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Disaggregation of Revenue (Detail) - USD ($)
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Revenue $ 519,907,752 $ 356,355,930
Commercial [Member]    
Revenue 197,008,079 116,947,692
Medicare [Member]    
Revenue 187,862,209 120,448,509
Medicaid [Member]    
Revenue 90,850,313 92,590,894
Other Third Parties [Member]    
Revenue $ 44,187,151 $ 26,368,835