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Allowance for Doubtful Accounts (Detail) (USD $)
3 Months Ended
Mar. 31, 2015
Mar. 31, 2014
Allowance For Doubtful Accounts Receivable Rollforward    
Balance at beginning of period $ 1,741,571us-gaap_AllowanceForDoubtfulAccountsReceivable  
Provisions recognized as reduction in revenues 421,024us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts 361,517us-gaap_HealthCareOrganizationPatientServiceRevenueProvisionforBadDebts
Write-offs, net of recoveries (1,387,622)us-gaap_AllowanceForDoubtfulAccountsReceivableWriteOffs  
Balance at end of period $ 774,973us-gaap_AllowanceForDoubtfulAccountsReceivable