Quarterly report pursuant to Section 13 or 15(d)

Leases - Additional Information (Details)

v3.19.2
Leases - Additional Information (Details) - USD ($)
 3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2019
Jan. 01, 2019
Lessee Lease Description [Line Items]      
Operating leases, lease term 10 years 10 years  
Operating lease, option to extend   options to extend the leases for up to 5 years.  
Operating lease, existence of option to extend [true false]   true  
Operating lease right-of-use asset $ 5,461,000 $ 5,461,000 $ 6,418,000
Operating lease, liability 6,462,000 6,462,000 $ 6,418,000
Operating lease cost   $ 1,087,000  
Annual percentage increase in rental expense   3.50%  
Lease payments annual increase description   Lease payments will increase annually by the lesser of the change, if any, in the Consumer Price Index of the Bureau of Labor Statistics of the U.S. Department of Labor or three and one-half percent (3.5%) at each annual adjustment date thereafter.  
MedSupport Systems B.V.      
Lessee Lease Description [Line Items]      
Operating lease cost $ 8,000 $ 16,000  
Minimum      
Lessee Lease Description [Line Items]      
Operating leases, lease term 2 years 2 years  
Additional operating lease cost   $ 11,549,000  
Maximum      
Lessee Lease Description [Line Items]      
Operating leases, lease term 8 years 8 years  
Operating lease option to extend term   5 years