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Pay vs Performance Disclosure
 12 Months Ended
Dec. 31, 2023
USD ($)
$ / shares
Dec. 31, 2022
USD ($)
$ / shares
Dec. 31, 2021
USD ($)
$ / shares
Dec. 31, 2020
USD ($)
$ / shares
Pay vs Performance Disclosure        
Pay vs Performance Disclosure, Table
Year
Summary Compensation Table Total for PEO (Joseph Zubretsky)(1)
($)
Compensation
Actually Paid to
PEO (Joseph Zubretsky)(1),(2),(3)
($)
Average Summary Compensation Table Total for
Non-PEO NEOs(1)
($)
Average Compensation Actually Paid to
Non-PEO NEOs(1),(2),(3)
($)
Value of Initial Fixed $100 Investment Based on:(4)
Net Income
($ Millions)
Adjusted Net Income per Diluted Share(5)
($)
TSR
($)		Peer Group TSR
($)
(a)(b)(c)(d)(e)(f)(g)(h)(i)
202321,491,723 25,202,450 4,707,296 2,881,779 266.28 155.73 1,091 20.88 
202222,131,256 41,668,352 5,392,703 9,278,192 243.36 155.74 792 17.92 
202119,961,698 75,905,547 4,196,221 10,545,861 234.42 141.70 659 13.54 
202017,812,327 58,165,935 4,428,117 8,983,969 156.74 106.73 673 10.67 
      
Company Selected Measure Name Adjusted EPS      
Named Executive Officers, Footnote Joseph Zubretsky was our PEO for each year presented. The individuals comprising the Non-PEO NEOs for each year presented are listed below.
2020202120222023
Mark L. KeimMark L. KeimMark L. KeimMark L. Keim
James E. WoysJames E. WoysJames E. WoysJames E. Woys
Jeff D. BarlowJeff D. BarlowJeff D. BarlowJeff D. Barlow
Marc S. RussoMarc S. RussoMarc S. RussoMaurice S. Hebert
Thomas L. TranThomas L. TranMarc S. Russo
      
Peer Group Issuers, Footnote The Peer Group TSR set forth in this table utilizes the peer companies (the “Compensation Peer Group”) used for compensation benchmarking purposes for the year 2023 (which was the same peer group for year 2022), which is listed in our Compensation Discussion & Analysis section of the proxy statement. The Peer Group TSR is weighted according to the respective peer companies’ stock market capitalization on December 31, 2019. The comparison assumes $100 was invested for the period starting December 31, 2019, through the end of the listed year in the Company and in the Compensation Peer Group, respectively. Historical stock performance is not necessarily indicative of future stock performance.      
PEO Total Compensation Amount $ 21,491,723 $ 22,131,256 $ 19,961,698 $ 17,812,327
PEO Actually Paid Compensation Amount $ 25,202,450 41,668,352 75,905,547 58,165,935
Adjustment To PEO Compensation, Footnote
YearSummary Compensation Table Total for
Joseph Zubretsky
($)		Exclusion of Change in Pension Value for
Joseph Zubretsky
($)		Exclusion of
Stock Awards for
Joseph Zubretsky
($)		Inclusion of
Equity Values for
Joseph Zubretsky
($)		Compensation
Actually Paid to
Joseph Zubretsky
($)
202321,491,723 — (15,500,092)19,210,819 25,202,450 
The amounts in the Inclusion of Equity Values in the tables above are derived from the amounts set forth in the following tables:
YearYear-End Fair Value
of Equity Awards Granted During Year That Remained Unvested as of Last Day of Year for
Joseph Zubretsky
($)		Change in Fair Value from Last Day of Prior Year to Last Day of Year of Unvested Equity Awards for Joseph Zubretsky
($)		Vesting-Date Fair Value of Equity Awards Granted During Year that Vested During Year for Joseph Zubretsky
($)		Change in Fair Value from Last Day of Prior Year to Vesting Date of Unvested Equity Awards that Vested During Year for Joseph Zubretsky
($)		Fair Value at
Last Day of
Prior Year of
Equity Awards Forfeited During Year for Joseph Zubretsky
($)		Total - Inclusion of Equity Values for Joseph Zubretsky
($)
202320,454,120 8,066,563 — (9,309,864)— 19,210,819 
      
Non-PEO NEO Average Total Compensation Amount $ 4,707,296 5,392,703 4,196,221 4,428,117
Non-PEO NEO Average Compensation Actually Paid Amount $ 2,881,779 9,278,192 10,545,861 8,983,969
Adjustment to Non-PEO NEO Compensation Footnote
YearSummary Compensation Table Total for
Non-PEO NEOs
($)		Average Exclusion of Change in Pension Value for Non-PEO NEOs
($)		Average Exclusion of
Stock Awards for
Non-PEO NEOs
($)		Average Inclusion of
Equity Values for
Non-PEO NEOs
($)		Average Compensation Actually Paid to
Non-PEO NEOs
($)
20234,707,296 (36,594)(2,829,997)1,041,074 2,881,779 
YearAverage Year-End Fair Value of Equity Awards Granted During Year That Remained Unvested as of Last Day of Year for Non-PEO NEOs
($)		Average Change in Fair Value from Last Day of Prior Year to Last Day of Year of Unvested Equity Awards for Non-PEO NEOs
($)		Average Vesting-Date Fair Value of Equity Awards Granted During Year that Vested During Year for Non-PEO NEOs
($) 		Average Change in Fair Value from Last Day of Prior Year to Vesting Date of Unvested Equity Awards that Vested During Year for Non-PEO NEOs
($)		Average Fair Value at Last Day of Prior Year of Equity Awards Forfeited During Year for Non-PEO NEOs
($)		Total - Average Inclusion of Equity Values for Non-PEO NEOs
($)
20232,876,750 1,043,874 — (1,548,252)(1,331,298)1,041,074 
      
Compensation Actually Paid vs. Total Shareholder Return
The following chart sets forth the relationship between Compensation Actually Paid to our PEO, the average of Compensation Actually Paid to our other NEOs, and the Company’s cumulative TSR over the four most recently completed fiscal years.
5497558147065
      
Compensation Actually Paid vs. Net Income
The following chart sets forth the relationship between Compensation Actually Paid to our PEO, the average of Compensation Actually Paid to our other NEOs, and our net income during the four most recently completed fiscal years.
5497558147076
      
Compensation Actually Paid vs. Company Selected Measure
The following chart sets forth the relationship between Compensation Actually Paid to our PEO, the average of Compensation Actually Paid to our other NEOs, and our Adjusted EPS during the four most recently completed fiscal years. The equity compensation actually paid to the PEO and NEOs was significantly impacted by stock price appreciation related both to the Company’s financial results and to its forward P/E multiple from significant actual and expected revenue growth.
5497558147090
      
Total Shareholder Return Vs Peer Group
The following chart compares our cumulative TSR over the four most recently completed fiscal years to that of the Compensation Peer Group over the same period.
5497558147097
      
Tabular List, Table
Performance Measures
Adjusted Net Income per Diluted Share
      
Total Shareholder Return Amount $ 266.28 243.36 234.42 156.74
Peer Group Total Shareholder Return Amount 155.73 155.74 141.70 106.73
Net Income (Loss) $ 1,091,000,000 $ 792,000,000 $ 659,000,000 $ 673,000,000
Company Selected Measure Amount | $ / shares 20.88 17.92 13.54 10.67
PEO Name Joseph Zubretsky      
Additional 402(v) Disclosure The amounts shown for Compensation Actually Paid have been calculated in accordance with Item 402(v) of Regulation S-K and do not reflect compensation actually earned, realized, or received by the Company’s NEOs. These amounts reflect the Summary Compensation Table Total with certain adjustments as described in footnote 3 below. Compensation Actually Paid reflects the exclusions and inclusions of certain amounts for the PEO and the Non-PEO NEOs as set forth below. Equity values are calculated in accordance with FASB ASC Topic 718. Amounts in the Exclusion of Stock Awards column are the amounts from the Stock Awards column set forth in the Summary Compensation Table.      
Measure:: 1        
Pay vs Performance Disclosure        
Name Adjusted Net Income per Diluted Share      
Non-GAAP Measure Description We determined Adjusted EPS to be the most important financial performance measure used to link Company performance to Compensation Actually Paid to our PEO and Non-PEO NEOs in 2023. Adjusted EPS represents adjusted net income divided by weighted average common shares outstanding on a fully diluted basis. Adjusted net income represents GAAP net income recognizing adjustments, net of tax. Adjustments represent additions and deductions to GAAP net income which include the non-cash impact of amortization of acquired intangible assets, acquisition-related expenses, and the impact of certain expenses and other items that management believes are not indicative of longer-term business trends and operations. This performance measure may not have been the most important financial performance measure for years 2022, 2021 and 2020 and we may determine a different financial performance measure to be the most important financial performance measure in future years.      
PEO | Change In Pension Value [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount $ 0      
PEO | Stock Awards Adjustments [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (15,500,092)      
PEO | Equity Award Adjustments [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 19,210,819      
PEO | Equity Awards Granted During the Year, Unvested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 20,454,120      
PEO | Equity Awards Granted in Prior Years, Unvested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 8,066,563      
PEO | Equity Awards Granted During the Year, Vested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 0      
PEO | Equity Awards Granted in Prior Years, Vested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards (9,309,864)      
PEO | Equity Awards that Failed to Meet Vesting Conditions [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 0      
Non-PEO NEO | Change In Pension Value [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (36,594)      
Non-PEO NEO | Stock Awards Adjustments [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount (2,829,997)      
Non-PEO NEO | Equity Award Adjustments [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation, Amount 1,041,074      
Non-PEO NEO | Equity Awards Granted During the Year, Unvested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 2,876,750      
Non-PEO NEO | Equity Awards Granted in Prior Years, Unvested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 1,043,874      
Non-PEO NEO | Equity Awards Granted During the Year, Vested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards 0      
Non-PEO NEO | Equity Awards Granted in Prior Years, Vested [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards (1,548,252)      
Non-PEO NEO | Equity Awards that Failed to Meet Vesting Conditions [Member]        
Pay vs Performance Disclosure        
Adjustment to Compensation Amount, Equity Awards $ (1,331,298)