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v3.20.4

Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
Segment Reporting Information [Line Items] |  |  |
Revenues | $ 51,533 | $ 51,336 | $ 46,677
Equity in earnings of affiliates | (54) | (43) | (29)
Adjusted segment EBITDA | 10,037 | 9,857 | 8,949
Depreciation and amortization | 2,721 | 2,596 | 2,278
Interest expense | 1,584 | 1,824 | 1,755
Losses (gains) on sales of facilities | 7 | (18) | (428)
Losses on retirement of debt | 295 | 211 | 9
Income before income taxes | 5,430 | 5,244 | 5,335
Assets | 47,490 | 45,058 | 39,207
Goodwill and other intangible assets, Beginning Balance | 8,269 | 7,953 | 7,394
Goodwill and other intangible assets, Acquisitions | 344 | 332 | 636
Goodwill and other intangible assets, Foreign currency translation and other |  | (16) | (77)
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (35) |  |
Goodwill and other intangible assets, Ending Balance | 8,578 | 8,269 | 7,953
National Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 25,694 | 25,913 | 22,581
Equity in earnings of affiliates | (28) | (2) | (4)
Adjusted segment EBITDA | 5,532 | 5,634 | 4,980
Depreciation and amortization | 1,216 | 1,161 | 946
Assets | 18,913 | 18,290 | 14,839
Goodwill and other intangible assets, Beginning Balance | 1,739 | 1,597 | 1,474
Goodwill and other intangible assets, Acquisitions | 38 | 155 | 132
Goodwill and other intangible assets, Foreign currency translation and other |  | (13) | (9)
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (2) |  |
Goodwill and other intangible assets, Ending Balance | 1,775 | 1,739 | 1,597
American Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 23,593 | 23,173 | 21,959
Equity in earnings of affiliates | (42) | (44) | (40)
Adjusted segment EBITDA | 5,333 | 4,904 | 4,593
Depreciation and amortization | 1,164 | 1,117 | 1,027
Assets | 20,760 | 20,608 | 19,122
Goodwill and other intangible assets, Beginning Balance | 5,765 | 5,729 | 5,265
Goodwill and other intangible assets, Acquisitions | 27 | 39 | 504
Goodwill and other intangible assets, Foreign currency translation and other |  | (3) | (40)
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (17) |  |
Goodwill and other intangible assets, Ending Balance | 5,775 | 5,765 | 5,729
Corporate and Other [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 2,246 | 2,250 | 2,137
Equity in earnings of affiliates | 16 | 3 | 15
Adjusted segment EBITDA | (828) | (681) | (624)
Depreciation and amortization | 341 | 318 | 305
Assets | 7,817 | 6,160 | 5,246
Goodwill and other intangible assets, Beginning Balance | 765 | 627 | 655
Goodwill and other intangible assets, Acquisitions | 279 | 138 |
Goodwill and other intangible assets, Foreign currency translation and other |  |  | (28)
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (16) |  |
Goodwill and other intangible assets, Ending Balance | $ 1,028 | $ 765 | $ 627

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