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Acquisitions (Details) (USD $)
12 Months Ended 1 Months Ended
Dec. 31, 2011
Dec. 31, 2009
Jul. 31, 2009
First Health Services
Business acquisitions      
Payment to acquire business, net of cash $ 376,000 $ 115,438,000 $ 114,500,000
Payment attributable to excess working capital     $ 6,500,000