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GOODWILL AND OTHER INTANGIBLE ASSETS
 9 Months Ended
Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
GOODWILL AND OTHER INTANGIBLE ASSETS GOODWILL AND OTHER INTANGIBLE ASSETS
Changes in the carrying amount of goodwill consist of the following activity for the three and nine months ended September 30, 2023 (in thousands):
Balance at December 31, 2022$1,533,424 
Purchase accounting adjustments145 
Balance at March 31, 2023$1,533,569 
Acquisitions6,998 
Balance at June 30, 2023$1,540,567 
Purchase accounting adjustments(321)
Balance at September 30, 2023$1,540,246 
The carrying amount and accumulated amortization of intangible assets consist of the following as of September 30, 2023 and December 31, 2022 (in thousands):
September 30, 2023December 31, 2022
Gross intangible assets:
Referral sources$514,388 $509,646 
Trademarks/names39,136 38,508 
Other amortizable intangible assets1,003 912 
Total gross intangible assets554,527 549,066 
Accumulated amortization:
Referral sources(191,262)(167,902)
Trademarks/names(18,973)(16,901)
Other amortizable intangible assets(298)(148)
Total accumulated amortization(210,533)(184,951)
Total intangible assets, net$343,994 $364,115 
Amortization expense for intangible assets was $8.6 million and $25.6 million for the three and nine months ended September 30, 2023, respectively. Amortization expense for intangible assets was $8.4 million and $24.6 million for the three and nine months ended September 30, 2022, respectively.