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Revenue
 9 Months Ended
Sep. 30, 2023
Revenue.  
Revenue

Note 12. Revenue

We derive our revenue from the sale and rental of our products to our customers in the United States. The following table presents our revenue, inclusive of sales and rental revenue, disaggregated by product line:

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Three Months Ended

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Nine Months Ended

​

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September 30,

​

September 30,

(In thousands)

    

2023

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2022

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2023

​

2022

Revenue

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​

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Lymphedema products

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$

62,506

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$

54,214

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$

172,257

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$

146,502

Airway clearance products

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​

7,080

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​

11,048

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​

24,514

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​

26,383

Total

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$

69,586

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$

65,262

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$

196,771

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$

172,885

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Percentage of total revenue

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Lymphedema products

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90%

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83%

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88%

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85%

Airway clearance products

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10%

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17%

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12%

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15%

Total

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100%

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100%

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100%

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100%

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Our revenue by channel, inclusive of sales and rental revenue, for the three and nine months ended September 30, 2023 and 2022, are summarized in the following table:

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Three Months Ended

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Nine Months Ended

​

​

September 30,

​

September 30,

(In thousands)

    

2023

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2022

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2023

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2022

Private insurers and other payers

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$

39,376

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$

36,188

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$

101,300

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$

97,726

Veterans Administration

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​

7,259

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​

6,755

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​

20,203

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​

19,118

Medicare

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​

15,871

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​

11,271

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​

50,754

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​

29,658

Durable medical equipment distributors

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​

7,080

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​

11,048

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​

24,514

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​

26,383

Total

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$

69,586

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$

65,262

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$

196,771

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$

172,885

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Our rental revenue is derived from rent-to-purchase arrangements that typically range from three to ten months. As title transfers to the patient, with whom we have the contract, upon the termination of the lease term and because collectability is probable, under ASC 842, these are recognized as sales-type leases. Each rental agreement contains two components, the controller and related garments, both of which are interdependent and recognized as one lease component.

The revenue and associated cost of revenue of sales-type leases are recognized on the lease commencement date and a net investment in leases is recorded on the Condensed Consolidated Balance Sheet. We bill the patients’ insurance payers monthly over the duration of the rental term. We record the net investment in leases and recognize revenue upon commencement of the lease in the amount of the expected consideration to be received through the monthly payments. Similar to our sales revenue, the transaction price is impacted by multiple factors, including the terms and conditions contracted by third-party payers. As the rental contract resides with the patients, we have elected the portfolio approach, at the payer level, to determine the expected consideration, which considers the impact of early terminations. While the contract is with the patient, in certain circumstances, the third-party payer elects an initial rental period with an option to extend. We assess the likelihood of extending the lease at the onset of the lease to determine if the option is reasonably certain to be exercised. As the lease is short-term in nature, we anticipate collection of substantially all of the net investment within the first year of the lease agreement. Completion of these payments represents the fair market value of the equipment, and as such, interest income is not applicable.

Rental revenue for the three and nine months ended September 30, 2023 and 2022, was primarily from private insurers. Sales-type lease revenue and the associated cost of revenue for the three and nine months ended September 30, 2023 and 2022, was:

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Three Months Ended September 30,

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Nine Months Ended September 30,

(In thousands)

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2023

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2022

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2023

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2022

Sales-type lease revenue

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$

10,720

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$

9,717

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$

25,312

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$

24,905

Cost of sales-type lease revenue

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3,211

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2,992

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9,122

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7,640

Gross profit

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$

7,509

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$

6,725

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$

16,190

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$

17,265

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