Revenue (a) Summary The Company measures revenue based on consideration specified in a contract with a customer: hospitals and distributors. The Company excludes any amounts related to taxes assessed by governmental authorities from this revenue measurement and reduces revenue by any sales incentives offered by the Company to its customers. The Company recognizes revenue when it satisfies a performance obligation by transferring control of products to customers. Shipping and handling costs billed to customers are reported within revenue, with the corresponding costs within costs of goods sold. In addition, any shipping and handling costs related to outbound freight after control over a product has transferred to a customer are accounted for as fulfillment costs and are included in cost of revenues. (b) Contracts with Customers The Company recognizes revenue when all of the following criteria are met:  A contract has been identified with the customer;  The performance obligations have been identified;  The transaction price has been determined and allocated to respective performance obligations; and  The performance obligations have been satisfied. Respective performance obligations are satisfied at a point in time for sales made to both hospitals and distributors. Payment terms with customers range between 30 and 180 days which reflects days from the date the Company satisfies the performance obligations. For implant-based sales, the Company recognizes revenue when the AAA products are utilized in a procedure or implanted in a patient. For shipment-based sales, the Company recognizes revenue when control over a product has transferred to the customer, which is typically at the time of shipment, without a right of return. The Company provides certain sales incentives to customers for meeting certain purchase thresholds and accordingly, the transaction price is reduced by the Companys best estimate of this variable consideration. The Company estimates this variable consideration through the most likely amount method. (c) Revenue Disaggregation The Company disaggregated revenue in accordance with the new revenue recognition standard to depict how the nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factors. These economic factors are primarily attributable to different geographic regions and the timing of transfer of control of products to customers. Accordingly, sales in which control of the product has passed to the customer at the time of procedure or implant into a patient or at the time of shipment have been bifurcated as Implant-based and Shipment-based revenue, respectively. The table below includes a reconciliation of disaggregated revenue with the Companys reportable segment: Three Months Ended September 30, Three Months Ended September 30, Nine Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Implant-based Shipment-based Total Implant-based Shipment-based Total Implant-based Shipment-based Total Implant-based Shipment-based Total United States $ 25,194 $ 505 $ 25,699 $ 29,949 $ 928 $ 30,877 $ 82,480 $ 2,580 $ 85,060 $ 91,934 $ 1,738 $ 93,672 International 4,876 4,181 9,057 6,092 9,017 15,109 16,268 20,452 36,720 16,804 26,678 43,482 Total Revenue $ 30,070 $ 4,686 $ 34,756 $ 36,041 $ 9,945 $ 45,986 $ 98,748 $ 23,032 $ 121,780 $ 108,738 $ 28,416 $ 137,154 (d) Transitional Disclosures In May 2014, the Financial Accounting Standards Board (the FASB) issued Accounting Standards Update (ASU ) No. 2014-09, Revenue from Contracts with Customers, which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. ASU No. 2014-09 replaced most existing revenue recognition guidance in U.S. GAAP when it became effective for the Company on January 1, 2018. The new revenue standard permits the use of either the full retrospective or modified retrospective transition method; these methods may be applied retrospectively to each prior period presented or retrospectively with the cumulative effect recognized as of the date of initial application. The Company adopted the new revenue standard in the first quarter of 2018 utilizing the modified retrospective adoption method. The new revenue standard has been applied to all contracts at the date of initial application. The Company did not record a cumulative adjustment to the opening balance of retained earnings for the Companys first quarter of 2018 financial statements.