EXHIBITS AND FINANCIAL STATEMENT SCHEDULE - Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Balance at beginning of year	$ 1,251,705	$ 1,091,310	$ 791,842
Amount charged against operating revenue	6,069,245	5,921,519	5,436,786
Accounts receivable contractual adjustments and write-offs (net of recoveries)	(6,214,050)	(5,761,124)	(5,137,318)
Balance at end of year	$ 1,106,900	$ 1,251,705	$ 1,091,310