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Goodwill and Intangible Assets (Tables)
 9 Months Ended
Sep. 30, 2016
Goodwill and Intangible Assets Disclosure [Abstract]  
Changes in carrying amount of goodwill
The changes in the carrying amount of goodwill for the nine months ended September 30, 2016 were as follows (in thousands):

 
2016
Goodwill balance at January 1
$
184,472

Effect of foreign exchange
13

Additions as the result of acquisitions
28,584

Goodwill balance at September 30
$
213,069
Other intangible assets
Other intangible assets at September 30, 2016 and December 31, 2015, consisted of the following (in thousands):

 
September 30, 2016
 
Gross Carrying
Amount
 
Accumulated
Amortization
 
Net Carrying
Amount
Patents
$
13,518

 
$
(2,952
)
 
$
10,566

Distribution agreements
5,626

 
(3,366
)
 
2,260

License agreements
20,448

 
(3,113
)
 
17,335

Trademarks
12,369

 
(3,080
)
 
9,289

Covenants not to compete
1,021

 
(912
)
 
109

Customer lists
21,893

 
(14,751
)
 
7,142

Royalty agreements
267

 
(267
)
 
—

 
 
 
 
 
 
Total
$
75,142

 
$
(28,441
)
 
$
46,701


 
December 31, 2015
 
Gross Carrying
Amount
 
Accumulated
Amortization
 
Net Carrying
Amount
Patents
$
12,014

 
$
(2,595
)
 
$
9,419

Distribution agreements
5,626

 
(2,853
)
 
2,773

License agreements
19,109

 
(2,438
)
 
16,671

Trademarks
7,259

 
(2,554
)
 
4,705

Covenants not to compete
1,028

 
(873
)
 
155

Customer lists
20,793

 
(15,023
)
 
5,770

Royalty agreements
267

 
(267
)
 
—

 
 
 
 
 
 
Total
$
66,096

 
$
(26,603
)
 
$
39,493
Estimated amortization expense
Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of September 30, 2016 (in thousands):

Year Ending December 31
 
Remaining 2016
$
5,558

2017
21,646

2018
21,171

2019
20,854

2020
19,788