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Inventories (Tables)
3 Months Ended
Mar. 31, 2014
Inventories (Tables) [Abstract]  
Inventory Disclosure Tables [Text Block]
   March 31, 2014  December 31, 2013
Finished goods$751,027 $640,355
Raw materials and purchased components 194,808  185,146
Health care supplies 186,687  195,519
Work in process 74,250  76,084
 Inventories$1,206,772 $1,097,104