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Property and Equipment - Additional Information (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Property, Plant and Equipment [Line Items] |  |  |
Depreciation expense on property and equipment | $ 574,799 | $ 544,129 | $ 494,945
Investment and other asset impairments | 17,338 | 295,234 | 14,993
Capitalized interest | 25,978 | 19,176 | $ 12,990
Pharmacy Business |  |  |
Property, Plant and Equipment [Line Items] |  |  |
Investment and other asset impairments | $ 17,338 | $ 15,168 |

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- Definition The aggregate expense recognized in the current period that allocates the cost of tangible assets, intangible assets, or depleting assets to periods that benefit from use of the assets. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 280 -SubTopic 10 -Section 50 -Paragraph 22 -Subparagraph (e) -URI http://asc.fasb.org/extlink&oid=115929826&loc=d3e8736-108599 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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- Definition The charge against earnings resulting from the write down of long lived assets other than goodwill due to the difference between the carrying value and lower fair value. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 360 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109226691&loc=d3e2921-110230 Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 + Details
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