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Revenue - (Tables)
 6 Months Ended
Jun. 30, 2019
Revenue from Contract with Customer [Abstract]  
Schedule of revenue by product and customer
The following table and description below reflect the products from which the Company generated its revenue:
 
 
Three Months Ended June 30,
 
Six Months Ended June 30,
Revenue by product (in thousands)
 
2019
 
2018
 
2019
 
2018
MACI implants and kits
 
 
 
 
 
 
 
 
Implants based on contracted rate sold through a specialty pharmacy (a)
 
$
12,989

 
$
7,363

 
$
22,776

 
$
15,155

Implants subject to third-party reimbursement sold through a specialty pharmacy (b)
 
3,459

 
2,639

 
6,202

 
3,647

Implants sold direct based on contracted rates (c)
 
3,450

 
3,409

 
6,676

 
6,083

Implants sold direct subject to third-party reimbursement (d)
 
281

 
297

 
603

 
580

Biopsy kits - direct bill
 
557

 
468

 
1,099

 
904

Change in estimates related to prior periods
 
87

 
(51
)
 
50

 
(189
)
Epicel
 
 
 
 
 
 
 
 
     Direct bill (hospital)
 
5,328

 
4,886

 
10,555

 
10,858

Total revenue
 
$
26,151

 
$
19,011

 
$
47,961

 
$
37,038

 
 
 
 
 
 
 
 
 
(a) Represents implants sold through Orsini or AllCare in which such specialty pharmacy has entered into a direct contract with the underlying insurance provider. The amount of reimbursement is known at the time of sale supported by the pharmacy's direct contract.
 
 
 
 
 
 
 
 
 
(b) Represents implants sold through Orsini or AllCare in which such specialty pharmacy does not have a direct contract with the underlying payer. The amount of reimbursement is established based on a payer or state fee schedule and/or payer history.
 
 
 
 
 
 
 
 
 
(c) Represents implants sold directly from the Company to the facility based on a contract and known price agreed upon prior to the surgery date.
 
 
 
 
 
 
 
 
 
(d) Represents implants sold directly from the Company to the facility based on a contract and known price agreed upon prior to the surgery date. The payment terms are subject to third-party reimbursement from an underlying insurance provider.
Schedules of concentration of risk 's total revenue and accounts receivable balances were comprised of the following concentrations from its largest customers of MACI and Epicel, as follows:

Revenue Concentration

Accounts Receivable Concentration

Three Months Ended June 30,

Six Months Ended June 30,

June 30,

December 31,

2019

2018

2019

2018

2019

2018
MACI
7
%
 
39
%
 
7
%
 
41
%
 
7
%

8
%
Epicel
6
%
 
9
%
 
8
%
 
12
%
 
3
%

4
%