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Revenue Recognition | 12 Months Ended
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Dec. 31, 2020
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Revenue from Contract with Customer | Revenue recognition and accounts receivable The Company's revenues by segment and primary payor source were as follows:
| Year ended December 31, 2020
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 6,048,043 |  |  | $ |  | $ | 6,048,043 |
Medicaid and Managed Medicaid | 744,862 |  |  |  |  | 744,862 |
Other government | 455,897 |  |  | 380,584 |  |  | 836,481 |
Commercial | 3,370,562 |  |  | 170,394 |  |  | 3,540,956 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage |  |  | 419,662 |  |  | 419,662 |
Medicaid and Managed Medicaid |  |  | 1,227 |  |  | 1,227 |
Commercial |  |  | 33,246 |  |  | 33,246 |
Other(1) | 40,571 |  |  | 47,585 |  |  | 88,156 |
Eliminations of intersegment revenues | (145,286) |  |  | (16,743) |  |  | (162,029) |
Total | $ | 10,514,649 |  |  | $ | 1,035,955 |  |  | $ | 11,550,604 |
(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.
| Year ended December 31, 2019
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 6,129,697 |  |  | $ |  | $ | 6,129,697 |
Medicaid and Managed Medicaid | 669,089 |  |  |  |  | 669,089 |
Other government | 446,010 |  |  | 352,765 |  |  | 798,775 |
Commercial | 3,286,089 |  |  | 144,256 |  |  | 3,430,345 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage |  |  | 264,538 |  |  | 264,538 |
Medicaid and Managed Medicaid |  |  | 606 |  |  | 606 |
Commercial |  |  | 130,823 |  |  | 130,823 |
Other(1) | 32,021 |  |  | 78,940 |  |  | 110,961 |
Eliminations of intersegment revenues | (132,325) |  |  | (14,030) |  |  | (146,355) |
Total | $ | 10,430,581 |  |  | $ | 957,898 |  |  | $ | 11,388,479 |
(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.
| Year ended December 31, 2018
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 6,063,891 |  |  | $ |  | $ | 6,063,891 |
Medicaid and Managed Medicaid | 628,766 |  |  |  |  | 628,766 |
Other government | 446,999 |  |  | 335,594 |  |  | 782,593 |
Commercial | 3,176,413 |  |  | 101,681 |  |  | 3,278,094 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage |  |  | 492,812 |  |  | 492,812 |
Medicaid and Managed Medicaid |  |  | 44,246 |  |  | 44,246 |
Commercial |  |  | 90,890 |  |  | 90,890 |
Other(1) | 19,880 |  |  | 130,865 |  |  | 150,745 |
Eliminations of intersegment revenues | (92,950) |  |  | (34,236) |  |  | (127,186) |
Total | $ | 10,242,999 |  |  | $ | 1,161,852 |  |  | $ | 11,404,851 |
(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. The Company had no allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 as of December 31, 2020 and such allowance was $8,328 as of December 31, 2019. As described in Note 1, there are significant risks associated with estimating revenue, many of which take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues including determining applicable primary and secondary coverage, changes in patient coverage and coordination of benefits. As these estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period. As a result of these changes in estimates, no additional revenue was recognized during the year ended December 31, 2020 associated with performance obligations satisfied prior to January 1, 2018 and additional revenue of $37,274 was recognized during the year ended December 31, 2019 associated with performance obligations satisfied in years prior to January 1, 2018. There is no single commercial payor that accounted for more than 10% of total consolidated accounts receivable or consolidated revenues at or for the years ended December 31, 2020 or 2019. Net dialysis services accounts receivable and other receivables from Medicare, including Medicare Advantage plans, and Medicaid, including managed Medicaid plans, were approximately $1,101,837 and $1,038,248 as of December 31, 2020 and 2019, respectively. Approximately 17% and 18% of the Company’s net patient services accounts receivable balances as of December 31, 2020 and 2019, respectively, were more than six months old. There were no significant balances over one year old at December 31, 2020. The Company's accounts receivable are principally due from Medicare and Medicaid programs and commercial insurance plans.

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- Definition The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -URI http://asc.fasb.org/topic&trid=49130388 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 10 -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130551-203045 Reference 3: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 13 -Subparagraph (b)(2) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130556-203045 Reference 4: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045 Reference 5: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 9 -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130550-203045 Reference 6: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 12 -Subparagraph (e) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045 Reference 7: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 12 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045 Reference 8: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 12 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045 Reference 9: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 15 -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130558-203045 Reference 10: http://www.xbrl.org/2003/role/disclosureRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 12 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045 + Details
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