Quarterly report pursuant to Section 13 or 15(d)

Revenue Recognition - Schedule of Disaggregation of Revenue (Details)

v3.19.2
Revenue Recognition - Schedule of Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Disaggregation of Revenue [Line Items]        
Total revenues $ 226,368 $ 263,685 $ 448,820 $ 518,598
Services        
Disaggregation of Revenue [Line Items]        
Total revenues 178,458 216,055 357,349 427,369
Healthcare insurers        
Disaggregation of Revenue [Line Items]        
Total revenues 106,278 131,695 211,207 262,769
Government payers        
Disaggregation of Revenue [Line Items]        
Total revenues 28,634 38,860 59,037 75,103
Client payers        
Disaggregation of Revenue [Line Items]        
Total revenues 38,101 39,664 76,559 77,830
Patients        
Disaggregation of Revenue [Line Items]        
Total revenues $ 5,445 $ 5,836 $ 10,546 $ 11,667