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Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) | 12 Months Ended
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Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014
Valuation and Qualifying Accounts [Abstract] |  |  |
Balance at beginning of year | $ 1,129,301 | $ 848,767 | $ 712,285
Amount charged against operating revenue | 7,464,030 | 6,389,195 | 5,403,437
Accounts receivable contractual adjustments and write-offs (net of recoveries) | (7,368,965) | (6,108,661) | (5,266,955)
Balance at end of year | $ 1,224,366 | $ 1,129,301 | $ 848,767

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- Definition Amount of increase (decrease) in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from adjustments. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + 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 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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- Definition Amount of increase in the allowances and reserves, which consist of the valuation and qualifying accounts that are either netted against the cost of an asset or that reflect a liability established to represent expected future costs, from charges 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 -Subparagraph (SX 210.12-09) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e24092-122690 + Details
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