Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Payables and Accruals [Abstract]
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

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Accrued Settlement Costs, Current

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Carrying value as of the balance sheet date of obligations incurred and payable, pertaining to costs that are statutory in nature, are incurred on contractual obligations, or accumulate over time and for which invoices have not yet been received or will not be rendered. Examples include taxes, interest, rent and utilities. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Carrying value as of the balance sheet date of obligations incurred through that date and payable for professional fees, such as for legal and accounting services received.

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Carrying value as of the balance sheet date of obligations incurred through that date and payable for sales commissions. Used to reflect the current portion of the liabilities (due within one year or within the normal operating cycle if longer).

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Amount of liability for consideration received or receivable from customer which is not included in transaction price, when consideration is expected to be refunded to customer, classified as current.

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Amount of loss contingency liability expected to be resolved within one year or the normal operating cycle, if longer.

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Amount of expenses incurred but not yet paid classified as other, due within one year or the normal operating cycle, if longer.

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