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Product Revenue, Net
 9 Months Ended
Sep. 30, 2022
Revenue from Contract with Customer [Abstract]  
Product Revenue, Net PRODUCT REVENUE, NET
We received approval from the FDA in September 2019 to market IBSRELA, the first and only NHE3 inhibitor for the treatment of IBS-C in adults, in the U.S. We began selling IBSRELA in the U.S. in March 2022. We recorded net revenue for IBSRELA of $4.9 million and $6.9 million during the three and nine months ended September 30, 2022, respectively.
Sales to AmerisourceBergen Drug Corporation, Cardinal Health, and McKesson Corporation made up 26.4%, 25.2%, and 20.2% of our gross product revenue during the three months ended September 30, 2022 and 28.9%, 24.2%, and 20.9% during the nine months ended September 30, 2022.
The activities and ending reserve balances for each significant category of discounts and allowances, which constitute variable consideration, were as follows (in thousands):
Discounts and ChargebacksRebatesOther Fees, Copay and ReturnsTotal
Balance as of December 31, 2021$— $— $— $— 
Activity related to 2022 sales358 1,158 1,115 2,631 
Credits/deductions issued(250)(438)(576)(1,264)
Balance as of September 30, 2022$108 $720 $539 $1,367 
There were no product sales or gross-to-net accruals during the three and nine months ended September 30, 2021.