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Contingencies - Additional Information (Detail) - USD ($) $ in Thousands		1 Months Ended	3 Months Ended		6 Months Ended
	Jun. 27, 2018	Dec. 31, 2017	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Other Commitments [Line Items]
Gain on litigation settlement			$ 0	$ 0	$ 0	$ 526,827
2016 U.S. Attorney Prescription Drug Investigation
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party		$ 63,700
Loss Contingency Accrual, Payments		41,500
Loss Contingency Accrual, Partial Payment		$ 22,200
White, Kathleen, et al
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded to Other Party	$ 375,000
Loss Contingency, Damages Awarded, Value	$ 8,500
US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Litigation Settlement, Amount Awarded from Other Party			538,000
Gain on litigation settlement			527,000
Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement			9,000
Operating Income (Loss) | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement			530,000
Equity Method Investments | Noncontrolling Interest | US Department Of Veterans Affairs Suit
Other Commitments [Line Items]
Gain on litigation settlement			$ 3,000

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