Note C — Revenue Recognition

Patient Care Segment

Revenue in our Patient Care segment is primarily derived from contracts with third party payors for the provision of O&P devices and is recognized upon the transfer of control of promised products or services to the patient at the time the patient receives the device. At, or subsequent to delivery, we issue an invoice to the third party payor, which primarily consists of commercial insurance companies, Medicare, Medicaid, the U.S. Department of Veterans Affairs, and private or patient pay (“Private Pay”) individuals. We recognize revenue for the amounts we expect to receive from payors based on expected contractual reimbursement rates, which are net of estimated contractual discounts and implicit price concessions. These revenue amounts are further revised as claims are adjudicated, which may result in additional disallowances.

The following table disaggregates revenue from contracts with customers in our Patient Care segment for the three and six months ended June 30, 2019 and 2018:


	For the Three Months Ended				For the Six Months Ended
	June 30,				June 30,
(in thousands)	2019		2018		2019		2018
Patient Care Segment
Medicare	$	75,640	$	70,469	$	133,416	$	127,781
Medicaid		37,344		33,648		67,491		63,400
Commercial Insurance/ Managed Care (excluding Medicare and Medicaid Managed Care)		78,808		77,621		149,026		148,432
Veterans Administration		22,497		20,904		40,819		37,547
Private Pay		16,879		15,516		31,017		29,505
Total	$	231,168	$	218,158	$	421,769	$	406,665

The impact to revenue related to prior period performance obligations was not material for the three and six months ended June 30, 2019.

Products & Services Segment

Revenue in our Products & Services segment is derived from the distribution of O&P components and the leasing and sale of rehabilitation equipment and ancillary consumable supplies combined with equipment maintenance, education, and training.

The following table disaggregates revenue from contracts with customers in our Product & Services segment for the three and six months ended June 30, 2019 and 2018:


	For the Three Months Ended				For the Six Months Ended
	June 30,				June 30,
(in thousands)	2019		2018		2019		2018
Products & Services Segment
Distribution services, net of intersegment revenue eliminations	$	37,662	$	34,684	$	70,857	$	66,035
Therapeutic solutions		12,268		14,124		24,891		28,261
Total	$	49,930	$	48,808	$	95,748	$	94,296