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Revenue Recognition (Tables)
9 Months Ended
Sep. 30, 2020
Revenue from Contract with Customer [Abstract]  
Schedule of Disaggregation of Revenue
The composition of Revenue from services by payor for the nine months ended September 30, 2020 and 2019 was as follows:
 Three months ended September 30,Nine months ended September 30,
(In thousands)2020201920202019
Healthcare insurers$136,531 $104,020 $319,763 $315,227 
Government payers21,537 28,206 64,322 87,243 
Client payers207,886 43,750 388,078 120,309 
Patients16,544 5,163 32,146 15,709 
Total$382,498 $181,139 $804,309 $538,488 
Client payers include cities, states and companies for which BioReference provides COVID-19 testing services.
Schedule of Product Sales Allowances and Accruals
The following table presents an analysis of product sales allowances and accruals for the three and nine months ended September 30, 2020:
(In thousands)Chargebacks, discounts, rebates and feesGovernmental ReturnsTotal
Balance at June 30, 2020$2,890 $6,999 $3,830 $13,719 
  Provision related to current period sales4,269 9,335 264 13,868 
  Credits or payments made(4,965)(6,522)(159)(11,646)
Balance at September 30, 2020$2,194 $9,812 $3,935 $15,941 
Total gross Rayaldee sales
$22,010 
Provision for Rayaldee sales allowances and accruals as a percentage of gross Rayaldee sales
63%
(In thousands)Chargebacks, discounts, rebates and feesGovernmental ReturnsTotal
Balance at December 31, 2019$3,194 $5,841 $2,751 $11,786 
  Provision related to current period sales13,562 25,615 1,654 40,831 
  Credits or payments made(14,562)(21,644)(470)(36,676)
Balance at September 30, 2020$2,194 $9,812 $3,935 $15,941 
Total gross Rayaldee sales
$67,569 
Provision for Rayaldee sales allowances and accruals as a percentage of gross Rayaldee sales
60%
Changes in Contractual Liabilities Balance Changes in the contractual liabilities balance during the nine months ended September 30, 2020 are as follows:
(In thousands)
Balance at December 31, 2019$21,767 
Balance at September 30, 202017,050 
Revenue recognized in the period from:
Amounts included in contracts liability at the beginning of the period18,376