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Revenue Recognition Segment revenue by major payor (Tables) | 6 Months Ended
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Jun. 30, 2023
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, 2023 |  | Three months ended June 30, 2022
| U.S. dialysis |  | Other — Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other — Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 1,539,639 |  |  |  |  | $ | 1,539,639 |  |  | $ | 1,529,534 |  |  |  |  | $ | 1,529,534 |
Medicaid and Managed Medicaid | 216,014 |  |  |  |  | 216,014 |  |  | 186,873 |  |  |  |  | 186,873 |
Other government | 92,525 |  |  | $ | 125,964 |  |  | 218,489 |  |  | 86,079 |  |  | $ | 116,653 |  |  | 202,732 |
Commercial | 876,033 |  |  | 60,871 |  |  | 936,904 |  |  | 854,662 |  |  | 55,708 |  |  | 910,370 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  | 87,236 |  |  | 87,236 |  |  |  |  | 93,262 |  |  | 93,262 |
Medicaid and Managed Medicaid |  |  | 396 |  |  | 396 |  |  |  |  | 232 |  |  | 232 |
Commercial |  |  | 3,619 |  |  | 3,619 |  |  |  |  | 8,207 |  |  | 8,207 |
Other(1) | 6,404 |  |  | 13,437 |  |  | 19,841 |  |  | 6,092 |  |  | 8,844 |  |  | 14,936 |
Eliminations of intersegment revenues | (20,361) |  |  | (1,408) |  |  | (21,769) |  |  | (19,389) |  |  |  |  | (19,389) |
Total | $ | 2,710,254 |  |  | $ | 290,115 |  |  | $ | 3,000,369 |  |  | $ | 2,643,851 |  |  | $ | 282,906 |  |  | $ | 2,926,757 |
(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. integrated kidney care (IKC) and other ancillary services and international operations.
| Six months ended June 30, 2023 |  | Six months ended June 30, 2022
| U.S. dialysis |  | Other — Ancillary services |  | Consolidated |  | U.S. dialysis |  | Other — Ancillary services |  | Consolidated
Dialysis patient service revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage | $ | 3,022,405 |  |  |  |  | $ | 3,022,405 |  |  | $ | 2,993,621 |  |  |  |  | $ | 2,993,621 |
Medicaid and Managed Medicaid | 421,790 |  |  |  |  | 421,790 |  |  | 376,528 |  |  |  |  | 376,528 |
Other government | 174,570 |  |  | $ | 247,550 |  |  | 422,120 |  |  | 166,879 |  |  | $ | 233,548 |  |  | 400,427 |
Commercial | 1,711,427 |  |  | 115,387 |  |  | 1,826,814 |  |  | 1,689,240 |  |  | 108,132 |  |  | 1,797,372 |
Other revenues: |  |  |  |  |  |  |  |  |  |  |
Medicare and Medicare Advantage |  |  | 180,475 |  |  | 180,475 |  |  |  |  | 176,859 |  |  | 176,859 |
Medicaid and Managed Medicaid |  |  | 965 |  |  | 965 |  |  |  |  | 769 |  |  | 769 |
Commercial |  |  | 4,825 |  |  | 4,825 |  |  |  |  | 9,546 |  |  | 9,546 |
Other(1) | 12,583 |  |  | 26,275 |  |  | 38,858 |  |  | 12,068 |  |  | 18,680 |  |  | 30,748 |
Eliminations of intersegment revenues | (42,410) |  |  | (2,774) |  |  | (45,184) |  |  | (41,558) |  |  |  |  | (41,558) |
Total | $ | 5,300,365 |  |  | $ | 572,703 |  |  | $ | 5,873,068 |  |  | $ | 5,196,778 |  |  | $ | 547,534 |  |  | $ | 5,744,312 |
(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. integrated kidney care (IKC) and other ancillary services and international operations.

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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 -Topic 606 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 5 -Publisher FASB -URI https://asc.fasb.org//1943274/2147479806/606-10-50-5 + Details
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