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Segment Information - Additional Information (Detail) (USD $)
3 Months Ended
Mar. 31, 2014
Segment
Mar. 31, 2013
Segment Reporting Information [Line Items]    
Number of reportable segments 3  
Member co-share amounts and government subsidies $ 1,900,000,000 $ 1,500,000,000
Depreciation and amortization classified as benefit expense $ 25,000,000 $ 22,000,000