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Significant Accounting Policies - Schedule of Balances of Allowance for Doubtful Accounts (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2018
Sep. 30, 2017
SEC Schedule, 12-09, Valuation and Qualifying Accounts Disclosure [Line Items]    
Accounts, receivables deemed uncollectible, period 2 years  
Allowance for Doubtful Accounts    
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]    
Balance at beginning of period $ 182,965 $ 169,014
Additions: charges to bad debt expense 74,969 79,408
Deductions (90,494) (68,155)
Balance at end of period $ 167,440 $ 180,267