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Revenue (Tables) | 3 Months Ended
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Mar. 31, 2020
Risks and Uncertainties [Abstract] |
Disaggregation of Revenue | The following table and description below shows the products from which the Company generated its revenue:
|  | Three Months Ended March 31,
Revenue by product (in thousands) |  | 2020 |  | 2019
MACI implants and kits |  |  |  |
Implants based on contracted rate sold through a specialty pharmacy (a) |  | $ | 11,338 |  |  | $ | 9,787 |
Implants subject to third party reimbursement sold through a specialty pharmacy (b) |  | 3,730 |  |  | 2,743 |
Implants sold direct based on contracted rates (c) |  | 3,109 |  |  | 3,226 |
Implants sold direct subject to third party reimbursement (d) |  | 436 |  |  | 322 |
Biopsy kits - direct bill |  | 466 |  |  | 542 |
Change in estimates related to prior periods (e) |  | 1,207 |  |  | (37 | )
Epicel |  |  |  |
Direct bill (hospital) |  | 6,392 |  |  | 5,227 |
Total revenue |  | $ | 26,678 |  |  | $ | 21,810 |
(a) Represents implants sold through Orsini and AllCare in both 2020 and 2019 in which such specialty pharmacies have entered into a direct contract with the underlying insurance provider. The amount of reimbursement is based on contracted rates at the time of sale supported by the pharmacy's direct contracts. Also represents direct sales under a contract to the specialty distributor DMS.
(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.
(e) Primarily represents changes in estimates related to implants sold through Orsini or AllCare in which such specialty pharmacy does not have a direct contract with the underlying payer. The initial estimate of the amount of reimbursement is established based on a payer or state fee schedule and/or payer history. The change in estimates is a result of additional information or actual cash collections received in the current period.
Schedules of concentration of risk | The table below shows the Company’s total Epicel revenue and accounts receivable balances from customers whose revenue or accounts receivable concentration is greater than 10% in any of the periods disclosed below. The Company did not have MACI revenue or accounts receivable concentrations greater than 10% in any of the periods disclosed below.
| Revenue Concentration |  | Accounts Receivable Concentration
| Three Months Ended March 31, |  | March 31, |  | December 31,
| 2020 |  | 2019 |  | 2020 |  | 2019
Epicel | 12 | % |  | 9 | % |  | 3 | % |  | 2 | %

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