XML 76 R58.htm IDEA: XBRL DOCUMENT v3.22.4
Revenue Recognition and Accounts Receivable Revenue Recognition Segment Revenue by Payor (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Revenue Recognition      
Other revenues $ 433,430 $ 405,282 $ 524,353
Total revenues 11,609,894 11,618,797 11,550,604
Intersegment Elimination      
Revenue Recognition      
Total revenues (91,241) (95,090) (162,029)
Medicare and Medicare Advantage      
Revenue Recognition      
Patient service revenues 6,041,496 6,133,235 6,169,226
Other revenues 345,340 326,696 419,662
Medicaid and Managed Medicaid      
Revenue Recognition      
Patient service revenues 759,579 782,430 744,862
Other revenues 1,546 1,321 1,227
Other Government Payors      
Revenue Recognition      
Patient service revenues 801,912 791,641 715,298
Commercial Payors      
Revenue Recognition      
Patient service revenues 3,660,522 3,596,721 3,540,956
Other revenues 22,211 15,553 33,246
Other      
Revenue Recognition      
Other revenues 68,529 66,290 88,156
U.S. dialysis      
Revenue Recognition      
Total revenues 10,512,774 10,576,167 10,514,649
U.S. dialysis | Intersegment Elimination      
Revenue Recognition      
Total revenues (87,035) (90,796) (145,286)
U.S. dialysis | Medicare and Medicare Advantage      
Revenue Recognition      
Patient service revenues 6,041,496 6,133,235 6,169,226
U.S. dialysis | Medicaid and Managed Medicaid      
Revenue Recognition      
Patient service revenues 759,579 782,430 744,862
U.S. dialysis | Other Government Payors      
Revenue Recognition      
Patient service revenues 336,991 328,256 334,714
U.S. dialysis | Commercial Payors      
Revenue Recognition      
Patient service revenues 3,437,306 3,397,697 3,370,562
U.S. dialysis | Other      
Revenue Recognition      
Other revenues 24,437 25,345 40,571
Other - Ancillary services      
Revenue Recognition      
Total revenues 1,097,120 1,042,630 1,035,955
Other - Ancillary services | Intersegment Elimination      
Revenue Recognition      
Total revenues (4,206) (4,294) (16,743)
Other - Ancillary services | Medicare and Medicare Advantage      
Revenue Recognition      
Other revenues 345,340 326,696 419,662
Other - Ancillary services | Medicaid and Managed Medicaid      
Revenue Recognition      
Other revenues 1,546 1,321 1,227
Other - Ancillary services | Other Government Payors      
Revenue Recognition      
Patient service revenues 464,921 463,385 380,584
Other - Ancillary services | Commercial Payors      
Revenue Recognition      
Patient service revenues 223,216 199,024 170,394
Other revenues 22,211 15,553 33,246
Other - Ancillary services | Other      
Revenue Recognition      
Other revenues $ 44,092 $ 40,945 $ 47,585