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Accrued Expenses (Tables)
9 Months Ended
Sep. 30, 2019
Payables and Accruals [Abstract]  
Schedule of Accrued Liabilities
Accrued expenses include of the following (in thousands):
 
September 30, 2019
 
December 31, 2018
Legal costs
$
16,576

 
$
10,056

Settlement costs
7,944

 
8,673

Pricing adjustment settlement with Veterans Affairs
6,894

 
6,894

Estimated returns
2,365

 
2,325

Accrued clinical trials
1,337

 
1,233

External commissions
1,139

 
962

Other
1,183

 
1,699

   Total
$
37,438

 
$
31,842