v3.3.1.900
Schedule II - Valuation and Qualifying Consolidated Accounts (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2015
Dec. 31, 2014
Dec. 31, 2013
Allowance for Doubtful Accounts, Current [Member]      
Valuation and Qualifying Accounts Disclosure [Line Items]      
Balance at Beginning of Year $ 1,351 $ 1,001 $ 50
Additions Charged to Costs and Expenses 3,800 350 951
Balance at End of Year 5,151 1,351 1,001
Allowance for Inventory [Member]      
Valuation and Qualifying Accounts Disclosure [Line Items]      
Balance at Beginning of Year 13,517 12,292 12,361
Additions Charged to Costs and Expenses 1,868 1,225  
Deductions     69
Balance at End of Year 15,385 13,517 12,292
Allowance for Contractual Discounts [Member]      
Valuation and Qualifying Accounts Disclosure [Line Items]      
Balance at Beginning of Year 96,590 74,711 50,389
Additions Charged to Costs and Expenses 439,991 408,362 312,927
Deductions 432,980 386,483 288,605
Balance at End of Year 103,601 96,590 74,711
Allowance for Uncompensated Care [Member]      
Valuation and Qualifying Accounts Disclosure [Line Items]      
Balance at Beginning of Year 41,858 46,387 52,168
Additions Charged to Costs and Expenses 84,470 79,564 71,011
Deductions 84,404 84,093 76,792
Balance at End of Year $ 41,924 $ 41,858 $ 46,387