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Revenue Recognition (Tables)
 9 Months Ended
Sep. 30, 2018
Revenue from Contract with Customer [Abstract]  
Disaggregated revenue
The following table provides information about disaggregated revenue by products for the three and nine months ended September 30, 2018 and 2017 (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Product sales, net
 
 
 
 
 
 
 
Makena
$
80,221

 
$
97,635

 
$
275,377

 
$
286,771

Feraheme
36,963

 
26,095

 
99,796

 
79,492

Intrarosa
4,925

 
360

 
10,331

 
360

MuGard
129

 
241

 
302

 
567

Total
$
122,238

 
$
124,331

 
$
385,806

 
$
367,190


Total gross product sales were offset by product sales allowances and accruals for the three and nine months ended September 30, 2018 and 2017 as follows (in thousands):
 
Three Months Ended September 30,
 
Nine Months Ended September 30,
 
2018
 
2017
 
2018
 
2017
Gross product sales
$
238,856

 
$
235,299

 
$
776,458

 
$
676,377

Provision for product sales allowances and accruals:
 

 
 

 
 

 
 

Contractual adjustments
93,213

 
80,110

 
290,896

 
225,622

Governmental rebates
23,405

 
30,858

 
99,756

 
83,565

Total
116,618

 
110,968

 
390,652

 
309,187

Product sales, net
$
122,238

 
$
124,331

 
$
385,806

 
$
367,190
Product revenue allowance and accrual activity
The following table summarizes the product revenue allowance and accrual activity for the three and nine months ended September 30, 2018 (in thousands):
 
Contractual
 
Governmental
 
 
 
Adjustments
 
Rebates
 
Total
Balance at December 31, 2017
$
62,164

 
$
50,598

 
$
112,762

Provisions related to current period sales
199,716

 
71,514

 
271,230

Adjustments related to prior period sales
(2,034
)
 
4,837

 
2,803

Payments/returns relating to current period sales
(132,618
)
 
(2,453
)
 
(135,071
)
Payments/returns relating to prior period sales
(55,973
)
 
(51,142
)
 
(107,115
)
Balance at June 30, 2018
71,255

 
73,354

 
144,609

Provisions related to current period sales
93,824

 
20,719

 
114,543

Adjustments related to prior period sales
(614
)
 
2,710

 
2,096

Payments/returns relating to current period sales
(102,627
)
 
(52,040
)
 
(154,667
)
Payments/returns relating to prior period sales
(2,207
)
 
(7,002
)
 
(9,209
)
Balance at September 30, 2018
$
59,631

 
$
37,741

 
$
97,372