Note 7 - Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2024

Notes Tables

Schedule of Goodwill [Table Text Block]

	2024
Balance at January 1, 2024	$	191,379
Acquisition of TCPS		690
Acquisition of The Clinical Hub		194
Effect of exchange rate changes		(1,043	)
Balance at December 31, 2024	$	191,220

	2023
Balance at January 1, 2023	$	192,398
Post-closing adjustment for eeds		(1,305	)
Effect of exchange rate changes		286
Balance at December 31, 2023	$	191,379

Schedule of Finite-Lived Intangible Assets [Table Text Block]

	As of December 31, 2024							As of December 31, 2023
	Gross Amount		Accumulated Amortization			Net		Gross Amount		Accumulated Amortization			Net
Customer related	$	106,001	$	(58,536	)	$	47,465	$	111,837	$	(57,095	)	$	54,742
Other		27,865		(19,782	)		8,083		29,892		(16,603	)		13,289
Total	$	133,866	$	(78,318	)	$	55,548	$	141,729	$	(73,698	)	$	68,031

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]

2025	$	12,757
2026		9,528
2027		8,745
2028		5,547
2029		3,935
Thereafter		15,036
Total	$	55,548