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EXHIBITS AND FINANCIAL STATEMENT SCHEDULE - Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract] |  |  |
Balance at beginning of year | $ 1,251,705 | $ 1,091,310 | $ 791,842
Amount charged against operating revenue | 6,069,245 | 5,921,519 | 5,436,786
Accounts receivable contractual adjustments and write-offs (net of recoveries) | (6,214,050) | (5,761,124) | (5,137,318)
Balance at end of year | $ 1,106,900 | $ 1,251,705 | $ 1,091,310

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- Definition Amount of valuation and qualifying accounts and reserves. + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 235 -SubTopic 10 -Name Accounting Standards Codification -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09(Column B)) -Publisher FASB -URI https://asc.fasb.org//1943274/2147480678/235-10-S99-4 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 235 -SubTopic 10 -Name Accounting Standards Codification -Section S99 -Paragraph 4 -Subparagraph (SX 210.12-09(Column E)) -Publisher FASB -URI https://asc.fasb.org//1943274/2147480678/235-10-S99-4 + Details
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