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Revenue Recognition (Tables)
3 Months Ended
Mar. 31, 2020
Revenue from Contract with Customer [Abstract]  
Disaggregated revenue
The following table provides information about disaggregated revenue by products for the three months ended March 31, 2020 and 2019 (in thousands):
 Three Months Ended March 31,
20202019
Product sales, net
Feraheme$44,433  $40,015  
Makena21,777  31,257  
Intrarosa3,169  4,414  
Other(751) 43  
Total product sales, net$68,628  $75,729  

Total gross product sales were offset by product sales allowances and accruals for the three months ended March 31, 2020 and 2019 as follows (in thousands):
 Three Months Ended March 31,
 20202019
Gross product sales$232,741  $211,718  
Provision for product sales allowances and accruals:  
Contractual adjustments143,175  108,884  
Governmental rebates20,938  27,105  
Total164,113  135,989  
Product sales, net$68,628  $75,729  
Product revenue allowance and accrual activity
The following table summarizes the product revenue allowance and accrual activity for the three months ended March 31, 2020 (in thousands):
 ContractualGovernmental 
 AdjustmentsRebatesTotal
Balance at December 31, 2019$95,221  $41,319  $136,540  
Provisions related to current period sales147,235  18,175  165,410  
Adjustments related to prior period sales(4,060) 2,762  (1,298) 
Payments/returns relating to current period sales(95,284) —  (95,284) 
Payments/returns relating to prior period sales(37,969) (29,646) (67,615) 
Balance at March 31, 2020$105,143  $32,610  $137,753