General - Customers Exceeding Ten Percent of Segment Revenues (Details) - USD ($) $ in Thousands	3 Months Ended
Mar. 31, 2021	Mar. 31, 2020
Significant customers
Revenues	$ 1,161,649	$ 1,122,379
Healthcare
Significant customers
Revenues	533,010	488,906
Healthcare \| Customer A
Significant customers
Revenues	92,982	88,539
Healthcare \| Customer B
Significant customers
Revenues	55,486	49,438
Pharmacy Management
Significant customers
Revenues	632,199	638,213
Pharmacy Management \| Customer C
Significant customers
Revenues	$ 88,651	$ 98,617

Amount, including tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value-added and excise.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details