CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (USD $) In Thousands, except Per Share data, unless otherwise specified	12 Months Ended
	Dec. 31, 2012		Dec. 31, 2011		Dec. 31, 2010
Net revenue:
Managed care and other	$ 2,857,099		$ 2,551,991		$ 2,734,406
Dispensing	350,298		247,409		234,834
Total net revenue	3,207,397		2,799,400		2,969,240
Costs and expenses:
Cost of care	2,071,890		1,784,724		1,907,985
Cost of goods sold	328,414		232,038		218,630
Direct service costs and other operating expenses	557,512	[1]	529,634	[1]	566,582	[1]
Depreciation and amortization	60,488		58,623		54,682
Interest expense	2,247		2,502		2,233
Interest income	(2,019)		(2,781)		(3,275)
Total cost and expenses	3,018,532		2,604,740		2,746,837
Income before income taxes	188,865		194,660		222,403
Provision for income taxes	37,838		65,037		83,744
Net income	151,027		129,623		138,659
Net income per common share -basic: (in dollars per share)	$ 5.51		$ 4.25		$ 4.10
Net income per common share -diluted: (in dollars per share)	$ 5.42		$ 4.17		$ 4.03
Other comprehensive (loss) income:
Unrealized (losses) gains on available-for-sale securities	115	[2]	(159)	[2]	(105)	[2]
Comprehensive income	$ 151,142		$ 129,464		$ 138,554

[1] Includes stock compensation expense of $15,102, $17,418 and $17,783 for the years ended December 31, 2010, 2011 and 2012, respectively.

[2] Net of income tax (benefit) provision of $(68), $(102) and $73 for the years ended December 31, 2010, 2011 and 2012, respectively.