Valuation and Qualifying Accounts (Details) (Allowance for Uncollectible Deductibles [Member], USD $)	12 Months Ended
Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Allowance for Uncollectible Deductibles [Member]
Reserves and allowances deducted from asset accounts:
Balance at Beginning of Period	$ 15,598,912	$ 16,589,779	$ 18,587,569
Charged to Costs and Expenses	13,247,731	10,597,432	28,463,029
Deductions	(11,930,188)	(11,588,299)	(30,460,819)
Balance at end of period	$ 16,916,455	$ 15,598,912	$ 16,589,779

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Total of allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 09

-Article 12

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 235

-SubTopic 10

-Section S99

-Paragraph 4

-URI http://asc.fasb.org/extlink&oid=6881521&loc=d3e24092-122690

+ Details

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- Definition

+ References

+ Details

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- Definition

Total of the deductions in a given period to allowances and reserves, the valuation and qualifying accounts that are either netted against the cost of an asset (in order to value it at its carrying value) or that reflect a liability established to represent expected future costs, representing receivables written off as uncollectible and portions of the reserves utilized, respectively.

+ References

+ Details

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