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Acquisitions - Assets acquired and liabilities assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill	$ 7,076,610	$ 7,046,241	$ 6,919,109
Series of individually immaterial business acquisitions
Business Acquisition [Line Items]
Current assets	6,389	9,134	23,607
Property and equipment	7,481	9,277	37,457
Customer relationships	0	17,200	34,625
Noncompetition agreements and other long-term assets	1,066	9,964	10,168
Indefinite-lived licenses	19,610	11,432	22,136
Goodwill	49,047	173,244	130,057
Deferred income taxes	0	0	(3,962)
Liabilities Assumed	(6,081)	(14,200)	(34,068)
Noncontrolling interests assumed	(867)	(3,921)	(1,729)
Aggregate purchase price	$ 76,645	$ 212,130	$ 218,291

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Amount of assets that are expected to be realized or consumed within one year or the normal operating cycle, if longer, acquired at the acquisition date.

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Amount of deferred tax liability attributable to taxable temporary differences assumed at the acquisition date.

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