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CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Revenues:      
Premium and service revenues $ 56,435 $ 45,620 $ 37,579
Premium tax and health insurer fee 3,681 2,762 3,028
Total revenues 60,116 48,382 40,607
Expenses:      
Medical costs 46,057 37,851 30,636
Cost of services 2,386 1,847 1,864
Selling, general and administrative expenses 6,043 4,446 3,673
Amortization of acquired intangible assets 211 156 147
Premium tax expense 3,252 2,883 2,563
Health insurer fee expense 709 0 461
Total operating expenses 58,658 47,183 39,344
Earnings from operations 1,458 1,199 1,263
Other income (expense):      
Investment and other income 253 190 114
Interest expense (343) (255) (217)
Earnings from operations, before income tax expense 1,368 1,134 1,160
Income tax expense 474 326 599
Net earnings 894 808 561
Loss attributable to noncontrolling interests 6 20 1
Net earnings attributable to Centene Corporation $ 900 $ 828 $ 562
Net earnings per common share attributable to Centene Corporation:      
Basic earnings per common share (in usd per share) $ 2.31 $ 2.40 $ 1.76
Diluted earnings per common share (in usd per share) $ 2.26 $ 2.34 $ 1.71
Premium      
Revenues:      
Premium and service revenues $ 53,629 $ 43,353 $ 35,399
Service      
Revenues:      
Premium and service revenues $ 2,806 $ 2,267 $ 2,180