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Customer, Supplier and Product Concentration - Sales and Receivables (Details) - Big 3 Wholesalers combined - Customer Concentration Risk
3 Months Ended 9 Months Ended 12 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Dec. 31, 2018
Percentage of gross trade accounts receivable          
Concentration Risk [Line Items]          
Concentration risk percentage     83.00%   86.00%
Percentage of gross sales          
Concentration Risk [Line Items]          
Concentration risk percentage 81.00% 83.00% 83.00% 83.00%