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Schedule II - Valuation and Qualifying Accounts (Detail) (USD $) | 12 Months Ended
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Dec. 31, 2014 | Dec. 31, 2013 | Dec. 31, 2012
Valuation and Qualifying Accounts [Abstract] |  |  |
Balance at beginning of year | $ 712,285 us-gaap_ValuationAllowancesAndReservesBalance | $ 624,896 us-gaap_ValuationAllowancesAndReservesBalance | $ 576,030 us-gaap_ValuationAllowancesAndReservesBalance
Amount charged against operating revenue | 5,403,437 us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense | 4,695,232 us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense | 3,994,924 us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense
Accounts receivable contractual adjustments and write-offs (net of recoveries) | (5,266,955)us-gaap_ValuationAllowancesAndReservesAdjustments | (4,607,843)us-gaap_ValuationAllowancesAndReservesAdjustments | (3,946,058)us-gaap_ValuationAllowancesAndReservesAdjustments
Balance at end of year | $ 848,767 us-gaap_ValuationAllowancesAndReservesBalance | $ 712,285 us-gaap_ValuationAllowancesAndReservesBalance | $ 624,896 us-gaap_ValuationAllowancesAndReservesBalance

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- Definition Total of the adjustments in a given period to allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 09 -Article 12 + Details
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- Definition Total of allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 09 -Article 12 + Details
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- Definition Total of allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs, charged to costs and expenses. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 09 -Article 12 + Details
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