Revenue Recognition and Accounts Receivable Segment revenue by major payor (Tables)

12 Months Ended

Dec. 31, 2024

Disaggregation of Revenue [Abstract]

The Company's revenues by segment and primary payor source were as follows:


	Year ended December 31, 2024
	U.S. dialysis		Other - Ancillary services		Consolidated
Patient service revenues:
Medicare and Medicare Advantage	$	6,374,882	$		$	6,374,882
Medicaid and Managed Medicaid	863,947				863,947
Other government	343,705		717,735		1,061,440
Commercial	3,783,827		248,026		4,031,853
Other revenues:
Medicare and Medicare Advantage			463,731		463,731
Medicaid and Managed Medicaid			740		740
Commercial			21,396		21,396
Other(1)	24,356		58,862		83,218
Eliminations of intersegment revenues	(71,747)		(13,910)		(85,657)
Total	$	11,318,970	$	1,496,580	$	12,815,550


	Year ended December 31, 2023
	U.S. dialysis		Other - Ancillary services		Consolidated
Patient service revenues:
Medicare and Medicare Advantage	$	6,100,183	$		$	6,100,183
Medicaid and Managed Medicaid	833,744				833,744
Other government	354,304		500,137		854,441
Commercial	3,623,516		251,279		3,874,795
Other revenues:
Medicare and Medicare Advantage			460,991		460,991
Medicaid and Managed Medicaid			1,733		1,733
Commercial			32,329		32,329
Other(1)	25,251		52,754		78,005
Eliminations of intersegment revenues	(88,222)		(7,852)		(96,074)
Total	$	10,848,776	$	1,291,371	$	12,140,147


	Year ended December 31, 2022
	U.S. dialysis		Other - Ancillary services		Consolidated
Patient service revenues:
Medicare and Medicare Advantage	$	6,041,496	$		$	6,041,496
Medicaid and Managed Medicaid	759,579				759,579
Other government	336,991		464,921		801,912
Commercial	3,437,306		223,216		3,660,522
Other revenues:
Medicare and Medicare Advantage			345,340		345,340
Medicaid and Managed Medicaid			1,546		1,546
Commercial			22,211		22,211
Other(1)	24,437		44,092		68,529
Eliminations of intersegment revenues	(87,035)		(4,206)		(91,241)
Total	$	10,512,774	$	1,097,120	$	11,609,894

(1)Consists primarily of management service fees in the Company's U.S. dialysis business and research fees, management fees, and other non-patient service revenues in the Other - ancillary services businesses.