Annual report pursuant to Section 13 and 15(d)

Goodwill and Intangible Assets

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Goodwill and Intangible Assets
 12 Months Ended
Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets Goodwill and Intangible Assets
The changes in the carrying value of goodwill by segment are as follows (in thousands):
  DME Services (a)
Balance as of December 31, 2020 $ —
Goodwill acquired 3,710
Balance as of December 31, 2021 $ 3,710
(a) The ITS segment has no recorded goodwill.
The Company assessed the indicators of goodwill impairment as part of its annual impairment test, as of October 1, 2021, and through December 31, 2021, by performing a qualitative assessment of goodwill. In performing the qualitative assessment, the Company evaluated events and circumstances since the last impairment analysis, recent operating performance, changes in the business climate and company-specific factors. The results of the qualitative assessment indicated that it was more likely than not that the estimated fair value of each reporting unit exceeded its carrying value amount as of the test date.
The carrying amount and accumulated amortization of intangible assets were as follows (in thousands):
December 31, 2021 December 31, 2020
Gross Assets Accumulated Amortization Net Gross Assets Accumulated Amortization Net
Nonamortizable intangible assets
Trade names
 $ 2,000  $ —  $ 2,000  $ 2,000  — $ 2,000 
Amortizable intangible assets
Trade names
 23  (23) —  23  (23) — 
Physician and customer relationships
 38,834  (31,401) 7,433  36,534  (28,924) 7,610 
Unpatented technology 943  (123) 820  —  —  — 
Non-competition agreements 472  (67) 405  —  —  — 
Software
 11,530  (11,258) 272  11,230  (9,663) 1,567 
Total nonamortizable and amortizable intangible assets
 $ 53,802  $ (42,872) $ 10,930  $ 49,787  $ (38,610) $ 11,177 
Amortization expense for intangible assets for the years ended December 31, 2021, 2020 and 2019 was $4.3 million, $4.3 million and $4.4 million, respectively, which was recorded in "amortization of intangibles expenses" for each period.
Expected remaining annual amortization expense for the next five years for intangible assets recorded as of December 31, 2021 is as follows (in thousands):
2022 2023 2024 2025 2026 2027 and
thereafter
Amortization expense
 $ 2,494  $ 990  $ 990  $ 810  $ 524  $ 3,122