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Revenue Recognition Segment revenue by major payor (Tables)
 6 Months Ended
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, 2023Three months ended June 30, 2022
U.S. dialysisOther — Ancillary servicesConsolidatedU.S. dialysisOther — Ancillary servicesConsolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage$1,539,639 $1,539,639 $1,529,534 $1,529,534 
Medicaid and Managed Medicaid216,014 216,014 186,873 186,873 
Other government92,525 $125,964 218,489 86,079 $116,653 202,732 
Commercial876,033 60,871 936,904 854,662 55,708 910,370 
Other revenues:
Medicare and Medicare Advantage87,236 87,236 93,262 93,262 
Medicaid and Managed Medicaid396 396 232 232 
Commercial3,619 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, 2023Six months ended June 30, 2022
U.S. dialysisOther — Ancillary servicesConsolidatedU.S. dialysisOther — Ancillary servicesConsolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage$3,022,405 $3,022,405 $2,993,621 $2,993,621 
Medicaid and Managed Medicaid421,790 421,790 376,528 376,528 
Other government174,570 $247,550 422,120 166,879 $233,548 400,427 
Commercial1,711,427 115,387 1,826,814 1,689,240 108,132 1,797,372 
Other revenues:
Medicare and Medicare Advantage180,475 180,475 176,859 176,859 
Medicaid and Managed Medicaid965 965 769 769 
Commercial4,825 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.