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Revenue Recognition Segment revenue by major payor (Tables) | 6 Months Ended
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Jun. 30, 2022
Revenues by major payor [Abstract] |
Disaggregation of Revenue [Table Text Block] | The following tables summarize the Company's segment revenues by primary payor source:
| Three months ended June 30, 2022 |  | Three months ended June 30, 2021
| U.S. dialysis |  | Other — Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other — Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 1,529,534 |  |  | $ |  | $ | 1,529,534 |  |  | $ | 1,562,164 |  |  | $ |  | $ | 1,562,164 |
Medicaid and Managed Medicaid | 186,873 |  |  |  |  | 186,873 |  |  | 194,641 |  |  |  |  | 194,641 |
Other government | 86,079 |  |  | 116,653 |  |  | 202,732 |  |  | 82,317 |  |  | 118,464 |  |  | 200,781 |
Commercial | 854,662 |  |  | 55,708 |  |  | 910,370 |  |  | 830,801 |  |  | 50,817 |  |  | 881,618 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  | 93,262 |  |  | 93,262 |  |  |  |  | 80,211 |  |  | 80,211 |
Medicaid and Managed Medicaid |  |  | 232 |  |  | 232 |  |  |  |  | 305 |  |  | 305 |
Commercial |  |  | 8,207 |  |  | 8,207 |  |  |  |  | 1,189 |  |  | 1,189 |
Other(1) | 6,092 |  |  | 8,844 |  |  | 14,936 |  |  | 6,415 |  |  | 10,503 |  |  | 16,918 |
Eliminations of intersegment revenues | (19,389) |  |  |  |  | (19,389) |  |  | (21,317) |  |  | — |  |  | (21,317) |
Total | $ | 2,643,851 |  |  | $ | 282,906 |  |  | $ | 2,926,757 |  |  | $ | 2,655,021 |  |  | $ | 261,489 |  |  | $ | 2,916,510 |
(1)Other primarily consists of management service fees earned in the respective Company line of business as well as other non-patient service revenue from the Company's U.S. ancillary services and international operations.
| Six months ended June 30, 2022 |  | Six months ended June 30, 2021
| U.S. dialysis |  | Other - Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other - Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 2,993,621 |  |  | $ |  | $ | 2,993,621 |  |  | $ | 3,042,461 |  |  | $ |  | $ | 3,042,461 |
Medicaid and Managed Medicaid | 376,528 |  |  |  |  | 376,528 |  |  | 381,884 |  |  |  |  | 381,884 |
Other government | 166,879 |  |  | 233,548 |  |  | 400,427 |  |  | 162,501 |  |  | 225,293 |  |  | 387,794 |
Commercial | 1,689,240 |  |  | 108,132 |  |  | 1,797,372 |  |  | 1,666,280 |  |  | 102,315 |  |  | 1,768,595 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  | 176,859 |  |  | 176,859 |  |  |  |  | 165,807 |  |  | 165,807 |
Medicaid and Managed Medicaid |  |  | 769 |  |  | 769 |  |  |  |  | 605 |  |  | 605 |
Commercial |  |  | 9,546 |  |  | 9,546 |  |  |  |  | 7,223 |  |  | 7,223 |
Other(1) | 12,068 |  |  | 18,680 |  |  | 30,748 |  |  | 13,091 |  |  | 21,665 |  |  | 34,756 |
Eliminations of intersegment revenues | (41,558) |  |  |  |  | (41,558) |  |  | (48,320) |  |  | (4,294) |  |  | (52,614) |
Total | $ | 5,196,778 |  |  | $ | 547,534 |  |  | $ | 5,744,312 |  |  | $ | 5,217,897 |  |  | $ | 518,614 |  |  | $ | 5,736,511 |
(1) Other primarily consists of management service fees earned in the respective Company line of business as well as other non-patient service revenue from the Company's U.S. ancillary services and international operations.

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- Definition Revenues by major payor [Abstract] + References No definition available. + Details
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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 https://asc.fasb.org/extlink&oid=126920106&loc=SL49130545-203045 + Details
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