and $69.7 million, respectively, as compared to $24.1 million and $72.0 million for the three and nine months ended September 30, 2024, respectively.