2018 Q4 Form 10-K Financial Statement
#000119312519040891 Filed on February 14, 2019
Income Statement
Concept | 2018 Q4 | 2018 Q3 | 2018 Q2 |
---|---|---|---|
Revenue | $932.7M | $896.7M | $915.9M |
YoY Change | 2.4% | 3.19% | 8.66% |
Cost Of Revenue | |||
YoY Change | |||
Gross Profit | |||
YoY Change | |||
Gross Profit Margin | |||
Selling, General & Admin | -$736.8M | $695.1M | $694.0M |
YoY Change | -226.01% | 1.05% | 4.46% |
% of Gross Profit | |||
Research & Development | |||
YoY Change | |||
% of Gross Profit | |||
Depreciation & Amortization | $29.89M | $28.71M | $26.52M |
YoY Change | 13.16% | 14.31% | 3.04% |
% of Gross Profit | |||
Operating Expenses | $829.1M | $787.5M | $787.2M |
YoY Change | 5.6% | 6.06% | 9.18% |
Operating Profit | $103.6M | $109.2M | $128.7M |
YoY Change | -17.6% | -13.66% | 5.56% |
Interest Expense | $25.45M | $21.78M | $21.60M |
YoY Change | 28.24% | 18.2% | 16.56% |
% of Operating Profit | 24.57% | 19.95% | 16.79% |
Other Income/Expense, Net | -$22.20M | -$18.71M | -$19.15M |
YoY Change | 27.9% | 1.52% | 9.52% |
Pretax Income | $81.37M | $90.45M | $109.5M |
YoY Change | -24.9% | -16.25% | 4.89% |
Income Tax | $21.16M | $24.87M | $30.12M |
% Of Pretax Income | 26.0% | 27.5% | 27.5% |
Net Earnings | $60.21M | $65.58M | $79.41M |
YoY Change | -55.76% | -0.46% | 24.67% |
Net Earnings / Revenue | 6.46% | 7.31% | 8.67% |
Basic Earnings Per Share | $0.69 | $0.72 | $0.85 |
Diluted Earnings Per Share | $0.68 | $0.72 | $0.85 |
COMMON SHARES | |||
Basic Shares Outstanding | 87.81M shares | 90.98M shares | 92.99M shares |
Diluted Shares Outstanding | 88.26M | 91.36M shares | 93.53M shares |
Balance Sheet
Concept | 2018 Q4 | 2018 Q3 | 2018 Q2 |
---|---|---|---|
SHORT-TERM ASSETS | |||
Cash & Short-Term Investments | $47.40M | $48.40M | $48.00M |
YoY Change | -32.77% | -18.52% | -6.98% |
Cash & Equivalents | $40.77M | $34.46M | $38.06M |
Short-Term Investments | $21.90M | $14.00M | $9.900M |
Other Short-Term Assets | $17.17M | $16.31M | $14.22M |
YoY Change | -53.81% | -73.09% | 7.19% |
Inventory | |||
Prepaid Expenses | $17.12M | $17.84M | $15.75M |
Receivables | $506.7M | $522.8M | $528.0M |
Other Receivables | $0.00 | $0.00 | $0.00 |
Total Short-Term Assets | $660.0M | $625.4M | $624.9M |
YoY Change | 5.22% | -4.27% | 12.08% |
LONG-TERM ASSETS | |||
Property, Plant & Equipment | $90.43M | $137.8M | $131.9M |
YoY Change | -26.8% | 20.02% | 19.41% |
Goodwill | $4.061B | $4.303B | $4.305B |
YoY Change | -5.19% | 4.5% | 9.03% |
Intangibles | |||
YoY Change | |||
Long-Term Investments | $69.70M | $81.20M | $90.20M |
YoY Change | -13.63% | -1.34% | 4.52% |
Other Assets | $103.1M | $95.42M | $92.63M |
YoY Change | 12.18% | 39.04% | 50.08% |
Total Long-Term Assets | $5.278B | $5.213B | $5.235B |
YoY Change | 0.71% | 3.7% | 7.94% |
TOTAL ASSETS | |||
Total Short-Term Assets | $660.0M | $625.4M | $624.9M |
Total Long-Term Assets | $5.278B | $5.213B | $5.235B |
Total Assets | $5.937B | $5.839B | $5.860B |
YoY Change | 1.2% | 2.78% | 8.36% |
SHORT-TERM LIABILITIES | |||
YoY Change | |||
Accounts Payable | $31.06M | $30.71M | $28.38M |
YoY Change | -10.32% | 12.33% | -6.55% |
Accrued Expenses | $417.5M | $383.0M | $329.9M |
YoY Change | 3.5% | 2.13% | 13.88% |
Deferred Revenue | |||
YoY Change | |||
Short-Term Debt | $0.00 | $0.00 | $0.00 |
YoY Change | |||
Long-Term Debt Due | $300.0K | $500.0K | $900.0K |
YoY Change | -78.57% | -98.29% | -96.67% |
Total Short-Term Liabilities | $502.8M | $435.9M | $411.2M |
YoY Change | -5.39% | -8.41% | 17.44% |
LONG-TERM LIABILITIES | |||
Long-Term Debt | $1.974B | $2.006B | $1.891B |
YoY Change | 6.64% | 11.62% | 8.3% |
Other Long-Term Liabilities | $31.83M | $40.94M | $36.20M |
YoY Change | -45.03% | -3.17% | -20.86% |
Total Long-Term Liabilities | $31.83M | $40.94M | $36.20M |
YoY Change | -45.03% | -3.17% | -20.86% |
TOTAL LIABILITIES | |||
Total Short-Term Liabilities | $502.8M | $435.9M | $411.2M |
Total Long-Term Liabilities | $31.83M | $40.94M | $36.20M |
Total Liabilities | $2.850B | $2.823B | $2.673B |
YoY Change | 1.74% | 2.15% | 4.03% |
SHAREHOLDERS EQUITY | |||
Retained Earnings | $2.094B | $2.016B | $2.153B |
YoY Change | 2.25% | 5.42% | 16.64% |
Common Stock | $993.5M | $999.6M | $1.034B |
YoY Change | -2.43% | -0.49% | 4.18% |
Preferred Stock | |||
YoY Change | |||
Treasury Stock (at cost) | |||
YoY Change | |||
Treasury Stock Shares | |||
Shareholders Equity | $3.088B | $3.015B | $3.187B |
YoY Change | |||
Total Liabilities & Shareholders Equity | $5.937B | $5.839B | $5.860B |
YoY Change | 1.2% | 2.78% | 8.36% |
Cashflow Statement
Concept | 2018 Q4 | 2018 Q3 | 2018 Q2 |
---|---|---|---|
OPERATING ACTIVITIES | |||
Net Income | $60.21M | $65.58M | $79.41M |
YoY Change | -55.76% | -0.46% | 24.67% |
Depreciation, Depletion And Amortization | $29.89M | $28.71M | $26.52M |
YoY Change | 13.16% | 14.31% | 3.04% |
Cash From Operating Activities | $163.8M | $140.5M | $136.2M |
YoY Change | -9.9% | -29.71% | -1.02% |
INVESTING ACTIVITIES | |||
Capital Expenditures | $7.700M | -$6.500M | -$9.800M |
YoY Change | 32.76% | -35.64% | -3.92% |
Acquisitions | |||
YoY Change | |||
Other Investing Activities | -$102.6M | -$2.300M | -$7.000M |
YoY Change | -47.38% | -99.03% | 218.18% |
Cash From Investing Activities | -$95.00M | -$8.800M | -$16.80M |
YoY Change | -49.76% | -96.45% | 36.59% |
FINANCING ACTIVITIES | |||
Cash Dividend Paid | |||
YoY Change | |||
Common Stock Issuance & Retirement, Net | |||
YoY Change | |||
Debt Paid & Issued, Net | |||
YoY Change | |||
Cash From Financing Activities | -30.30M | -135.5M | -121.3M |
YoY Change | -219.76% | -343.27% | -4.26% |
NET CHANGE | |||
Cash From Operating Activities | 163.8M | 140.5M | 136.2M |
Cash From Investing Activities | -95.00M | -8.800M | -16.80M |
Cash From Financing Activities | -30.30M | -135.5M | -121.3M |
Net Change In Cash | 38.50M | -3.800M | -1.900M |
YoY Change | 113.89% | -148.1% | 35.71% |
FREE CASH FLOW | |||
Cash From Operating Activities | $163.8M | $140.5M | $136.2M |
Capital Expenditures | $7.700M | -$6.500M | -$9.800M |
Free Cash Flow | $156.1M | $147.0M | $146.0M |
YoY Change | -11.31% | -30.0% | -1.22% |
Facts In Submission
Frame | Concept Type | Concept / XBRL Key | Value | Unit |
---|---|---|---|---|
CY2016Q4 | us-gaap |
Operating Loss Carryforwards
OperatingLossCarryforwards
|
130000000 | |
CY2016Q4 | us-gaap |
Stockholders Equity Including Portion Attributable To Noncontrolling Interest
StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest
|
2760767000 | |
CY2016Q4 | us-gaap |
Unrecognized Tax Benefits
UnrecognizedTaxBenefits
|
9469000 | |
CY2017Q4 | us-gaap |
Assets Current
AssetsCurrent
|
627235000 | |
CY2017Q4 | us-gaap |
Accrued Income Taxes Current
AccruedIncomeTaxesCurrent
|
92007000 | |
CY2019Q1 | dei |
Entity Common Stock Shares Outstanding
EntityCommonStockSharesOutstanding
|
87920463 | shares |
CY2016Q3 | md |
Unrecognized Tax Benefits Impact Effective Tax Rate
UnrecognizedTaxBenefitsImpactEffectiveTaxRate
|
10600000 | |
CY2018Q2 | dei |
Entity Public Float
EntityPublicFloat
|
3943237534 | |
CY2018Q3 | us-gaap |
Stock Repurchase Program Authorized Amount1
StockRepurchaseProgramAuthorizedAmount1
|
500000000 | |
CY2015Q4 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents
|
51572000 | |
CY2015Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted
MalpracticeLossContingencyAccrualUndiscounted
|
202527000 | |
CY2015Q4 | us-gaap |
Stockholders Equity Including Portion Attributable To Noncontrolling Interest
StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest
|
2437846000 | |
CY2015Q4 | us-gaap |
Unrecognized Tax Benefits
UnrecognizedTaxBenefits
|
18447000 | |
CY2016Q4 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents
|
55698000 | |
CY2016Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted
MalpracticeLossContingencyAccrualUndiscounted
|
202052000 | |
CY2017Q4 | us-gaap |
Allowance For Doubtful Accounts Receivable Current
AllowanceForDoubtfulAccountsReceivableCurrent
|
1286035000 | |
CY2017Q4 | us-gaap |
Accounts Receivable Net Current
AccountsReceivableNetCurrent
|
503999000 | |
CY2017Q4 | us-gaap |
Accumulated Depreciation Depletion And Amortization Property Plant And Equipment
AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment
|
169624000 | |
CY2017Q4 | us-gaap |
Additional Paid In Capital Common Stock
AdditionalPaidInCapitalCommonStock
|
1017328000 | |
CY2017Q4 | us-gaap |
Accounts Payable And Accrued Liabilities Current
AccountsPayableAndAccruedLiabilitiesCurrent
|
438017000 | |
CY2017Q4 | us-gaap |
Accounts Payable Current
AccountsPayableCurrent
|
34632000 | |
CY2017Q4 | us-gaap |
Accounts Receivable Gross Current
AccountsReceivableGrossCurrent
|
1790034000 | |
CY2017Q4 | us-gaap |
Accrued Salaries Current
AccruedSalariesCurrent
|
225429000 | |
CY2017Q4 | us-gaap |
Assets
Assets
|
5867278000 | |
CY2017Q4 | us-gaap |
Buildings And Improvements Gross
BuildingsAndImprovementsGross
|
33024000 | |
CY2017Q4 | us-gaap |
Capital Lease Obligations
CapitalLeaseObligations
|
1826000 | |
CY2017Q4 | us-gaap |
Capital Lease Obligations Current
CapitalLeaseObligationsCurrent
|
1401000 | |
CY2017Q4 | us-gaap |
Capital Lease Obligations Noncurrent
CapitalLeaseObligationsNoncurrent
|
425000 | |
CY2017Q4 | us-gaap |
Business Combination Liabilities Arising From Contingencies Amount Recognized
BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized
|
30500000 | |
CY2017Q4 | us-gaap |
Cash Surrender Value Fair Value Disclosure
CashSurrenderValueFairValueDisclosure
|
15600000 | |
CY2017Q4 | us-gaap |
Cash And Cash Equivalents At Carrying Value
CashAndCashEquivalentsAtCarryingValue
|
60200000 | |
CY2017Q4 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents
|
80200000 | |
CY2017Q4 | us-gaap |
Commitments And Contingencies
CommitmentsAndContingencies
|
||
CY2017Q4 | us-gaap |
Common Stock Shares Authorized
CommonStockSharesAuthorized
|
200000000 | shares |
CY2017Q4 | us-gaap |
Common Stock Shares Outstanding
CommonStockSharesOutstanding
|
93721000 | shares |
CY2017Q4 | us-gaap |
Common Stock Par Or Stated Value Per Share
CommonStockParOrStatedValuePerShare
|
0.01 | |
CY2017Q4 | us-gaap |
Common Stock Shares Issued
CommonStockSharesIssued
|
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CY2017Q4 | us-gaap |
Common Stock Value
CommonStockValue
|
937000 | |
CY2017Q4 | us-gaap |
Deferred Income Tax Liabilities
DeferredIncomeTaxLiabilities
|
294058000 | |
CY2017Q4 | us-gaap |
Debt Instrument Carrying Amount
DebtInstrumentCarryingAmount
|
1860500000 | |
CY2017Q4 | us-gaap |
Deferred Tax Assets Other
DeferredTaxAssetsOther
|
970000 | |
CY2017Q4 | us-gaap |
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|
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CY2017Q4 | us-gaap |
Deferred Tax Assets Valuation Allowance
DeferredTaxAssetsValuationAllowance
|
2615000 | |
CY2017Q4 | us-gaap |
Deferred Tax Liabilities Goodwill And Intangible Assets Intangible Assets
DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets
|
258618000 | |
CY2017Q4 | us-gaap |
Deferred Tax Assets Operating Loss Carryforwards
DeferredTaxAssetsOperatingLossCarryforwards
|
28569000 | |
CY2017Q4 | us-gaap |
Deferred Tax Liabilities Noncurrent
DeferredTaxLiabilitiesNoncurrent
|
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Deferred Tax Assets Gross
DeferredTaxAssetsGross
|
163709000 | |
CY2017Q4 | us-gaap |
Deferred Tax Assets Net
DeferredTaxAssetsNet
|
161094000 | |
CY2017Q4 | us-gaap |
Deferred Tax Assets Property Plant And Equipment
DeferredTaxAssetsPropertyPlantAndEquipment
|
685000 | |
CY2017Q4 | us-gaap |
Deferred Tax Assets Tax Deferred Expense Compensation And Benefits Share Based Compensation Cost
DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost
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Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Allowance For Doubtful Accounts
DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts
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CY2017Q4 | us-gaap |
Deferred Tax Liabilities
DeferredTaxLiabilities
|
132964000 | |
CY2017Q4 | us-gaap |
Deferred Tax Liabilities Deferred Expense Reserves And Accruals
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|
31290000 | |
CY2017Q4 | us-gaap |
Finite Lived Intangible Assets Accumulated Amortization
FiniteLivedIntangibleAssetsAccumulatedAmortization
|
266753000 | |
CY2017Q4 | us-gaap |
Finite Lived Intangible Assets Gross
FiniteLivedIntangibleAssetsGross
|
906681000 | |
CY2017Q4 | us-gaap |
Finite Lived Intangible Assets Net
FiniteLivedIntangibleAssetsNet
|
639928000 | |
CY2017Q4 | us-gaap |
Fixtures And Equipment Gross
FixturesAndEquipmentGross
|
253453000 | |
CY2017Q4 | us-gaap |
Goodwill
Goodwill
|
4283963000 | |
CY2017Q4 | us-gaap |
Held To Maturity Securities Current
HeldToMaturitySecuritiesCurrent
|
10292000 | |
CY2017Q4 | us-gaap |
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HeldToMaturitySecuritiesDebtMaturitiesAfterFiveThroughTenYearsNetCarryingAmount
|
2121000 | |
CY2017Q4 | us-gaap |
Income Tax Examination Penalties And Interest Accrued
IncomeTaxExaminationPenaltiesAndInterestAccrued
|
1200000 | |
CY2017Q4 | us-gaap |
Held To Maturity Securities Debt Maturities After One Through Five Years Net Carrying Amount
HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount
|
78561000 | |
CY2017Q4 | us-gaap |
Held To Maturity Securities Noncurrent
HeldToMaturitySecuritiesNoncurrent
|
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CY2017Q4 | us-gaap |
Interest Payable Current
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CY2017Q4 | us-gaap |
Liabilities Current
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531425000 | |
CY2017Q4 | us-gaap |
Land
Land
|
6683000 | |
CY2017Q4 | us-gaap |
Liabilities
Liabilities
|
2800824000 | |
CY2017Q4 | us-gaap |
Liabilities And Stockholders Equity
LiabilitiesAndStockholdersEquity
|
5867278000 | |
CY2017Q4 | us-gaap |
Long Term Debt
LongTermDebt
|
1846133000 | |
CY2017Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted
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|
250187000 | |
CY2017Q4 | us-gaap |
Long Term Debt And Capital Lease Obligations Current
LongTermDebtAndCapitalLeaseObligationsCurrent
|
1401000 | |
CY2017Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted Current
MalpracticeLossContingencyAccrualUndiscountedCurrent
|
37912000 | |
CY2017Q4 | us-gaap |
Long Term Line Of Credit
LongTermLineOfCredit
|
1110500000 | |
CY2017Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted Noncurrent
MalpracticeLossContingencyAccrualUndiscountedNoncurrent
|
212274000 | |
CY2017Q4 | us-gaap |
Other Accrued Liabilities Current
OtherAccruedLiabilitiesCurrent
|
53618000 | |
CY2017Q4 | us-gaap |
Other Assets Current
OtherAssetsCurrent
|
37160000 | |
CY2017Q4 | us-gaap |
Operating Loss Carryforwards
OperatingLossCarryforwards
|
116000000 | |
CY2017Q4 | us-gaap |
Other Assets Noncurrent
OtherAssetsNoncurrent
|
91934000 | |
CY2017Q4 | us-gaap |
Prepaid Expense Current
PrepaidExpenseCurrent
|
15584000 | |
CY2017Q4 | us-gaap |
Other Liabilities Noncurrent
OtherLiabilitiesNoncurrent
|
57905000 | |
CY2017Q4 | us-gaap |
Property Plant And Equipment Net
PropertyPlantAndEquipmentNet
|
123536000 | |
CY2017Q4 | us-gaap |
Preferred Stock Par Or Stated Value Per Share
PreferredStockParOrStatedValuePerShare
|
0.01 | |
CY2017Q4 | us-gaap |
Preferred Stock Shares Authorized
PreferredStockSharesAuthorized
|
1000000 | shares |
CY2017Q4 | us-gaap |
Preferred Stock Value
PreferredStockValue
|
||
CY2017Q4 | us-gaap |
Preferred Stock Shares Issued
PreferredStockSharesIssued
|
0 | shares |
CY2017Q4 | us-gaap |
Property Plant And Equipment Gross
PropertyPlantAndEquipmentGross
|
293160000 | |
CY2017Q4 | us-gaap |
Retained Earnings Accumulated Deficit
RetainedEarningsAccumulatedDeficit
|
2048189000 | |
CY2017Q4 | us-gaap |
Restricted Cash Noncurrent
RestrictedCashNoncurrent
|
20000000 | |
CY2017Q4 | us-gaap |
Self Insurance Reserve Current
SelfInsuranceReserveCurrent
|
138500000 | |
CY2017Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Nonvested Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue
|
60.21 | |
CY2017Q4 | us-gaap |
Stockholders Equity Including Portion Attributable To Noncontrolling Interest
StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest
|
3066454000 | |
CY2017Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Nonvested Number
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber
|
1041034 | shares |
CY2017Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Outstanding Number
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber
|
246342 | shares |
CY2017Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Outstanding Weighted Average Exercise Price
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice
|
27.51 | |
CY2017Q4 | us-gaap |
Unamortized Debt Issuance Expense
UnamortizedDebtIssuanceExpense
|
14367000 | |
CY2017Q4 | us-gaap |
Stockholders Equity
StockholdersEquity
|
3066454000 | |
CY2017Q4 | us-gaap |
Unrecognized Tax Benefits
UnrecognizedTaxBenefits
|
10972000 | |
CY2017Q4 | md |
Accrued Professional Liability
AccruedProfessionalLiability
|
111700000 | |
CY2017Q4 | md |
Money Market Funds At Fair Value
MoneyMarketFundsAtFairValue
|
9200000 | |
CY2017Q4 | md |
Accounts Payable And Accrued Liabilities Excluding Accrued Income Taxes Current
AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent
|
438017000 | |
CY2017Q4 | md |
Accrued Payroll Taxes And Benefits Current
AccruedPayrollTaxesAndBenefitsCurrent
|
75672000 | |
CY2017Q4 | md |
Long Term Debt And Capital Lease Obligations Excluding Long Term Line Of Credit
LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit
|
740923000 | |
CY2017Q4 | md |
Accrued Contingent Consideration Liability Current
AccruedContingentConsiderationLiabilityCurrent
|
6259000 | |
CY2017Q4 | md |
Deferred Tax Liabilities Change In Accounting Method
DeferredTaxLiabilitiesChangeInAccountingMethod
|
4150000 | |
CY2018Q4 | us-gaap |
Assets Current
AssetsCurrent
|
657409000 | |
CY2018Q4 | us-gaap |
Assets Held For Sale Not Part Of Disposal Group
AssetsHeldForSaleNotPartOfDisposalGroup
|
46000000 | |
CY2018Q4 | us-gaap |
Accrued Income Taxes Current
AccruedIncomeTaxesCurrent
|
30598000 | |
CY2018Q4 | us-gaap |
Allowance For Doubtful Accounts Receivable Current
AllowanceForDoubtfulAccountsReceivableCurrent
|
1489069000 | |
CY2018Q4 | us-gaap |
Accounts Receivable Net Current
AccountsReceivableNetCurrent
|
542272000 | |
CY2018Q4 | us-gaap |
Accumulated Depreciation Depletion And Amortization Property Plant And Equipment
AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment
|
207816000 | |
CY2018Q4 | us-gaap |
Additional Paid In Capital Common Stock
AdditionalPaidInCapitalCommonStock
|
992647000 | |
CY2018Q4 | us-gaap |
Accounts Payable And Accrued Liabilities Current
AccountsPayableAndAccruedLiabilitiesCurrent
|
469342000 | |
CY2018Q4 | us-gaap |
Accounts Payable Current
AccountsPayableCurrent
|
31059000 | |
CY2018Q4 | us-gaap |
Accounts Receivable Gross Current
AccountsReceivableGrossCurrent
|
2031341000 | |
CY2018Q4 | us-gaap |
Accrued Salaries Current
AccruedSalariesCurrent
|
249834000 | |
CY2018Q4 | us-gaap |
Assets
Assets
|
5934911000 | |
CY2018Q4 | us-gaap |
Buildings And Improvements Gross
BuildingsAndImprovementsGross
|
33189000 | |
CY2018Q4 | us-gaap |
Capital Lease Obligations
CapitalLeaseObligations
|
441000 | |
CY2018Q4 | us-gaap |
Capital Lease Obligations Current
CapitalLeaseObligationsCurrent
|
253000 | |
CY2018Q4 | us-gaap |
Capital Lease Obligations Noncurrent
CapitalLeaseObligationsNoncurrent
|
188000 | |
CY2018Q4 | us-gaap |
Business Acquisition Purchase Price Allocation Goodwill Expected Tax Deductible Amount
BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount
|
63000000 | |
CY2018Q4 | us-gaap |
Business Combination Liabilities Arising From Contingencies Amount Recognized
BusinessCombinationLiabilitiesArisingFromContingenciesAmountRecognized
|
20000000 | |
CY2018Q4 | us-gaap |
Capital Leases Future Minimum Payments Due Current
CapitalLeasesFutureMinimumPaymentsDueCurrent
|
253000 | |
CY2018Q4 | us-gaap |
Cash Surrender Value Fair Value Disclosure
CashSurrenderValueFairValueDisclosure
|
10500000 | |
CY2018Q4 | us-gaap |
Capital Leases Future Minimum Payments Due In Three Years
CapitalLeasesFutureMinimumPaymentsDueInThreeYears
|
74000 | |
CY2018Q4 | us-gaap |
Cash And Cash Equivalents At Carrying Value
CashAndCashEquivalentsAtCarryingValue
|
36745000 | |
CY2018Q4 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents
|
56745000 | |
CY2018Q4 | us-gaap |
Commitments And Contingencies
CommitmentsAndContingencies
|
||
CY2018Q4 | us-gaap |
Common Stock Shares Authorized
CommonStockSharesAuthorized
|
200000000 | shares |
CY2018Q4 | us-gaap |
Common Stock Shares Outstanding
CommonStockSharesOutstanding
|
87820000 | shares |
CY2018Q4 | us-gaap |
Capital Leases Future Minimum Payments Due In Two Years
CapitalLeasesFutureMinimumPaymentsDueInTwoYears
|
114000 | |
CY2018Q4 | us-gaap |
Common Stock Par Or Stated Value Per Share
CommonStockParOrStatedValuePerShare
|
0.01 | |
CY2018Q4 | us-gaap |
Common Stock Shares Issued
CommonStockSharesIssued
|
87820000 | shares |
CY2018Q4 | us-gaap |
Common Stock Value
CommonStockValue
|
878000 | |
CY2018Q4 | us-gaap |
Deferred Income Tax Liabilities
DeferredIncomeTaxLiabilities
|
396498000 | |
CY2018Q4 | us-gaap |
Debt Instrument Carrying Amount
DebtInstrumentCarryingAmount
|
1989500000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Other
DeferredTaxAssetsOther
|
1197000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Reserves
DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsReserves
|
59270000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Valuation Allowance
DeferredTaxAssetsValuationAllowance
|
2628000 | |
CY2018Q4 | us-gaap |
Interest Payable Current
InterestPayableCurrent
|
9477000 | |
CY2018Q4 | us-gaap |
Liabilities Current
LiabilitiesCurrent
|
500193000 | |
CY2018Q4 | us-gaap |
Line Of Credit Facility Remaining Borrowing Capacity
LineOfCreditFacilityRemainingBorrowingCapacity
|
1300000000 | |
CY2018Q4 | us-gaap |
Land
Land
|
6683000 | |
CY2018Q4 | us-gaap |
Letters Of Credit Outstanding Amount
LettersOfCreditOutstandingAmount
|
200000 | |
CY2018Q4 | us-gaap |
Liabilities
Liabilities
|
2847027000 | |
CY2018Q4 | us-gaap |
Liabilities And Stockholders Equity
LiabilitiesAndStockholdersEquity
|
5934911000 | |
CY2018Q4 | us-gaap |
Long Term Debt
LongTermDebt
|
1969818000 | |
CY2018Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted
MalpracticeLossContingencyAccrualUndiscounted
|
243991000 | |
CY2018Q4 | us-gaap |
Long Term Debt And Capital Lease Obligations Current
LongTermDebtAndCapitalLeaseObligationsCurrent
|
253000 | |
CY2018Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted Current
MalpracticeLossContingencyAccrualUndiscountedCurrent
|
34931000 | |
CY2018Q4 | us-gaap |
Long Term Line Of Credit
LongTermLineOfCredit
|
739500000 | |
CY2018Q4 | us-gaap |
Deferred Tax Liabilities Goodwill And Intangible Assets Intangible Assets
DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets
|
286552000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Operating Loss Carryforwards
DeferredTaxAssetsOperatingLossCarryforwards
|
25226000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Operating Loss Carryforwards Not Subject To Expiration
DeferredTaxAssetsOperatingLossCarryforwardsNotSubjectToExpiration
|
27600000 | |
CY2018Q4 | us-gaap |
Deferred Tax Liabilities Noncurrent
DeferredTaxLiabilitiesNoncurrent
|
131240000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Gross
DeferredTaxAssetsGross
|
289796000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Net
DeferredTaxAssetsNet
|
287168000 | |
CY2018Q4 | us-gaap |
Deferred Tax Liabilities Other
DeferredTaxLiabilitiesOther
|
489000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Operating Loss Carryforwards Subject To Expiration
DeferredTaxAssetsOperatingLossCarryforwardsSubjectToExpiration
|
74300000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Property Plant And Equipment
DeferredTaxAssetsPropertyPlantAndEquipment
|
26000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Tax Deferred Expense Compensation And Benefits Share Based Compensation Cost
DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost
|
9201000 | |
CY2018Q4 | us-gaap |
Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Allowance For Doubtful Accounts
DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts
|
194876000 | |
CY2018Q4 | us-gaap |
Deferred Tax Liabilities
DeferredTaxLiabilities
|
109330000 | |
CY2018Q4 | us-gaap |
Deferred Tax Liabilities Deferred Expense Reserves And Accruals
DeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals
|
39000 | |
CY2018Q4 | us-gaap |
Equity Method Investment Ownership Percentage
EquityMethodInvestmentOwnershipPercentage
|
0.490 | pure |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Accumulated Amortization
FiniteLivedIntangibleAssetsAccumulatedAmortization
|
322576000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Amortization Expense Next Twelve Months
FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths
|
66532000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Amortization Expense Year Four
FiniteLivedIntangibleAssetsAmortizationExpenseYearFour
|
46249000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Amortization Expense Year Five
FiniteLivedIntangibleAssetsAmortizationExpenseYearFive
|
40448000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Amortization Expense Year Three
FiniteLivedIntangibleAssetsAmortizationExpenseYearThree
|
53771000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Amortization Expense Year Two
FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo
|
59969000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Gross
FiniteLivedIntangibleAssetsGross
|
910888000 | |
CY2018Q4 | us-gaap |
Finite Lived Intangible Assets Net
FiniteLivedIntangibleAssetsNet
|
588312000 | |
CY2018Q4 | us-gaap |
Fixtures And Equipment Gross
FixturesAndEquipmentGross
|
300981000 | |
CY2018Q4 | us-gaap |
Goodwill
Goodwill
|
4382995000 | |
CY2018Q4 | us-gaap |
Held To Maturity Securities Current
HeldToMaturitySecuritiesCurrent
|
21923000 | |
CY2018Q4 | us-gaap |
Income Tax Examination Penalties And Interest Accrued
IncomeTaxExaminationPenaltiesAndInterestAccrued
|
1100000 | |
CY2018Q4 | us-gaap |
Held To Maturity Securities Debt Maturities After One Through Five Years Net Carrying Amount
HeldToMaturitySecuritiesDebtMaturitiesAfterOneThroughFiveYearsNetCarryingAmount
|
69699000 | |
CY2018Q4 | us-gaap |
Held To Maturity Securities Noncurrent
HeldToMaturitySecuritiesNoncurrent
|
69699000 | |
CY2018Q4 | us-gaap |
Insurance Settlements Receivable
InsuranceSettlementsReceivable
|
16700000 | |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Nonvested Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue
|
54.46 | |
CY2018Q4 | us-gaap |
Sharebased Compensation Arrangement By Sharebased Payment Award Options Exercisable Intrinsic Value1
SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1
|
700000 | |
CY2018Q4 | us-gaap |
Stockholders Equity Including Portion Attributable To Noncontrolling Interest
StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest
|
3087884000 | |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Nonvested Number
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber
|
1310853 | shares |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Exercisable Number
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber
|
112976 | shares |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due In Four Years
OperatingLeasesFutureMinimumPaymentsDueInFourYears
|
12708000 | |
CY2018Q4 | us-gaap |
Prepaid Expense Current
PrepaidExpenseCurrent
|
18763000 | |
CY2018Q4 | us-gaap |
Other Liabilities Noncurrent
OtherLiabilitiesNoncurrent
|
32254000 | |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Exercisable Weighted Average Exercise Price
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice
|
27.65 | |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Outstanding Number
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber
|
112976 | shares |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Outstanding Weighted Average Exercise Price
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice
|
27.65 | |
CY2018Q4 | us-gaap |
Unamortized Debt Issuance Expense
UnamortizedDebtIssuanceExpense
|
19682000 | |
CY2018Q4 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Outstanding Intrinsic Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue
|
700000 | |
CY2018Q4 | us-gaap |
Stockholders Equity
StockholdersEquity
|
3087884000 | |
CY2018Q4 | us-gaap |
Unrecognized Tax Benefits
UnrecognizedTaxBenefits
|
11185000 | |
CY2018Q4 | us-gaap |
Unrecognized Tax Benefits That Would Impact Effective Tax Rate
UnrecognizedTaxBenefitsThatWouldImpactEffectiveTaxRate
|
10900000 | |
CY2018Q4 | us-gaap |
Property Plant And Equipment Net
PropertyPlantAndEquipmentNet
|
133037000 | |
CY2018Q4 | us-gaap |
Preferred Stock Par Or Stated Value Per Share
PreferredStockParOrStatedValuePerShare
|
0.01 | |
CY2018Q4 | us-gaap |
Preferred Stock Shares Authorized
PreferredStockSharesAuthorized
|
1000000 | shares |
CY2018Q4 | us-gaap |
Preferred Stock Value
PreferredStockValue
|
||
CY2018Q4 | us-gaap |
Preferred Stock Shares Issued
PreferredStockSharesIssued
|
0 | shares |
CY2018Q4 | us-gaap |
Property Plant And Equipment Gross
PropertyPlantAndEquipmentGross
|
340853000 | |
CY2018Q4 | us-gaap |
Restricted Cash Current
RestrictedCashCurrent
|
20000000 | |
CY2018Q4 | us-gaap |
Retained Earnings Accumulated Deficit
RetainedEarningsAccumulatedDeficit
|
2094359000 | |
CY2018Q4 | us-gaap |
Self Insurance Reserve Current
SelfInsuranceReserveCurrent
|
139100000 | |
CY2018Q4 | md |
Accrued Professional Liability
AccruedProfessionalLiability
|
104900000 | |
CY2018Q4 | md |
Money Market Funds At Fair Value
MoneyMarketFundsAtFairValue
|
500000 | |
CY2018Q4 | md |
Accounts Payable And Accrued Liabilities Excluding Accrued Income Taxes Current
AccountsPayableAndAccruedLiabilitiesExcludingAccruedIncomeTaxesCurrent
|
469342000 | |
CY2018Q4 | md |
Accrued Payroll Taxes And Benefits Current
AccruedPayrollTaxesAndBenefitsCurrent
|
80369000 | |
CY2018Q4 | md |
Long Term Debt And Capital Lease Obligations Excluding Long Term Line Of Credit
LongTermDebtAndCapitalLeaseObligationsExcludingLongTermLineOfCredit
|
1234780000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due Thereafter
OperatingLeasesFutureMinimumPaymentsDueThereafter
|
10522000 | |
CY2018Q4 | us-gaap |
Malpractice Loss Contingency Accrual Undiscounted Noncurrent
MalpracticeLossContingencyAccrualUndiscountedNoncurrent
|
209060000 | |
CY2018Q4 | us-gaap |
Other Accrued Liabilities Current
OtherAccruedLiabilitiesCurrent
|
44912000 | |
CY2018Q4 | us-gaap |
Other Assets Current
OtherAssetsCurrent
|
17706000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due In Three Years
OperatingLeasesFutureMinimumPaymentsDueInThreeYears
|
17946000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due
OperatingLeasesFutureMinimumPaymentsDue
|
103478000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due In Two Years
OperatingLeasesFutureMinimumPaymentsDueInTwoYears
|
22038000 | |
CY2018Q4 | us-gaap |
Operating Loss Carryforwards
OperatingLossCarryforwards
|
101900000 | |
CY2018Q4 | us-gaap |
Other Assets Noncurrent
OtherAssetsNoncurrent
|
103459000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due Current
OperatingLeasesFutureMinimumPaymentsDueCurrent
|
30824000 | |
CY2018Q4 | us-gaap |
Operating Leases Future Minimum Payments Due In Five Years
OperatingLeasesFutureMinimumPaymentsDueInFiveYears
|
9440000 | |
CY2018Q4 | md |
Accrued Contingent Consideration Liability Current
AccruedContingentConsiderationLiabilityCurrent
|
18760000 | |
CY2018Q4 | md |
Deferred Tax Liabilities Change In Accounting Method
DeferredTaxLiabilitiesChangeInAccountingMethod
|
109418000 | |
CY2017Q1 | md |
Deconsolidation Percentage
DeconsolidationPercentage
|
1.00 | pure |
CY2017Q1 | md |
Sale Of Minority Interest Percentage
SaleOfMinorityInterestPercentage
|
0.75 | pure |
CY2017 | us-gaap |
Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
|
29600000 | |
CY2017 | us-gaap |
Antidilutive Securities Excluded From Computation Of Earnings Per Share Amount
AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount
|
107000 | shares |
CY2017 | us-gaap |
Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value
AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue
|
29573000 | |
CY2017 | us-gaap |
Amortization Of Financing Costs And Discounts
AmortizationOfFinancingCostsAndDiscounts
|
5514000 | |
CY2017 | us-gaap |
Amortization Of Intangible Assets
AmortizationOfIntangibleAssets
|
68900000 | |
CY2017 | us-gaap |
Capital Expenditures Incurred But Not Yet Paid
CapitalExpendituresIncurredButNotYetPaid
|
2700000 | |
CY2017 | us-gaap |
Capital Lease Obligations Incurred
CapitalLeaseObligationsIncurred
|
684000 | |
CY2017 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect
|
24502000 | |
CY2017 | us-gaap |
Current Federal Tax Expense Benefit
CurrentFederalTaxExpenseBenefit
|
130053000 | |
CY2017 | us-gaap |
Current State And Local Tax Expense Benefit
CurrentStateAndLocalTaxExpenseBenefit
|
20070000 | |
CY2017 | us-gaap |
Deferred Federal Income Tax Expense Benefit
DeferredFederalIncomeTaxExpenseBenefit
|
-63038000 | |
CY2017 | us-gaap |
Deferred Income Tax Expense Benefit
DeferredIncomeTaxExpenseBenefit
|
-60073000 | |
CY2017 | us-gaap |
Deferred State And Local Income Tax Expense Benefit
DeferredStateAndLocalIncomeTaxExpenseBenefit
|
2965000 | |
CY2017 | us-gaap |
Depreciation
Depreciation
|
33900000 | |
CY2017 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
102879000 | |
CY2017 | us-gaap |
Defined Contribution Plan Cost Recognized
DefinedContributionPlanCostRecognized
|
50700000 | |
CY2017 | us-gaap |
Effective Income Tax Rate Continuing Operations
EffectiveIncomeTaxRateContinuingOperations
|
0.2194 | pure |
CY2017 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
3.45 | |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate
EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate
|
0.350 | pure |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation Other Reconciling Items Percent
EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent
|
0.0016 | pure |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation State And Local Income Taxes
EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes
|
0.0333 | pure |
CY2017 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
3.47 | |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation Change In Enacted Tax Rate
EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate
|
-0.1706 | pure |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation Nondeductible Expense
EffectiveIncomeTaxRateReconciliationNondeductibleExpense
|
0.0049 | pure |
CY2017 | us-gaap |
Effective Income Tax Rate Reconciliation Other Adjustments
EffectiveIncomeTaxRateReconciliationOtherAdjustments
|
0.0002 | pure |
CY2017 | us-gaap |
Federal Income Tax Expense Benefit Continuing Operations
FederalIncomeTaxExpenseBenefitContinuingOperations
|
67015000 | |
CY2017 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
417105000 | |
CY2017 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
410422000 | |
CY2017 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
952000 | |
CY2017 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
90050000 | |
CY2017 | us-gaap |
Increase Decrease In Liability For Claims And Claims Adjustment Expense Reserve
IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve
|
18478000 | |
CY2017 | us-gaap |
Increase Decrease In Prepaid Deferred Expense And Other Assets
IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets
|
2792000 | |
CY2017 | us-gaap |
Income Taxes Paid Net
IncomeTaxesPaidNet
|
75427000 | |
CY2017 | us-gaap |
Increase Decrease In Accounts Payable And Accrued Liabilities
IncreaseDecreaseInAccountsPayableAndAccruedLiabilities
|
24551000 | |
CY2017 | us-gaap |
Increase Decrease In Accrued Income Taxes Payable
IncreaseDecreaseInAccruedIncomeTaxesPayable
|
73050000 | |
CY2017 | us-gaap |
Increase Decrease In Other Noncurrent Assets
IncreaseDecreaseInOtherNoncurrentAssets
|
2709000 | |
CY2017 | us-gaap |
Increase Decrease In Accounts Receivable
IncreaseDecreaseInAccountsReceivable
|
-7803000 | |
CY2017 | us-gaap |
Interest Expense
InterestExpense
|
74559000 | |
CY2017 | us-gaap |
Increase Decrease In Other Operating Liabilities
IncreaseDecreaseInOtherOperatingLiabilities
|
-735000 | |
CY2017 | us-gaap |
Incremental Common Shares Attributable To Share Based Payment Arrangements
IncrementalCommonSharesAttributableToShareBasedPaymentArrangements
|
527000 | shares |
CY2017 | us-gaap |
Interest Paid Net
InterestPaidNet
|
73837000 | |
CY2017 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
3953000 | |
CY2017 | us-gaap |
Lease And Rental Expense
LeaseAndRentalExpense
|
42600000 | |
CY2017 | us-gaap |
Malpractice Loss Contingency Claims Incurred Net
MalpracticeLossContingencyClaimsIncurredNet
|
23855000 | |
CY2017 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-69654000 | |
CY2017 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Period
MalpracticeLossContingencyClaimsIncurredInPeriod
|
712000 | |
CY2017 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Prior Periods
MalpracticeLossContingencyClaimsIncurredInPriorPeriods
|
23143000 | |
CY2017 | us-gaap |
Net Cash Provided By Used In Investing Activities
NetCashProvidedByUsedInInvestingActivities
|
-576613000 | |
CY2017 | us-gaap |
Net Cash Provided By Used In Financing Activities
NetCashProvidedByUsedInFinancingActivities
|
89737000 | |
CY2017 | us-gaap |
Net Cash Provided By Used In Operating Activities
NetCashProvidedByUsedInOperatingActivities
|
511378000 | |
CY2017 | us-gaap |
Net Income Loss
NetIncomeLoss
|
320372000 | |
CY2017 | us-gaap |
Other Noncash Income Expense
OtherNoncashIncomeExpense
|
3783000 | |
CY2017 | us-gaap |
Operating Expenses
OperatingExpenses
|
2978236000 | |
CY2017 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
480076000 | |
CY2017 | us-gaap |
Payments Of Financing Costs
PaymentsOfFinancingCosts
|
3525000 | |
CY2017 | us-gaap |
Payments To Acquire Investments
PaymentsToAcquireInvestments
|
27723000 | |
CY2017 | us-gaap |
Payments To Acquire Other Property Plant And Equipment
PaymentsToAcquireOtherPropertyPlantAndEquipment
|
49309000 | |
CY2017 | us-gaap |
Payments For Repurchase Of Common Stock
PaymentsForRepurchaseOfCommonStock
|
70192000 | |
CY2017 | us-gaap |
Payments To Acquire Businesses Net Of Cash Acquired
PaymentsToAcquireBusinessesNetOfCashAcquired
|
531696000 | |
CY2017 | us-gaap |
Payment For Contingent Consideration Liability Financing Activities
PaymentForContingentConsiderationLiabilityFinancingActivities
|
5449000 | |
CY2017 | us-gaap |
Payment For Contingent Consideration Liability Operating Activities
PaymentForContingentConsiderationLiabilityOperatingActivities
|
750000 | |
CY2017 | us-gaap |
Payments For Proceeds From Other Investing Activities
PaymentsForProceedsFromOtherInvestingActivities
|
-6705000 | |
CY2017 | us-gaap |
Proceeds From Issuance Of Common Stock
ProceedsFromIssuanceOfCommonStock
|
23276000 | |
CY2017 | us-gaap |
Proceeds From Minority Shareholders
ProceedsFromMinorityShareholders
|
894000 | |
CY2017 | us-gaap |
Proceeds From Sale Maturity And Collections Of Investments
ProceedsFromSaleMaturityAndCollectionsOfInvestments
|
25410000 | |
CY2017 | us-gaap |
Proceeds And Excess Tax Benefit From Sharebased Compensation
ProceedsAndExcessTaxBenefitFromSharebasedCompensation
|
4800000 | |
CY2017 | us-gaap |
Proceeds From Lines Of Credit
ProceedsFromLinesOfCredit
|
2846000000 | |
CY2017 | us-gaap |
Repayments Of Lines Of Credit
RepaymentsOfLinesOfCredit
|
2699000000 | |
CY2017 | us-gaap |
Profit Loss
ProfitLoss
|
320372000 | |
CY2017 | us-gaap |
Repayments Of Long Term Capital Lease Obligations
RepaymentsOfLongTermCapitalLeaseObligations
|
2267000 | |
CY2017 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
3458312000 | |
CY2017 | us-gaap |
Share Based Compensation
ShareBasedCompensation
|
29573000 | |
CY2017 | us-gaap |
Stock Issued1
StockIssued1
|
2657000 | |
CY2017 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vested In Period Total Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue
|
29300000 | |
CY2017 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Grants In Period Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue
|
54.22 | |
CY2017 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Exercises In Period Total Intrinsic Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue
|
5500000 | |
CY2017 | us-gaap |
State And Local Income Tax Expense Benefit Continuing Operations
StateAndLocalIncomeTaxExpenseBenefitContinuingOperations
|
23035000 | |
CY2017 | us-gaap |
Stock Repurchased During Period Value
StockRepurchasedDuringPeriodValue
|
70192000 | |
CY2017 | us-gaap |
Stock Issued During Period Value Share Based Compensation
StockIssuedDuringPeriodValueShareBasedCompensation
|
23276000 | |
CY2017 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Prior Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions
|
2284000 | |
CY2017 | us-gaap |
Unrecognized Tax Benefits Reductions Resulting From Lapse Of Applicable Statute Of Limitations
UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations
|
2068000 | |
CY2017 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
92958000 | shares |
CY2017 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92431000 | shares |
CY2017 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Current Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions
|
1430000 | |
CY2017 | us-gaap |
Unrecognized Tax Benefits Period Increase Decrease
UnrecognizedTaxBenefitsPeriodIncreaseDecrease
|
1500000 | |
CY2017 | us-gaap |
Unrecognized Tax Benefits Decreases Resulting From Prior Period Tax Positions
UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions
|
143000 | |
CY2017 | md |
Accrued Professional Liabilities Assumed Through Acquisition
AccruedProfessionalLiabilitiesAssumedThroughAcquisition
|
20716000 | |
CY2017 | md |
Income Tax Expense For Excess Tax Deficiencies
IncomeTaxExpenseForExcessTaxDeficiencies
|
200000 | |
CY2017 | md |
Provision Adjustment For Losses Related To Prior Year
ProvisionAdjustmentForLossesRelatedToPriorYear
|
9983000 | |
CY2017 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
120518000 | |
CY2017 | md |
Malpractice Loss Contingency Provision For Losses
MalpracticeLossContingencyProvisionForLosses
|
51274000 | |
CY2017 | md |
Provision Adjustment For Losses Related To Current Year
ProvisionAdjustmentForLossesRelatedToCurrentYear
|
41291000 | |
CY2017 | md |
Stock Issued During Period Value Restricted Stock Acquisition Consideration
StockIssuedDuringPeriodValueRestrictedStockAcquisitionConsideration
|
2658000 | |
CY2017 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
2337734000 | |
CY2017 | md |
Number Of Pediatric Multi Specialty Practices Acquired
NumberOfPediatricMultiSpecialtyPracticesAcquired
|
1 | Company |
CY2017 | md |
Number Of Physician Group Practices Acquired
NumberOfPhysicianGroupPracticesAcquired
|
10 | Company |
CY2017 | md |
Number Of Maternalfetal Medicine Practices Acquired
NumberOfMaternalfetalMedicinePracticesAcquired
|
2 | Company |
CY2017 | md |
Number Of Pediatric Subspecialty Practices Acquired
NumberOfPediatricSubspecialtyPracticesAcquired
|
2 | Company |
CY2017 | md |
Number Of Radiology Practices Acquired
NumberOfRadiologyPracticesAcquired
|
4 | Company |
CY2017 | md |
Number Of Neonatology Practices Acquired
NumberOfNeonatologyPracticesAcquired
|
1 | Company |
CY2017 | md |
Percentage Of Net Patient Service Revenue By Type Of Payor
PercentageOfNetPatientServiceRevenueByTypeOfPayor
|
1.00 | pure |
CY2018 | us-gaap |
Adjustments To Additional Paid In Capital Tax Effect From Share Based Compensation
AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation
|
0 | |
CY2018 | us-gaap |
Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
|
38700000 | |
CY2018 | us-gaap |
Antidilutive Securities Excluded From Computation Of Earnings Per Share Amount
AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount
|
214000 | shares |
CY2018 | dei |
Amendment Flag
AmendmentFlag
|
false | |
CY2018 | us-gaap |
Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value
AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue
|
38703000 | |
CY2018 | us-gaap |
Amortization Of Financing Costs And Discounts
AmortizationOfFinancingCostsAndDiscounts
|
4572000 | |
CY2018 | us-gaap |
Amortization Of Intangible Assets
AmortizationOfIntangibleAssets
|
72800000 | |
CY2018 | us-gaap |
Business Combination Contingent Consideration Arrangements Change In Amount Of Contingent Consideration Liability1
BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1
|
-5300000 | |
CY2018 | us-gaap |
Capital Expenditures Incurred But Not Yet Paid
CapitalExpendituresIncurredButNotYetPaid
|
2927000 | |
CY2018 | dei |
Document Type
DocumentType
|
10-K | |
CY2018 | us-gaap |
Defined Contribution Plan Cost Recognized
DefinedContributionPlanCostRecognized
|
55800000 | |
CY2018 | us-gaap |
Business Combination Consideration Transferred1
BusinessCombinationConsiderationTransferred1
|
111800000 | |
CY2018 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect
|
-23455000 | |
CY2018 | us-gaap |
Current Federal Tax Expense Benefit
CurrentFederalTaxExpenseBenefit
|
97754000 | |
CY2018 | us-gaap |
Current State And Local Tax Expense Benefit
CurrentStateAndLocalTaxExpenseBenefit
|
26605000 | |
CY2018 | dei |
Current Fiscal Year End Date
CurrentFiscalYearEndDate
|
--12-31 | |
CY2018 | us-gaap |
Deferred Federal Income Tax Expense Benefit
DeferredFederalIncomeTaxExpenseBenefit
|
-20176000 | |
CY2018 | us-gaap |
Deferred Income Tax Expense Benefit
DeferredIncomeTaxExpenseBenefit
|
-24149000 | |
CY2018 | us-gaap |
Deferred State And Local Income Tax Expense Benefit
DeferredStateAndLocalIncomeTaxExpenseBenefit
|
-3973000 | |
CY2018 | us-gaap |
Depreciation
Depreciation
|
38500000 | |
CY2018 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
111281000 | |
CY2018 | dei |
Document Fiscal Period Focus
DocumentFiscalPeriodFocus
|
FY | |
CY2018 | dei |
Document Fiscal Year Focus
DocumentFiscalYearFocus
|
2018 | |
CY2018 | us-gaap |
Effective Income Tax Rate Continuing Operations
EffectiveIncomeTaxRateContinuingOperations
|
0.2717 | pure |
CY2018 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
2.93 | |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate
EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate
|
0.210 | pure |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation Other Reconciling Items Percent
EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent
|
0.0120 | pure |
CY2018 | dei |
Entity Central Index Key
EntityCentralIndexKey
|
0000893949 | |
CY2018 | dei |
Entity Well Known Seasoned Issuer
EntityWellKnownSeasonedIssuer
|
Yes | |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation State And Local Income Taxes
EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes
|
0.0480 | pure |
CY2018 | dei |
Entity Registrant Name
EntityRegistrantName
|
MEDNAX, INC. | |
CY2018 | dei |
Entity Shell Company
EntityShellCompany
|
false | |
CY2018 | dei |
Entity Small Business
EntitySmallBusiness
|
false | |
CY2018 | dei |
Entity Voluntary Filers
EntityVoluntaryFilers
|
No | |
CY2018 | dei |
Document Period End Date
DocumentPeriodEndDate
|
2018-12-31 | |
CY2018 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
2.95 | |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation Change In Enacted Tax Rate
EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate
|
-0.0032 | pure |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation Nondeductible Expense
EffectiveIncomeTaxRateReconciliationNondeductibleExpense
|
0.0044 | pure |
CY2018 | us-gaap |
Effective Income Tax Rate Reconciliation Other Adjustments
EffectiveIncomeTaxRateReconciliationOtherAdjustments
|
0.0005 | pure |
CY2018 | dei |
Entity Current Reporting Status
EntityCurrentReportingStatus
|
Yes | |
CY2018 | dei |
Entity Emerging Growth Company
EntityEmergingGrowthCompany
|
false | |
CY2018 | dei |
Entity Ex Transition Period
EntityExTransitionPeriod
|
false | |
CY2018 | dei |
Entity Filer Category
EntityFilerCategory
|
Large Accelerated Filer | |
CY2018 | us-gaap |
Federal Income Tax Expense Benefit Continuing Operations
FederalIncomeTaxExpenseBenefitContinuingOperations
|
77578000 | |
CY2018 | us-gaap |
Goodwill Period Increase Decrease
GoodwillPeriodIncreaseDecrease
|
99000000 | |
CY2018 | us-gaap |
Finitelived Intangible Assets Acquired1
FinitelivedIntangibleAssetsAcquired1
|
17200000 | |
CY2018 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
432378000 | |
CY2018 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
368839000 | |
CY2018 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
6825000 | |
CY2018 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
100210000 | |
CY2018 | us-gaap |
Increase Decrease In Deferred Liabilities
IncreaseDecreaseInDeferredLiabilities
|
-23600000 | |
CY2018 | us-gaap |
Increase Decrease In Liability For Claims And Claims Adjustment Expense Reserve
IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve
|
-4490000 | |
CY2018 | us-gaap |
Increase Decrease In Prepaid Deferred Expense And Other Assets
IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets
|
5472000 | |
CY2018 | us-gaap |
Income Taxes Paid Net
IncomeTaxesPaidNet
|
185416000 | |
CY2018 | us-gaap |
Increase Decrease In Accounts Payable And Accrued Liabilities
IncreaseDecreaseInAccountsPayableAndAccruedLiabilities
|
15390000 | |
CY2018 | us-gaap |
Increase Decrease In Accrued Income Taxes Payable
IncreaseDecreaseInAccruedIncomeTaxesPayable
|
-61256000 | |
CY2018 | us-gaap |
Increase Decrease In Other Noncurrent Assets
IncreaseDecreaseInOtherNoncurrentAssets
|
395000 | |
CY2018 | us-gaap |
Increase Decrease In Accounts Receivable
IncreaseDecreaseInAccountsReceivable
|
36598000 | |
CY2018 | us-gaap |
Interest Expense
InterestExpense
|
88769000 | |
CY2018 | us-gaap |
Increase Decrease In Other Operating Liabilities
IncreaseDecreaseInOtherOperatingLiabilities
|
-4294000 | |
CY2018 | us-gaap |
Incremental Common Shares Attributable To Share Based Payment Arrangements
IncrementalCommonSharesAttributableToShareBasedPaymentArrangements
|
502000 | shares |
CY2018 | us-gaap |
Interest Paid Net
InterestPaidNet
|
82540000 | |
CY2018 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
4935000 | |
CY2018 | us-gaap |
Lease And Rental Expense
LeaseAndRentalExpense
|
42900000 | |
CY2018 | us-gaap |
Malpractice Loss Contingency Claims Incurred Net
MalpracticeLossContingencyClaimsIncurredNet
|
52254000 | |
CY2018 | us-gaap |
Line Of Credit Facility Expiration Date1
LineOfCreditFacilityExpirationDate1
|
2022-10-31 | |
CY2018 | us-gaap |
Nature Of Operations
NatureOfOperations
|
<div> <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: "Times New Roman"; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"> <b>1.    General:</b></p> <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: "Times New Roman"; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 6pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"> The principal business activity of MEDNAX, Inc. (“MEDNAX” or the “Company”) and its subsidiaries is to provide neonatal, anesthesia, radiology and teleradiology, maternal-fetal and other pediatric subspecialty physician services. The Company has contracts with affiliated business corporations or professional associations, limited liability companies and partnerships (“affiliated professional contractors”), which are separate legal entities that provide physician services in certain states and Puerto Rico. The Company and its affiliated professional contractors also have contracts with hospitals and other healthcare facilities to provide physician services, which include <font style="WHITE-SPACE: nowrap"><font style="WHITE-SPACE: nowrap">(i) fee-for-service</font></font> contracts, whereby hospitals and other customers agree, in exchange for the Company’s services, to authorize the Company and its healthcare professionals to bill and collect the charges for medical services rendered by the Company’s affiliated healthcare professionals, and (ii) administrative fee contracts, whereby the Company is assured a minimum revenue level.</p> <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: "Times New Roman"; WHITE-SPACE: normal; WORD-SPACING: 0px; TEXT-TRANSFORM: none; FONT-WEIGHT: 400; COLOR: rgb(0,0,0); FONT-STYLE: normal; ORPHANS: 2; WIDOWS: 2; MARGIN-TOP: 12pt; LETTER-SPACING: normal; TEXT-INDENT: 4%; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial"> In addition to its national physician network, the Company also provides services nationwide to healthcare providers, including its own, through complementary businesses including a management services organization specializing in full-service revenue cycle management and a consulting services company.</p> </div> | |
CY2018 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-77009000 | |
CY2018 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Period
MalpracticeLossContingencyClaimsIncurredInPeriod
|
555000 | |
CY2018 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Prior Periods
MalpracticeLossContingencyClaimsIncurredInPriorPeriods
|
51699000 | |
CY2018 | us-gaap |
Net Cash Provided By Used In Investing Activities
NetCashProvidedByUsedInInvestingActivities
|
-142769000 | |
CY2018 | us-gaap |
Net Cash Provided By Used In Financing Activities
NetCashProvidedByUsedInFinancingActivities
|
-170611000 | |
CY2018 | us-gaap |
Net Cash Provided By Used In Operating Activities
NetCashProvidedByUsedInOperatingActivities
|
289925000 | |
CY2018 | us-gaap |
Net Income Loss
NetIncomeLoss
|
268629000 | |
CY2018 | us-gaap |
Other Noncash Income Expense
OtherNoncashIncomeExpense
|
10903000 | |
CY2018 | us-gaap |
Operating Expenses
OperatingExpenses
|
3201275000 | |
CY2018 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
445848000 | |
CY2018 | us-gaap |
Payments For Previous Acquisition
PaymentsForPreviousAcquisition
|
6400000 | |
CY2018 | us-gaap |
Payments Of Financing Costs
PaymentsOfFinancingCosts
|
7090000 | |
CY2018 | us-gaap |
Payments To Acquire Investments
PaymentsToAcquireInvestments
|
15884000 | |
CY2018 | us-gaap |
Payments To Acquire Other Property Plant And Equipment
PaymentsToAcquireOtherPropertyPlantAndEquipment
|
48868000 | |
CY2018 | us-gaap |
Payments For Repurchase Of Common Stock
PaymentsForRepurchaseOfCommonStock
|
302160000 | |
CY2018 | us-gaap |
Proceeds From Sale Maturity And Collections Of Investments
ProceedsFromSaleMaturityAndCollectionsOfInvestments
|
13710000 | |
CY2018 | us-gaap |
Proceeds And Excess Tax Benefit From Sharebased Compensation
ProceedsAndExcessTaxBenefitFromSharebasedCompensation
|
3700000 | |
CY2018 | us-gaap |
Payments To Acquire Businesses Net Of Cash Acquired
PaymentsToAcquireBusinessesNetOfCashAcquired
|
114491000 | |
CY2018 | us-gaap |
Payment For Contingent Consideration Liability Financing Activities
PaymentForContingentConsiderationLiabilityFinancingActivities
|
5263000 | |
CY2018 | us-gaap |
Payment For Contingent Consideration Liability Operating Activities
PaymentForContingentConsiderationLiabilityOperatingActivities
|
1093000 | |
CY2018 | us-gaap |
Proceeds From Issuance Of Common Stock
ProceedsFromIssuanceOfCommonStock
|
16258000 | |
CY2018 | us-gaap |
Proceeds From Issuance Of Senior Long Term Debt
ProceedsFromIssuanceOfSeniorLongTermDebt
|
500000000 | |
CY2018 | us-gaap |
Proceeds From Lines Of Credit
ProceedsFromLinesOfCredit
|
1723500000 | |
CY2018 | us-gaap |
Proceeds From Sales Of Business Affiliate And Productive Assets
ProceedsFromSalesOfBusinessAffiliateAndProductiveAssets
|
22764000 | |
CY2018 | us-gaap |
Repayments Of Lines Of Credit
RepaymentsOfLinesOfCredit
|
2094500000 | |
CY2018 | us-gaap |
Profit Loss
ProfitLoss
|
268629000 | |
CY2018 | us-gaap |
Repayments Of Long Term Capital Lease Obligations
RepaymentsOfLongTermCapitalLeaseObligations
|
1356000 | |
CY2018 | us-gaap |
Share Based Compensation Arrangements By Share Based Payment Award Options Exercises In Period Weighted Average Exercise Price
ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice
|
27.38 | |
CY2018 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
3647123000 | |
CY2018 | us-gaap |
Sharebased Compensation Arrangement By Sharebased Payment Award Options Outstanding Weighted Average Remaining Contractual Term2
SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2
|
P1Y3M18D | |
CY2018 | us-gaap |
Share Based Compensation
ShareBasedCompensation
|
38703000 | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Forfeited In Period
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod
|
69293 | shares |
CY2018 | us-gaap |
Sharebased Compensation Arrangement By Sharebased Payment Award Options Exercisable Weighted Average Remaining Contractual Term1
SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1
|
P1Y3M18D | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Grants In Period
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod
|
770480 | shares |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vested In Period
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod
|
431368 | shares |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vested In Period Total Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue
|
27400000 | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vested In Period Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue
|
63.57 | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Forfeitures Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue
|
56.65 | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Grants In Period Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue
|
51.99 | |
CY2018 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Exercises In Period Total Intrinsic Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue
|
2800000 | |
CY2018 | dei |
Trading Symbol
TradingSymbol
|
MD | |
CY2018 | us-gaap |
State And Local Income Tax Expense Benefit Continuing Operations
StateAndLocalIncomeTaxExpenseBenefitContinuingOperations
|
22632000 | |
CY2018 | us-gaap |
Stock Repurchased During Period Value
StockRepurchasedDuringPeriodValue
|
302160000 | |
CY2018 | us-gaap |
Stock Issued During Period Shares Stock Options Exercised
StockIssuedDuringPeriodSharesStockOptionsExercised
|
133366 | shares |
CY2018 | us-gaap |
Stock Issued During Period Value Share Based Compensation
StockIssuedDuringPeriodValueShareBasedCompensation
|
18919000 | |
CY2018 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Prior Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions
|
385000 | |
CY2018 | us-gaap |
Unrecognized Tax Benefits Reductions Resulting From Lapse Of Applicable Statute Of Limitations
UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations
|
3072000 | |
CY2018 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
91606000 | shares |
CY2018 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
91104000 | shares |
CY2018 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Current Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions
|
2900000 | |
CY2018 | us-gaap |
Unrecognized Tax Benefits Period Increase Decrease
UnrecognizedTaxBenefitsPeriodIncreaseDecrease
|
200000 | |
CY2018 | us-gaap |
Use Of Estimates
UseOfEstimates
|
<div> <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 18pt"> <b>Accounting Estimates and Assumptions</b></p> <p style="MARGIN-BOTTOM: 0pt; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman; MARGIN-TOP: 6pt; TEXT-INDENT: 4%"> The preparation of financial statements in conformity with accounting principles generally accepted in the United States (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting periods. Significant estimates and assumptions are involved in the calculation of the Company’s allowance for contractual adjustments and uncollectibles on accounts receivable, liabilities for self-insured amounts and claims incurred but not reported related to the Company’s professional liability risks and the fair value of goodwill. Actual results could differ from those estimates.</p> </div> | |
CY2018 | md |
Accrued Professional Liabilities Assumed Through Acquisition
AccruedProfessionalLiabilitiesAssumedThroughAcquisition
|
1276000 | |
CY2018 | md |
Payment For Purchase Consideration Related To Prior Period Acquisitions
PaymentForPurchaseConsiderationRelatedToPriorPeriodAcquisitions
|
1200000 | |
CY2018 | md |
Income Tax Expense For Excess Tax Deficiencies
IncomeTaxExpenseForExcessTaxDeficiencies
|
1400000 | |
CY2018 | md |
Provision Adjustment For Losses Related To Prior Year
ProvisionAdjustmentForLossesRelatedToPriorYear
|
10299000 | |
CY2018 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
122028000 | |
CY2018 | md |
Malpractice Loss Contingency Provision For Losses
MalpracticeLossContingencyProvisionForLosses
|
44782000 | |
CY2018 | md |
Provision Adjustment For Losses Related To Current Year
ProvisionAdjustmentForLossesRelatedToCurrentYear
|
34483000 | |
CY2018 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
2535588000 | |
CY2018 | md |
Cash And Cash Equivalents Maturity Description
CashAndCashEquivalentsMaturityDescription
|
90 | |
CY2018 | md |
Number Of Physician Group Practices Acquired
NumberOfPhysicianGroupPracticesAcquired
|
9 | Company |
CY2018 | md |
Number Of Pediatric Subspecialty Practices Acquired
NumberOfPediatricSubspecialtyPracticesAcquired
|
2 | Company |
CY2018 | md |
Number Of Radiology Practices Acquired
NumberOfRadiologyPracticesAcquired
|
5 | Company |
CY2018 | md |
Number Of Neonatology Practices Acquired
NumberOfNeonatologyPracticesAcquired
|
2 | Company |
CY2018 | md |
Business Combination Contingent Consideration Arrangements Time Period
BusinessCombinationContingentConsiderationArrangementsTimePeriod
|
P5Y | |
CY2018 | md |
Percentage Of Net Patient Service Revenue By Type Of Payor
PercentageOfNetPatientServiceRevenueByTypeOfPayor
|
1.00 | pure |
CY2018 | md |
Stock Issued During Period Value Stock Swaps
StockIssuedDuringPeriodValueStockSwaps
|
-2661000 | |
CY2018 | md |
Increase Decrease In Deferred Tax Assets Tax Deferred Expense Reserves And Accruals Allowance For Doubtful Accounts
IncreaseDecreaseInDeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAllowanceForDoubtfulAccounts
|
114800000 | |
CY2018 | md |
Increase Decrease In Deferred Tax Liabilities Deferred Expense Reserves And Accruals
IncreaseDecreaseInDeferredTaxLiabilitiesDeferredExpenseReservesAndAccruals
|
31300000 | |
CY2016 | us-gaap |
Adjustments To Additional Paid In Capital Tax Effect From Share Based Compensation
AdjustmentsToAdditionalPaidInCapitalTaxEffectFromShareBasedCompensation
|
4131000 | |
CY2016 | us-gaap |
Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
|
34000000 | |
CY2016 | us-gaap |
Antidilutive Securities Excluded From Computation Of Earnings Per Share Amount
AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount
|
2000 | shares |
CY2016 | us-gaap |
Adjustments To Additional Paid In Capital Sharebased Compensation Requisite Service Period Recognition Value
AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue
|
34000000 | |
CY2016 | us-gaap |
Amortization Of Financing Costs And Discounts
AmortizationOfFinancingCostsAndDiscounts
|
4816000 | |
CY2016 | us-gaap |
Adjustment To Additional Paid In Capital Income Tax Effect From Share Based Compensation Net
AdjustmentToAdditionalPaidInCapitalIncomeTaxEffectFromShareBasedCompensationNet
|
4200000 | |
CY2016 | us-gaap |
Amortization Of Intangible Assets
AmortizationOfIntangibleAssets
|
60300000 | |
CY2016 | us-gaap |
Capital Expenditures Incurred But Not Yet Paid
CapitalExpendituresIncurredButNotYetPaid
|
2673000 | |
CY2016 | us-gaap |
Capital Lease Obligations Incurred
CapitalLeaseObligationsIncurred
|
1619000 | |
CY2016 | us-gaap |
Cash Cash Equivalents Restricted Cash And Restricted Cash Equivalents Period Increase Decrease Including Exchange Rate Effect
CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect
|
4126000 | |
CY2016 | us-gaap |
Current Federal Tax Expense Benefit
CurrentFederalTaxExpenseBenefit
|
166758000 | |
CY2016 | us-gaap |
Current State And Local Tax Expense Benefit
CurrentStateAndLocalTaxExpenseBenefit
|
4296000 | |
CY2016 | us-gaap |
Deferred Federal Income Tax Expense Benefit
DeferredFederalIncomeTaxExpenseBenefit
|
15596000 | |
CY2016 | us-gaap |
Deferred Income Tax Expense Benefit
DeferredIncomeTaxExpenseBenefit
|
18149000 | |
CY2016 | us-gaap |
Deferred State And Local Income Tax Expense Benefit
DeferredStateAndLocalIncomeTaxExpenseBenefit
|
2553000 | |
CY2016 | us-gaap |
Depreciation
Depreciation
|
29000000 | |
CY2016 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
89264000 | |
CY2016 | us-gaap |
Defined Contribution Plan Cost Recognized
DefinedContributionPlanCostRecognized
|
45200000 | |
CY2016 | us-gaap |
Effective Income Tax Rate Continuing Operations
EffectiveIncomeTaxRateContinuingOperations
|
0.3680 | pure |
CY2016 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
3.49 | |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation At Federal Statutory Income Tax Rate
EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate
|
0.3500 | pure |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation Change In Deferred Tax Assets Valuation Allowance
EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance
|
0.0048 | pure |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation Other Reconciling Items Percent
EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent
|
0.0006 | pure |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation State And Local Income Taxes
EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes
|
0.0294 | pure |
CY2016 | us-gaap |
Excess Tax Benefit From Share Based Compensation Financing Activities
ExcessTaxBenefitFromShareBasedCompensationFinancingActivities
|
4241000 | |
CY2016 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
3.52 | |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation Nondeductible Expense
EffectiveIncomeTaxRateReconciliationNondeductibleExpense
|
0.0043 | pure |
CY2016 | us-gaap |
Effective Income Tax Rate Reconciliation Other Adjustments
EffectiveIncomeTaxRateReconciliationOtherAdjustments
|
-0.0211 | pure |
CY2016 | us-gaap |
Federal Income Tax Expense Benefit Continuing Operations
FederalIncomeTaxExpenseBenefitContinuingOperations
|
182354000 | |
CY2016 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
372572000 | |
CY2016 | us-gaap |
Interest Expense
InterestExpense
|
63092000 | |
CY2016 | us-gaap |
Increase Decrease In Other Operating Liabilities
IncreaseDecreaseInOtherOperatingLiabilities
|
-7405000 | |
CY2016 | us-gaap |
Incremental Common Shares Attributable To Share Based Payment Arrangements
IncrementalCommonSharesAttributableToShareBasedPaymentArrangements
|
687000 | shares |
CY2016 | us-gaap |
Interest Paid Net
InterestPaidNet
|
60453000 | |
CY2016 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
513799000 | |
CY2016 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
3185000 | |
CY2016 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
189203000 | |
CY2016 | us-gaap |
Increase Decrease In Liability For Claims And Claims Adjustment Expense Reserve
IncreaseDecreaseInLiabilityForClaimsAndClaimsAdjustmentExpenseReserve
|
-3452000 | |
CY2016 | us-gaap |
Increase Decrease In Prepaid Deferred Expense And Other Assets
IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets
|
783000 | |
CY2016 | us-gaap |
Income Taxes Paid Net
IncomeTaxesPaidNet
|
175962000 | |
CY2016 | us-gaap |
Increase Decrease In Accounts Payable And Accrued Liabilities
IncreaseDecreaseInAccountsPayableAndAccruedLiabilities
|
11617000 | |
CY2016 | us-gaap |
Increase Decrease In Accrued Income Taxes Payable
IncreaseDecreaseInAccruedIncomeTaxesPayable
|
-2234000 | |
CY2016 | us-gaap |
Increase Decrease In Other Noncurrent Assets
IncreaseDecreaseInOtherNoncurrentAssets
|
-10035000 | |
CY2016 | us-gaap |
Increase Decrease In Accounts Receivable
IncreaseDecreaseInAccountsReceivable
|
34000000 | |
CY2016 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
2019000 | |
CY2016 | us-gaap |
Lease And Rental Expense
LeaseAndRentalExpense
|
38000000 | |
CY2016 | us-gaap |
Malpractice Loss Contingency Claims Incurred Net
MalpracticeLossContingencyClaimsIncurredNet
|
13176000 | |
CY2016 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-57888000 | |
CY2016 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Period
MalpracticeLossContingencyClaimsIncurredInPeriod
|
766000 | |
CY2016 | us-gaap |
Malpractice Loss Contingency Claims Incurred In Prior Periods
MalpracticeLossContingencyClaimsIncurredInPriorPeriods
|
12410000 | |
CY2016 | us-gaap |
Net Cash Provided By Used In Investing Activities
NetCashProvidedByUsedInInvestingActivities
|
-821217000 | |
CY2016 | us-gaap |
Net Cash Provided By Used In Financing Activities
NetCashProvidedByUsedInFinancingActivities
|
381565000 | |
CY2016 | us-gaap |
Net Cash Provided By Used In Operating Activities
NetCashProvidedByUsedInOperatingActivities
|
443778000 | |
CY2016 | us-gaap |
Net Income Loss
NetIncomeLoss
|
324914000 | |
CY2016 | us-gaap |
Net Income Loss Attributable To Noncontrolling Interest
NetIncomeLossAttributableToNoncontrollingInterest
|
-318000 | |
CY2016 | us-gaap |
Other Noncash Income Expense
OtherNoncashIncomeExpense
|
-212000 | |
CY2016 | us-gaap |
Operating Expenses
OperatingExpenses
|
2611472000 | |
CY2016 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
571687000 | |
CY2016 | us-gaap |
Payments To Acquire Investments
PaymentsToAcquireInvestments
|
60976000 | |
CY2016 | us-gaap |
Payments To Acquire Other Property Plant And Equipment
PaymentsToAcquireOtherPropertyPlantAndEquipment
|
39264000 | |
CY2016 | us-gaap |
Payments For Repurchase Of Common Stock
PaymentsForRepurchaseOfCommonStock
|
61828000 | |
CY2016 | us-gaap |
Payments To Acquire Businesses Net Of Cash Acquired
PaymentsToAcquireBusinessesNetOfCashAcquired
|
762302000 | |
CY2016 | us-gaap |
Payment For Contingent Consideration Liability Financing Activities
PaymentForContingentConsiderationLiabilityFinancingActivities
|
10740000 | |
CY2016 | us-gaap |
Payment For Contingent Consideration Liability Operating Activities
PaymentForContingentConsiderationLiabilityOperatingActivities
|
1037000 | |
CY2016 | us-gaap |
Proceeds From Issuance Of Common Stock
ProceedsFromIssuanceOfCommonStock
|
22022000 | |
CY2016 | us-gaap |
Proceeds From Sale Maturity And Collections Of Investments
ProceedsFromSaleMaturityAndCollectionsOfInvestments
|
41325000 | |
CY2016 | us-gaap |
Proceeds And Excess Tax Benefit From Sharebased Compensation
ProceedsAndExcessTaxBenefitFromSharebasedCompensation
|
4700000 | |
CY2016 | us-gaap |
Proceeds From Lines Of Credit
ProceedsFromLinesOfCredit
|
1940000000 | |
CY2016 | us-gaap |
Repayments Of Lines Of Credit
RepaymentsOfLinesOfCredit
|
1510000000 | |
CY2016 | us-gaap |
Profit Loss
ProfitLoss
|
324596000 | |
CY2016 | us-gaap |
Repayments Of Long Term Capital Lease Obligations
RepaymentsOfLongTermCapitalLeaseObligations
|
2130000 | |
CY2016 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
3183159000 | |
CY2016 | us-gaap |
Share Based Compensation
ShareBasedCompensation
|
34000000 | |
CY2016 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Vested In Period Total Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodTotalFairValue
|
29800000 | |
CY2016 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Grants In Period Weighted Average Grant Date Fair Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue
|
67.90 | |
CY2016 | us-gaap |
Share Based Compensation Arrangement By Share Based Payment Award Options Exercises In Period Total Intrinsic Value
ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue
|
6800000 | |
CY2016 | us-gaap |
State And Local Income Tax Expense Benefit Continuing Operations
StateAndLocalIncomeTaxExpenseBenefitContinuingOperations
|
6849000 | |
CY2016 | us-gaap |
Stock Repurchased During Period Value
StockRepurchasedDuringPeriodValue
|
61828000 | |
CY2016 | us-gaap |
Stock Issued During Period Value Share Based Compensation
StockIssuedDuringPeriodValueShareBasedCompensation
|
22022000 | |
CY2016 | us-gaap |
Unrecognized Tax Benefits Decreases Resulting From Settlements With Taxing Authorities
UnrecognizedTaxBenefitsDecreasesResultingFromSettlementsWithTaxingAuthorities
|
5644000 | |
CY2016 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Prior Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromPriorPeriodTaxPositions
|
301000 | |
CY2016 | us-gaap |
Unrecognized Tax Benefits Reductions Resulting From Lapse Of Applicable Statute Of Limitations
UnrecognizedTaxBenefitsReductionsResultingFromLapseOfApplicableStatuteOfLimitations
|
1966000 | |
CY2016 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
93109000 | shares |
CY2016 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92422000 | shares |
CY2016 | us-gaap |
Unrecognized Tax Benefits Increases Resulting From Current Period Tax Positions
UnrecognizedTaxBenefitsIncreasesResultingFromCurrentPeriodTaxPositions
|
2258000 | |
CY2016 | us-gaap |
Unrecognized Tax Benefits Decreases Resulting From Prior Period Tax Positions
UnrecognizedTaxBenefitsDecreasesResultingFromPriorPeriodTaxPositions
|
3927000 | |
CY2016 | md |
Provision Adjustment For Losses Related To Prior Year
ProvisionAdjustmentForLossesRelatedToPriorYear
|
-25428000 | |
CY2016 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
118416000 | |
CY2016 | md |
Malpractice Loss Contingency Provision For Losses
MalpracticeLossContingencyProvisionForLosses
|
12701000 | |
CY2016 | md |
Provision Adjustment For Losses Related To Current Year
ProvisionAdjustmentForLossesRelatedToCurrentYear
|
38129000 | |
CY2016 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
2031220000 | |
CY2016 | md |
Percentage Of Net Patient Service Revenue By Type Of Payor
PercentageOfNetPatientServiceRevenueByTypeOfPayor
|
1.00 | pure |
CY2017Q1 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
25614000 | |
CY2017Q1 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.59 | |
CY2017Q1 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.59 | |
CY2017Q1 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
103765000 | |
CY2017Q1 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
89658000 | |
CY2017Q1 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
797000 | |
CY2017Q1 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
34967000 | |
CY2017Q1 | us-gaap |
Interest Expense
InterestExpense
|
17752000 | |
CY2017Q1 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
576000 | |
CY2017Q1 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-16379000 | |
CY2017Q1 | us-gaap |
Net Income Loss
NetIncomeLoss
|
54691000 | |
CY2017Q1 | us-gaap |
Operating Expenses
OperatingExpenses
|
729560000 | |
CY2017Q1 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
106037000 | |
CY2017Q1 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
835597000 | |
CY2017Q1 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
93143000 | shares |
CY2017Q1 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92360000 | shares |
CY2017Q1 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
27796000 | |
CY2017Q1 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
572385000 | |
CY2018Q1 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
26163000 | |
CY2018Q1 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.68 | |
CY2018Q1 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.68 | |
CY2018Q1 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
108776000 | |
CY2018Q1 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
87487000 | |
CY2018Q1 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
1525000 | |
CY2018Q1 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
24059000 | |
CY2018Q1 | us-gaap |
Interest Expense
InterestExpense
|
19935000 | |
CY2018Q1 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
1464000 | |
CY2018Q1 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-16946000 | |
CY2018Q1 | us-gaap |
Net Income Loss
NetIncomeLoss
|
63428000 | |
CY2018Q1 | us-gaap |
Net Income Loss Attributable To Noncontrolling Interest
NetIncomeLossAttributableToNoncontrollingInterest
|
0 | |
CY2018Q1 | us-gaap |
Operating Expenses
OperatingExpenses
|
797424000 | |
CY2018Q1 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
104433000 | |
CY2018Q1 | us-gaap |
Profit Loss
ProfitLoss
|
0 | |
CY2018Q1 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
901857000 | |
CY2018Q1 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
93505000 | shares |
CY2018Q1 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92859000 | shares |
CY2018Q1 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
30655000 | |
CY2018Q1 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
631830000 | |
CY2017Q2 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
25735000 | |
CY2017Q2 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.69 | |
CY2017Q2 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.69 | |
CY2017Q2 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
103015000 | |
CY2017Q2 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
104423000 | |
CY2017Q2 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
689000 | |
CY2017Q2 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
40725000 | |
CY2017Q2 | us-gaap |
Interest Expense
InterestExpense
|
18535000 | |
CY2017Q2 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
365000 | |
CY2017Q2 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-17481000 | |
CY2017Q2 | us-gaap |
Net Income Loss
NetIncomeLoss
|
63698000 | |
CY2017Q2 | us-gaap |
Operating Expenses
OperatingExpenses
|
721040000 | |
CY2017Q2 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
121904000 | |
CY2017Q2 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
842944000 | |
CY2017Q2 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
92812000 | shares |
CY2017Q2 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92181000 | shares |
CY2017Q2 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
30872000 | |
CY2017Q2 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
561418000 | |
CY2018Q2 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
26518000 | |
CY2018Q2 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.85 | |
CY2018Q2 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.85 | |
CY2018Q2 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
107908000 | |
CY2018Q2 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
109534000 | |
CY2018Q2 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
1257000 | |
CY2018Q2 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
30122000 | |
CY2018Q2 | us-gaap |
Interest Expense
InterestExpense
|
21604000 | |
CY2018Q2 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
1202000 | |
CY2018Q2 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-19145000 | |
CY2018Q2 | us-gaap |
Net Income Loss
NetIncomeLoss
|
79412000 | |
CY2018Q2 | us-gaap |
Net Income Loss Attributable To Noncontrolling Interest
NetIncomeLossAttributableToNoncontrollingInterest
|
0 | |
CY2018Q2 | us-gaap |
Operating Expenses
OperatingExpenses
|
787239000 | |
CY2018Q2 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
128679000 | |
CY2017Q3 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
126432000 | |
CY2017Q3 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
868951000 | |
CY2017Q3 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
92881000 | shares |
CY2017Q3 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92589000 | shares |
CY2017Q3 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
29497000 | |
CY2018Q2 | us-gaap |
Profit Loss
ProfitLoss
|
0 | |
CY2018Q2 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
915918000 | |
CY2018Q2 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
93529000 | shares |
CY2018Q2 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92987000 | shares |
CY2018Q2 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
31833000 | |
CY2018Q2 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
620980000 | |
CY2017Q3 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
25116000 | |
CY2017Q3 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.71 | |
CY2017Q3 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.71 | |
CY2017Q3 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
101430000 | |
CY2017Q3 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
107999000 | |
CY2017Q3 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
-240000 | |
CY2017Q3 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
42119000 | |
CY2017Q3 | us-gaap |
Interest Expense
InterestExpense
|
18428000 | |
CY2017Q3 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
235000 | |
CY2017Q3 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-18433000 | |
CY2017Q3 | us-gaap |
Net Income Loss
NetIncomeLoss
|
65880000 | |
CY2017Q3 | us-gaap |
Operating Expenses
OperatingExpenses
|
742519000 | |
CY2017Q3 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
586476000 | |
CY2018Q3 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
28709000 | |
CY2018Q3 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.72 | |
CY2018Q3 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.72 | |
CY2018Q3 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
102905000 | |
CY2018Q3 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
90448000 | |
CY2018Q3 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
1766000 | |
CY2018Q3 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
24873000 | |
CY2018Q3 | us-gaap |
Interest Expense
InterestExpense
|
21782000 | |
CY2018Q3 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
1302000 | |
CY2018Q3 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-18714000 | |
CY2018Q3 | us-gaap |
Net Income Loss
NetIncomeLoss
|
65575000 | |
CY2018Q3 | us-gaap |
Net Income Loss Attributable To Noncontrolling Interest
NetIncomeLossAttributableToNoncontrollingInterest
|
0 | |
CY2018Q3 | us-gaap |
Operating Expenses
OperatingExpenses
|
787490000 | |
CY2018Q3 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
109162000 | |
CY2018Q3 | us-gaap |
Profit Loss
ProfitLoss
|
0 | |
CY2018Q3 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
896652000 | |
CY2018Q3 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
91359000 | shares |
CY2018Q3 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
90984000 | shares |
CY2018Q3 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
30159000 | |
CY2018Q3 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
625717000 | |
CY2017Q4 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
26414000 | |
CY2017Q4 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
1.46 | |
CY2017Q4 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
1.47 | |
CY2017Q4 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
108895000 | |
CY2017Q4 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
108342000 | |
CY2017Q4 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
-294000 | |
CY2017Q4 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
-27761000 | |
CY2017Q4 | us-gaap |
Income Tax Expense Benefit Continuing Operations Adjustment Of Deferred Tax Asset Liability
IncomeTaxExpenseBenefitContinuingOperationsAdjustmentOfDeferredTaxAssetLiability
|
-70000000 | |
CY2017Q4 | us-gaap |
Interest Expense
InterestExpense
|
19844000 | |
CY2017Q4 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
2777000 | |
CY2017Q4 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-17361000 | |
CY2017Q4 | us-gaap |
Net Income Loss
NetIncomeLoss
|
136103000 | |
CY2017Q4 | us-gaap |
Operating Expenses
OperatingExpenses
|
785117000 | |
CY2017Q4 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
125703000 | |
CY2017Q4 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
910820000 | |
CY2017Q4 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
93159000 | shares |
CY2017Q4 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
92756000 | shares |
CY2017Q4 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
32353000 | |
CY2017Q4 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
617455000 | |
CY2018Q4 | us-gaap |
Depreciation Depletion And Amortization
DepreciationDepletionAndAmortization
|
29891000 | |
CY2018Q4 | us-gaap |
Earnings Per Share Diluted
EarningsPerShareDiluted
|
0.68 | |
CY2018Q4 | us-gaap |
Earnings Per Share Basic
EarningsPerShareBasic
|
0.69 | |
CY2018Q4 | us-gaap |
General And Administrative Expense
GeneralAndAdministrativeExpense
|
112789000 | |
CY2018Q4 | us-gaap |
Income Loss From Continuing Operations Before Income Taxes Extraordinary Items Noncontrolling Interest
IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest
|
81370000 | |
CY2018Q4 | us-gaap |
Income Loss From Equity Method Investments
IncomeLossFromEquityMethodInvestments
|
2277000 | |
CY2018Q4 | us-gaap |
Income Tax Expense Benefit
IncomeTaxExpenseBenefit
|
21156000 | |
CY2018Q4 | us-gaap |
Interest Expense
InterestExpense
|
25448000 | |
CY2018Q4 | us-gaap |
Investment Income Net
InvestmentIncomeNet
|
967000 | |
CY2018Q4 | us-gaap |
Nonoperating Income Expense
NonoperatingIncomeExpense
|
-22204000 | |
CY2018Q4 | us-gaap |
Net Income Loss
NetIncomeLoss
|
60214000 | |
CY2018Q4 | us-gaap |
Net Income Loss Attributable To Noncontrolling Interest
NetIncomeLossAttributableToNoncontrollingInterest
|
0 | |
CY2018Q4 | us-gaap |
Operating Expenses
OperatingExpenses
|
829122000 | |
CY2018Q4 | us-gaap |
Operating Income Loss
OperatingIncomeLoss
|
103574000 | |
CY2018Q4 | us-gaap |
Profit Loss
ProfitLoss
|
0 | |
CY2018Q4 | us-gaap |
Revenue From Contract With Customer Including Assessed Tax
RevenueFromContractWithCustomerIncludingAssessedTax
|
932696000 | |
CY2018Q4 | us-gaap |
Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
|
88258000 | shares |
CY2018Q4 | us-gaap |
Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
|
87810000 | shares |
CY2018Q4 | md |
Practice Supplies And Other Operating Expenses
PracticeSuppliesAndOtherOperatingExpenses
|
29381000 | |
CY2018Q4 | md |
Practice Salaries And Benefits
PracticeSalariesAndBenefits
|
657061000 |