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Revenue Recognition Segment revenue by major payor (Tables) | 9 Months Ended
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Sep. 30, 2020
Disaggregation of Revenue [Abstract] |
Disaggregation of Revenue [Table Text Block] | The following table summarizes the Company's segment revenues by primary payor source:
| Three months ended September 30, 2020 |  | Three months ended September 30, 2019
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 1,510,982 |  |  | $ |  | $ | 1,510,982 |  |  | $ | 1,558,890 |  |  | $ |  | $ | 1,558,890 |
Medicaid and Managed Medicaid | 193,254 |  |  |  |  |  | 193,254 |  |  | 176,292 |  |  |  |  | 176,292 |
Other government | 114,327 |  |  | 98,044 |  |  | 212,371 |  |  | 116,984 |  |  | 90,947 |  |  | 207,931 |
Commercial | 858,247 |  |  | 43,845 |  |  | 902,092 |  |  | 828,953 |  |  | 37,276 |  |  | 866,229 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  |  | 111,248 |  |  | 111,248 |  |  |  |  | 65,759 |  |  | 65,759 |
Medicaid and Managed Medicaid |  |  |  | 412 |  |  | 412 |  |  |  |  | 227 |  |  | 227 |
Commercial |  |  |  | 7,799 |  |  | 7,799 |  |  |  |  | 33,503 |  |  | 33,503 |
Other(1) | 17,409 |  |  | 9,895 |  |  | 27,304 |  |  | 10,308 |  |  | 20,784 |  |  | 31,092 |
Eliminations of intersegment revenues | (37,317 | ) |  | (4,079 | ) |  | (41,396 | ) |  | (32,362 | ) |  | (3,483 | ) |  | (35,845 | )
Total | $ | 2,656,902 |  |  | $ | 267,164 |  |  | $ | 2,924,066 |  |  | $ | 2,659,065 |  |  | $ | 245,013 |  |  | $ | 2,904,078 |
(1) | Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.
| Nine months ended September 30, 2020 |  | Nine months ended September 30, 2019
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 4,530,510 |  |  | $ |  | $ | 4,530,510 |  |  | $ | 4,572,599 |  |  | $ |  | $ | 4,572,599 |
Medicaid and Managed Medicaid | 547,045 |  |  |  |  | 547,045 |  |  | 490,723 |  |  |  |  | 490,723 |
Other government | 342,996 |  |  | 283,431 |  |  | 626,427 |  |  | 333,675 |  |  | 264,191 |  |  | 597,866 |
Commercial | 2,534,388 |  |  | 118,869 |  |  | 2,653,257 |  |  | 2,458,360 |  |  | 103,760 |  |  | 2,562,120 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  | 309,555 |  |  | 309,555 |  |  |  |  | 191,472 |  |  | 191,472 |
Medicaid and Managed Medicaid |  |  | 1,061 |  |  | 1,061 |  |  |  |  | 327 |  |  | 327 |
Commercial |  |  | 27,370 |  |  | 27,370 |  |  |  |  | 98,428 |  |  | 98,428 |
Other(1) | 30,846 |  |  | 36,600 |  |  | 67,446 |  |  | 20,715 |  |  | 59,204 |  |  | 79,919 |
Eliminations of intersegment revenues | (104,987 | ) |  | (12,402 | ) |  | (117,389 | ) |  | (93,337 | ) |  | (10,222 | ) |  | (103,559 | )
Total | $ | 7,880,798 |  |  | $ | 764,484 |  |  | $ | 8,645,282 |  |  | $ | 7,782,735 |  |  | $ | 707,160 |  |  | $ | 8,489,895 |
(1) Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.

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- Definition Tabular disclosure of disaggregation of revenue into categories depicting how nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factor. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130545-203045 + Details
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