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Revenue Recognition (Tables)
 6 Months Ended
Jun. 30, 2019
Revenue from Contract with Customer [Abstract]  
Disaggregated revenue
The following table provides information about disaggregated revenue by products for the three and six months ended June 30, 2019 and 2018 (in thousands):
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2019
 
2018
 
2019
 
2018
Product sales, net
 
 
 
 
 
 
 
Makena
$
30,935

 
$
105,172

 
$
62,192

 
$
195,156

Feraheme
42,074

 
37,699

 
82,089

 
62,833

Intrarosa
4,877

 
3,241

 
9,291

 
5,406

MuGard
90

 
107

 
133

 
172

Total product sales, net
$
77,976

 
$
146,219

 
$
153,705

 
$
263,567


Total gross product sales were offset by product sales allowances and accruals for the three and six months ended June 30, 2019 and 2018 as follows (in thousands):
 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2019
 
2018
 
2019
 
2018
Gross product sales
$
239,185

 
$
297,732

 
$
450,904

 
$
537,602

Provision for product sales allowances and accruals:
 

 
 

 
 

 
 

Contractual adjustments
128,641

 
111,539

 
237,526

 
197,683

Governmental rebates
32,568

 
39,974

 
59,673

 
76,352

Total
161,209

 
151,513

 
297,199

 
274,035

Product sales, net
$
77,976

 
$
146,219

 
$
153,705

 
$
263,567
Product revenue allowance and accrual activity
The following table summarizes the product revenue allowance and accrual activity for the three and six months ended June 30, 2019 (in thousands):
 
Contractual
 
Governmental
 
 
 
Adjustments
 
Rebates
 
Total
Balance at December 31, 2018
$
57,199

 
$
29,114

 
$
86,313

Provisions related to current period sales
107,388

 
18,502

 
125,890

Adjustments related to prior period sales
1,540

 
8,603

 
10,143

Payments/returns relating to current period sales
(65,839
)
 
—

 
(65,839
)
Payments/returns relating to prior period sales
(27,275
)
 
(14,292
)
 
(41,567
)
Balance at March 31, 2019
$
73,013

 
$
41,927

 
$
114,940

Provisions related to current period sales
125,917

 
26,037

 
151,954

Adjustments related to prior period sales
2,660

 
6,531

 
9,191

Payments/returns relating to current period sales
(110,553
)
 
(11,909
)
 
(122,462
)
Payments/returns relating to prior period sales
(13,263
)
 
(22,070
)
 
(35,333
)
Balance at June 30, 2019
$
77,774

 
$
40,516

 
$
118,290