NeoGenomics (NEO) 10-Q 29 Apr 20 2020 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2020	Apr. 24, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Transition Report	false
Entity File Number	001-35756
Entity Registrant Name	NEOGENOMICS, INC.
Entity Incorporation, State or Country Code	NV
Entity Tax Identification Number	74-2897368
Entity Address, Address Line One	12701 Commonwealth Drive,
Entity Address, Address Line Two	Suite 9,
Entity Address, State or Province	FL
Entity Address, City or Town	Fort Myers,
Entity Address, Postal Zip Code	33913
City Area Code	(239)
Local Phone Number	768-0600
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common stock ($0.001 par value)
Trading Symbol	NEO
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		105,335,242
Entity Central Index Key	0001077183
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false
Current Fiscal Year End Date	--12-31

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 86,254	$ 173,016
Accounts receivable, net	99,972	94,242
Inventories	20,286	14,405
Prepaid assets	6,884	6,327
Other current assets	2,046	2,748
Total current assets	215,442	290,738
Property and equipment (net of accumulated depreciation of $74,441 and $68,809, respectively)	83,392	64,188
Operating lease right-of-use assets	49,084	26,492
Intangible assets, net	128,289	126,640
Goodwill	210,833	198,601
Restricted cash, non-current	38,738	0
Prepaid lease asset	3,316	0
Other assets	3,153	2,847
Total assets	732,247	709,506
Current liabilities
Accounts payable	20,453	19,568
Accrued compensation	20,810	21,365
Accrued expenses and other liabilities	8,966	7,548
Short-term portion of financing obligations	4,941	5,432
Short-term portion of operating leases	4,505	3,381
Short-term portion of term loan	5,000	5,000
Pharma contract liability	2,974	1,610
Total current liabilities	67,649	63,904
Long-term liabilities
Long-term portion of financing obligations	2,428	3,199
Long-term portion of operating leases	45,910	24,034
Long-term portion of term loan, net	90,605	91,829
Other long term liabilities	4,235	3,566
Deferred income tax liability, net	16,377	15,566
Total long-term liabilities	159,555	138,194
Total liabilities	227,204	202,098
Stockholders' equity
Common stock, $0.001 par value, (250,000,000 shares authorized; 105,396,057 and 104,781,236 shares issued and outstanding, respectively)	105	105
Additional paid-in capital	525,929	520,278
Accumulated other comprehensive loss	(2,656)	(1,618)
Accumulated deficit	(18,335)	(11,357)
Total stockholders’ equity	505,043	507,408
Total liabilities and stockholders' equity	$ 732,247	$ 709,506

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 74,441	$ 68,809
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	250,000,000	250,000,000
Common stock, shares issued	105,396,057	104,781,236
Common stock, shares outstanding	105,396,057	104,781,236

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Total revenue	$ 106,030	$ 95,577
COST OF REVENUE	59,661	48,462
GROSS PROFIT	46,369	47,115
Operating expenses:
General and administrative	36,344	32,142
Research and development	2,060	1,209
Sales and marketing	13,258	11,216
Total operating expenses	51,662	44,567
(LOSS) INCOME FROM OPERATIONS	(5,293)	2,548
Interest expense, net	819	1,826
Other (income) expense	(223)	5,169
Loss before taxes	(5,889)	(4,447)
Income tax expense (benefit)	1,089	(2,023)
NET LOSS	$ (6,978)	$ (2,424)
NET LOSS PER SHARE
Basic (in dollars per share)	$ (0.07)	$ (0.03)
Diluted (in dollars per share)	$ (0.07)	$ (0.03)
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)	104,484	94,740
Diluted (in shares)	104,484	94,740
Clinical Services
Total revenue	$ 92,982	$ 86,210
GROSS PROFIT	44,059	43,559
Pharma Services
Total revenue	13,048	9,367
GROSS PROFIT	$ 2,310	$ 3,556

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
NET LOSS	$ (6,978)	$ (2,424)
OTHER COMPREHENSIVE LOSS:
Loss on effective cash flow hedges	(1,038)	(557)
Total other comprehensive loss	(1,038)	(557)
COMPREHENSIVE LOSS	$ (8,016)	$ (2,981)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss	$ (6,978)	$ (2,424)
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	6,240	5,271
Loss on disposal of assets	17	156
Amortization of intangibles	2,452	2,559
Amortization of debt issue costs	70	150
Non-cash stock-based compensation	2,186	2,139
Non-cash operating lease expense	2,021	1,141
Changes in assets and liabilities, net
Accounts receivable, net	(5,722)	(5,795)
Inventories	(5,348)	(1,019)
Prepaid assets	270	(250)
Prepaid lease asset	(3,316)	0
Other current assets	(16)	(265)
Accounts payable, accrued and other liabilities	1,191	4,434
Net cash (used in) provided by operating activities	(6,933)	6,097
CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of property and equipment	(4,708)	(3,196)
Business acquisition	(37,000)	0
Net cash used in investing activities	(41,708)	(3,196)
CASH FLOWS FROM FINANCING ACTIVITIES
Repayment of equipment financing obligations	(1,598)	(1,797)
Repayment of term loan	(1,250)	(1,968)
Issuance of common stock, net	3,465	4,248
Net cash provided by financing activities	617	483
Net change in cash, cash equivalents and restricted cash	(48,024)	3,384
Cash, cash equivalents and restricted cash, beginning of period	173,016	9,811
Cash, cash equivalents and restricted cash, end of period	124,992	13,195
Cash and cash equivalents	86,254
Restricted cash, non-current	38,738	0
Supplemental disclosure of cash flow information:
Interest paid	1,136	1,696
Income taxes paid, net	2	8
Supplemental disclosure of non-cash investing and financing information:
Equipment acquired under financing obligations	0	2,003
Property and equipment included in accounts payable	$ 1,844	$ 1,175

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2018		94,465,440
Beginning balance at Dec. 31, 2018	$ 320,443	$ 94	$ 340,291	$ (579)	$ (19,363)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)		36,032
Common stock issuance ESPP Plan	419		419
Stock issuance fees and expenses	(66)		(66)
Loss on effective cash flow hedges	(557)			(557)
Issuance of restricted stock, net of forfeitures (in shares)		182,502
Issuance of common stock for stock options (in shares)		619,536
Issuance of common stock for stock options	3,894	$ 1	3,893
ESPP expense	119		119
Stock based compensation expense - options and restricted stock	2,020		2,020
NET LOSS	(2,424)				(2,424)
Ending balance (in shares) at Mar. 31, 2019		95,303,510
Ending balance at Mar. 31, 2019	323,848	$ 95	346,676	(1,136)	(21,787)
Beginning balance (in shares) at Dec. 31, 2019		104,781,236
Beginning balance at Dec. 31, 2019	507,408	$ 105	520,278	(1,618)	(11,357)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)		34,330
Common stock issuance ESPP Plan	796		796
Stock issuance fees and expenses	(15)		(15)
Loss on effective cash flow hedges	(1,038)			(1,038)
Issuance of restricted stock, net of forfeitures (in shares)		76,618
Issuance of restricted stock, net of forfeitures	$ (212)		(212)
Issuance of common stock for stock options (in shares)	504,127	503,873
Issuance of common stock for stock options	$ 2,897		2,897
ESPP expense	194		194
Stock based compensation expense - options and restricted stock	1,991		1,991
NET LOSS	(6,978)				(6,978)
Ending balance (in shares) at Mar. 31, 2020		105,396,057
Ending balance at Mar. 31, 2020	$ 505,043	$ 105	$ 525,929	$ (2,656)	$ (18,335)

Nature of Business and Basis of

Nature of Business and Basis of Presentation	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business and Basis of Presentation	Nature of Business and Basis of Presentation NeoGenomics, Inc., a Nevada corporation, and its subsidiaries (the “Parent”, “Company”, or “NeoGenomics”), operates as a certified, high complexity clinical laboratory in accordance with the federal government’s Clinical Laboratory Improvement Act, as amended (“CLIA”), and is dedicated to the delivery of clinical diagnostic services to pathologists, oncologists, urologists, hospitals, and other laboratories as well as providing clinical trial services to pharmaceutical firms. The accompanying interim consolidated financial statements are unaudited and have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information. These accompanying consolidated financial statements include the accounts of the Parent and its subsidiaries. All intercompany transactions and balances have been eliminated in the accompanying consolidated financial statements. Certain information and footnote disclosures normally included in the Company’s annual audited consolidated financial statements and accompanying notes have been condensed or omitted in these accompanying interim consolidated financial statements and footnotes. Accordingly, the accompanying interim consolidated financial statements included herein should be read in conjunction with the audited consolidated financial statements and accompanying notes included in the Company’s annual report on Form 10-K for the year ended December 31, 2019. The results of operations presented in this quarterly report on Form 10-Q are not necessarily indicative of the results of operations that may be expected for any future periods. In the opinion of management, these unaudited consolidated financial statements include all adjustments and accruals, consisting only of normal, recurring adjustments that are necessary for a fair statement of the results of all interim periods reported herein.

Recently Adopted and Issued Acc

Recently Adopted and Issued Accounting Guidance	3 Months Ended
	Mar. 31, 2020
Accounting Changes and Error Corrections [Abstract]
Recently Adopted and Issued Accounting Guidance	Recently Adopted and Issued Accounting Guidance Recently Adopted Accounting Guidance In August 2018, the FASB issued ASU No. 2018-15, Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract , which changes the accounting for implementation costs incurred in a cloud computing arrangement that is a service contract. The update aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The implementation costs should be presented as a prepaid asset on the balance sheet and expensed over the term of the hosting arrangement. The Company adopted this pronouncement on January 1, 2020 and the impact was not material to the Company's Consolidated Financial Statements. In August 2018, the FASB also issued ASU No. 2018-13, Fair Value Measurement: Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement , which adds and modifies certain disclosure requirements for fair value measurements. Under the new guidance, entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, or valuation processes for Level 3 fair value measurements. However, public companies are required to disclose the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements, and related changes in unrealized gains and losses included in other comprehensive income. Certain provisions of the ASU must be adopted retrospectively, while others must be adopted prospectively. The Company adopted this pronouncement on January 1, 2020 and the impact was not material to the Company's Consolidated Financial Statements. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows ( “ Topic 230 ” ): Restricted Cash . The new guidance requires that the reconciliation of the beginning-of-period and end-of-period amounts shown in the statement of cash flows include cash, cash equivalents and restricted cash. ASU 2016-08 was effective for fiscal years beginning after December 15, 2017, including interim periods within those periods, using a retrospective transition method to each period presented. As a result, restricted cash of approximately $38.7 million as of March 31, 2020 is included with cash and cash equivalents when reconciling the beginning and ending balances in the Consolidated Statements of Cash Flows. Please refer to Note 3. Leases, for additional information regarding the use of restricted cash. There were no restricted cash balances in any reportable period prior to January 2020. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (“Topic 326”) : Measurement of Credit Losses on Financial Instruments, as modified by subsequently issued ASUs 2018-19 (issued November 2018), 2019-04 (issued April 2019), 2019-05 (issued May 2019), 2019-11 (issued November 2019), 2020-02 (issued February 2020) and 2020-03 (issued March 2020). Topic 326 modifies the measurement and recognition of credit losses for most financial assets and certain other instruments. The standard was effective January 1, 2020 and requires the use of forward-looking expected credit loss models based on historical experience, current economic conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount, which may result in earlier recognition of credit losses under the new standard. It also requires that credit losses related to available-for-sale debt securities be recorded as an allowance through net income rather than reducing the carrying amount under the current, other-than-temporary-impairment model. The standard required a modified retrospective approach with a cumulative effect adjustment to retained earnings. The Company adopted and applied the standard as of January 1, 2020. Based on management’s analysis, Topic 326 is applicable to the Company’s trade receivables as well as contract assets recognized within the Pharma Services segment. An assessment was performed on historical trends, current economic conditions, supportable forecasts, and customer and credit risks. The adoption of Topic 326 did not result in a material impact on the Company's Consolidated Financial Statements. Accounting Pronouncements Pending Adoption In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform ( “ Topic 848 ” ): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. A SU 2020-04 provides for temporary optional expedients and exceptions to the current guidance on certain contract modifications and hedging relationships to ease the burdens related to the expected market transition from the London Inter-bank Offered Rate ( “ LIBOR ” ) or other reference rates to alternative reference rates. The guidance is effective upon issuance and can be applied through December 31, 2022. The Company is currently evaluating the impact of this standard on the Company’s Consolidated Financial Statements. In January 2020, the FASB issued ASU No. 2020-01, Investments-Equity Securities (“Topic 321”), Investments-Equity Method and Joint Ventures (“Topic 323”) and Derivatives and Hedging (“Topic 815”) (ASU 2020-01). ASU 2020-01 clarifies the interaction of the accounting for equity securities under Topic 321, the accounting for the equity method investments in Topic 323 and the accounting for certain forward contracts and purchased options in Topic 815. ASU 2020-01 is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently evaluating the impact of this standard on the Company’s Consolidated Financial Statements. In December 2019, the FASB issued ASU No. 2019-12, Income Taxes: Simplifying the Accounting for Income Taxes (“Topic 740”) , which simplifies the accounting for income taxes, eliminates certain exceptions within Topic 740 and clarifies certain other aspects of the current guidance to promote consistency among reporting entities. The new standard is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently evaluating the impact of the provisions of this standard on the Company’s Consolidated Financial Statements.

Leases

Leases	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Leases	Leases The Company leases corporate offices and laboratory space throughout the world, all of which are classified as operating leases expiring at various dates and generally have terms ranging from 1 to 15 years. Leases with an initial term of 12 months or less are not recorded on the balance sheet. Some of the Company’s real estate lease agreements include options to either renew or early terminate the lease. Leases with renewal options allow the Company to extend the lease term typically between 1 and 5 years. When it is reasonably certain that the Company will exercise an option to renew or terminate a lease, these options are considered in determining the classification and measurement of the lease. Lease liabilities are recorded based on the present value of the future lease payments over the lease term and assessed as of the commencement date. Incentives received from landlords, such as reimbursements for tenant improvements and rent abatement periods, effectively reduce the total lease payments owed for leases. Certain real estate leases also include executory costs such as common area maintenance (non-lease component), as well as property insurance and property taxes (non-components). Lease payments, which may include lease components, non-lease components and non-components, are included in the measurement of the Company’s lease liabilities to the extent that such payments are either fixed amounts or variable amounts based on a rate or index (fixed in substance) as stipulated in the lease contract. Any actual costs in excess of such amounts are expensed as incurred as variable lease cost. The Company utilizes its incremental borrowing rate by lease term in order to calculate the present value of our future lease payments. The discount rate represents a risk-adjusted rate on a secured basis, and is the rate at which the Company would borrow funds to satisfy the scheduled lease liability payment streams commensurate with the lease term. The discount rate is determined using the incremental borrowing rate at lease commencement and based on the lease term. Operating Leases Operating lease costs include an immaterial amount of variable lease cost, and are recorded in cost of revenue and general and administrative expenses, depending on the nature of the leased asset. Aside from variable lease costs, operating lease costs represent fixed lease payments recognized on a straight-line basis over the lease term. As of March 31, 2020, the maturities of our operating lease liabilities and a reconciliation to the present value of lease liabilities were as follows (in thousands): Remaining Lease Payments Remainder of 2020 $ 4,850 2021 7,486 2022 5,358 2023 5,253 2024 5,309 Thereafter 37,340 Total remaining lease payments 65,596 Less: imputed interest (15,181) Total operating lease liabilities 50,415 Less: current portion (4,505) Long-term operating lease liabilities $ 45,910 Weighted-average remaining lease term (in years) 12.1 Weighted-average discount rate 4.4 % The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended Operating lease costs $ 2,105 Three Months Ended Right-of-use assets obtained in exchange for operating lease liabilities $ 24,071 Cash paid for operating leases $ 1,553

Revenue Recognition and Contrac

Revenue Recognition and Contractual Adjustments	3 Months Ended
	Mar. 31, 2020
Revenue from Contract with Customer [Abstract]
Revenue Recognition and Contractual Adjustments	Revenue Recognition and Contractual Adjustments The Company has two operating segments for which it recognizes revenue; Clinical Services and Pharma Services. The Clinical Services segment provides various clinical testing services to community-based pathology practices, oncology practices, hospital pathology labs and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and patients. The Pharma Services segment supports pharmaceutical firms in their drug development programs by providing testing services and data analytics for clinical trials and research. Clinical Services Revenue The Company’s specialized diagnostic services are performed based on a written test requisition form or electronic equivalent. The performance obligation is satisfied and revenues are recognized once the diagnostic services have been performed and the results have been delivered to the ordering physician. These diagnostic services are billed to various payers, including client direct billing, commercial insurance, Medicare and other government payers, and patients. Revenue is recorded for all payers based on the amount expected to be collected, which considers implicit price concessions. Implicit price concessions represent differences between amounts billed and the estimated consideration the Company expects to receive based on negotiated discounts, historical collection experience and other anticipated adjustments, including anticipated payer denials. Collection of consideration the Company expects to receive typically occurs within 30 to 60 days of billing for commercial insurance, Medicare and other governmental and self-pay payers and within 60 to 90 days of billing for client payers. Pharma Services Revenue The Company’s Pharma Services segment generally enters into contracts with pharmaceutical customers as well as other Contract Research Organizations (“CROs”) to provide research and clinical trial services ranging in duration from one month to several years. The Company records revenue on a unit-of-service basis based on number of units completed and the total expected contract value. The total expected contract value is estimated based on historical experience of total contracted units compared to realized units as well as known factors on a specific contract-by-contract basis. Certain contracts include upfront fees, final settlement amounts or billing milestones that may not align with the completion of performance obligations. The value of these upfront fees or final settlement amounts is usually recognized over time based on the number of units completed, which aligns with the progress of the Company towards fulfilling its obligations under the contract. The Company also enters into other contracts, such as validation studies, for which the sole deliverable is a final report that is sent to sponsors at the completion of contracted activities. For these contracts, revenue is recognized at a point in time upon delivery of the final report to the sponsor. Any contracts that contain multiple performance obligations and include both units-of-service and point-in-time deliverables are accounted for as separate performance obligations and revenue is recognized as previously disclosed. The Company negotiates billing schedules and payment terms on a contract-by-contract basis. While the contract terms generally provide for payments based on a unit-of-service arrangement, the billing schedules, payment terms and related cash payments may not align with the performance of services and, as such, may not correspond to revenue recognized in any given period. Amounts collected in advance of services being provided are deferred as contract liabilities on the Consolidated Balance Sheets. The associated revenue is recognized and the contract liability is reduced as the contracted services are subsequently performed. Contract assets are established for revenue that has been recognized but not yet billed. These contract assets are reduced once the customer is invoiced and a corresponding receivable is recorded. Additionally, certain costs to obtain contracts, primarily for sales commissions, are capitalized when incurred and are amortized over the term of the contract. Amounts capitalized for contracts with an initial contract term of twelve months or less are classified as current assets. All others are classified as non-current assets. Most contracts are terminable by the customer, either immediately or according to advance notice terms specified within the contracts. All contracts require payment of fees to the Company for services rendered through the date of termination and may require payment for subsequent services necessary to conclude the study or close out the contract. The following table summarizes the values of contract assets, capitalized commissions and contract liabilities as of March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Current pharma contract assets (1) $ 1,127 $ 1,000 Long-term pharma contract assets (2) 199 153 Total pharma contract assets $ 1,326 $ 1,153 Current pharma capitalized commissions (1) $ 141 $ 133 Long-term pharma capitalized commissions (2) 761 798 Total pharma capitalized commissions $ 902 $ 931 Current pharma contract liabilities $ 2,974 $ 1,610 Long-term pharma contract liabilities (3) 526 1,171 Total pharma contract liabilities $ 3,500 $ 2,781 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as “Other current assets” on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as “Other assets” on the Consolidated Balance Sheets. (3) Long-term pharma contract liabilities are classified as “Other long-term liabilities” on the Consolidated Balance Sheets. Pharma contract assets increased $0.2 million, or 15%, from December 31, 2019 to March 31, 2020. Pharma contract liabilities increased $0.7 million, or 26%, during the same period, while capitalized commissions decreased slightly by $29 thousand, or 3%. Revenue recognized for the three months ended March 31, 2020 and March 31, 2019 related to Pharma contract liability balances outstanding at the beginning of the period was $1.2 million and $1.3 million, respectively. Amortization of capitalized commissions for both three-month periods ended March 31, 2020 and March 31, 2019 was $0.2 million. Disaggregation of Revenue The Company considered various factors for both its Clinical Services and Pharma Services segments in determining appropriate levels of homogeneous data for its disaggregation of revenue, including the nature, amount, timing and uncertainty of revenue and cash flows. For Clinical Services, the categories identified align with our type of customer due to similarities of billing method, level of reimbursement and timing of cash receipts. Unbilled amounts are accrued and allocated to payor categories based on historical experience. In future periods, actual billings by payor category may differ from accrued amounts. Pharma Services revenue was not further disaggregated as substantially all of our revenue relates to contracts with large pharmaceutical and biotech customers as well as other CROs for which the nature, timing and uncertainty of revenue and cash flows is similar and primarily driven by individual contract terms. The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended March 31, 2020 2019 Clinical Services: Client direct billing $ 54,292 $ 49,756 Commercial Insurance 21,993 20,433 Medicare and Medicaid 16,483 15,793 Self-Pay 214 228 Total Clinical Services $ 92,982 $ 86,210 Pharma Services: 13,048 9,367 Total Revenue $ 106,030 $ 95,577

Acquisition

Acquisition	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Acquisition	Acquisition On January 10, 2020 (the “Acquisition Date”), the Company acquired the Oncology Division assets of Human Longevity, Inc. (“HLI - Oncology”) for a purchase price consisting of cash consideration of $37.0 million. Acquisition and integration costs related to HLI - Oncology were approximately $1.3 million for the three months ended March 31, 2020 and are reported as general and administrative expenses in the Company's Consolidated Statements of Operations. HLI - Oncology performs Next Generation Sequencing for pharmaceutical customers. The acquisition of HLI - Oncology adds whole exome and whole genome sequencing capabilities to the Company's current Pharma Services offerings. Revenue related to HLI - Oncology is reported in the Pharma Services segment. The acquisition included assets, primarily consisting of lab equipment, inventory, maintenance agreements for acquired equipment, backlog contracts with HLI - Oncology's customers, as well as HLI - Oncology’s molecular workforce that is experienced with Next Generation Sequencing. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Acquisition Date (in thousands): January 10, 2020 Inventory $ 534 Prepaid assets 185 Property and equipment 16,839 Internally developed software 3,110 Customer relationships (1) 4,100 Long-term assets 346 Goodwill (2) 12,232 Total assets acquired $ 37,346 Long-term liabilities (346) Net assets acquired $ 37,000 (1) Acquired intangible assets consisted of customer relationships which are amortized over seven years. (2) The goodwill arising from the acquisition of HLI - Oncology is the amount the Company paid in excess of the fair value of the net assets acquired was primarily for (i) the expected future cash flows derived from the existing business capabilities and infrastructure, (ii) expanding the Company's scientific expertise as a leading provider of Pharma Services and Next Generational Sequencing and (iii) an enhanced Pharma Services menu including germline, whole exome and whole genome sequencing. All of the goodwill resulting from the acquisition of HLI - Oncology is expected to be deductible for income tax purposes. The above purchase price and purchase price allocation are preliminary and subject to future revision as the acquired assets and liabilities assumed are dependent upon the finalization of the related valuations. The fair values assigned to assets acquired and liabilities assumed for HLI - Oncology are based upon management's best estimates and assumptions as of the reporting date, and are considered preliminary.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill as of March 31, 2020 and December 31, 2019 was $210.8 million and $198.6 million, respectively. Intangible assets consisted of the following as of (in thousands): March 31, 2020 Amortization Cost Accumulated Net Customer Relationships 84-180 months 143,371 28,529 114,842 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,818 $ 28,529 $ 128,289 December 31, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,679 $ — Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 26,078 113,193 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 29,784 $ 126,640 The Company recorded amortization expense of intangible assets of approximately $2.5 million and $2.6 million for the three months ended March 31, 2020 and 2019, respectively. The Company records amortization expense as a general and administrative expense. The estimated amortization expense related to amortizable intangible assets for each of the four succeeding fiscal years and thereafter as of March 31, 2020 is as follows (in thousands): Remainder of 2020 $ 7,403 2021 9,870 2022 9,870 2023 9,870 2024 9,870 Thereafter 67,959 Total $ 114,842

Debt

Debt	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Debt	Debt The following table summarizes the long term debt, net at March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Term loan $ 96,250 $ 97,500 Financing obligations 7,369 8,631 Total debt $ 103,619 $ 106,131 Less: Debt issuance costs (645) (671) Less: Current portion of long-term debt and financing obligations (9,941) (10,432) Total long-term debt, net $ 93,033 $ 95,028 The carrying value of the Company’s term loan and financing obligations approximates fair value based on the current market conditions for similar instruments. Senior Secured Credit Agreement On June 27, 2019 (the “Closing Date”), the Company entered into a new senior secured credit agreement (the “New Credit Agreement”) with PNC Bank National Association (“PNC”), as administrative agent, and the lenders party thereto. The New Credit Agreement provides for a $100.0 million revolving credit facility (the “Revolving Credit Facility”), a $100.0 million term loan facility (the “Term Loan Facility”), and a $50.0 million delayed draw term loan which has an availability period beginning on the Closing Date and ending on December 27, 2020 (the “Delayed Draw Term Loan”). The Term Loan Facility and amounts borrowed under the Revolving Credit Facility are secured on a first priority basis by a security interest in substantially all of the tangible and intangible assets of the Company. Borrowings under the New Credit Agreement bear interest at a rate per annum equal to an applicable margin plus, at the Company’s option, either (1) the Adjusted LIBOR rate for the relevant interest period, as defined within the agreement (2) an alternate base rate determined by reference to the greatest of (a) the federal funds rate for the relevant interest period plus 0.5% per annum, (b) the prime lending rate of PNC and (c) the daily LIBOR rate plus 1% per annum, or (3) a combination of (1) and (2). The applicable margin will range from 1.25% to 2.25% for LIBOR loans and 0.25% to 1.25% for base rate loans, in each case based on NeoGenomics’ Consolidated Leverage Ratio (as defined in the New Credit Agreement). Interest on borrowings under the New Credit Agreement is payable on the last day of each month, in the case of each base rate loan, and on the last day of each interest period (but no less frequently than every three months), in the case of LIBOR loans. The Company has previously entered into an interest rate swap agreements to hedge against changes in the variable rate for a portion of our long term debt. See Note 8. Derivative Instruments and Hedging Activities, for more information on these instruments. The Revolving Credit Facility includes a $10.0 million swing loan sublimit, with swing loans bearing interest at the alternate base rate plus the applicable margin. Any principal outstanding under the Revolving Credit Facility is due and payable on June 27, 2024 or such earlier date as the obligations under the New Credit Agreement become due and payable pursuant to the terms of the New Credit Agreement. No amounts were outstanding under Revolving Credit Facility as of March 31, 2020. Principal payments on the Term Loan Facility are due on the last day of each fiscal quarter with an annual principal amortization of 5% in the first year, 5% in the second year, 7.5% in the third year, 7.5% in the fourth year, and 10% in each year thereafter, with the remainder due upon maturity on June 27, 2024 or such earlier date as the obligations under the New Credit Agreement become due and payable pursuant to the terms of the New Credit Agreement. On March 31, 2020, the Company had current outstanding borrowings under the Term Loan Facility of approximately $5.0 million, and long-term outstanding borrowings of approximately $90.6 million, net of unamortized debt issuance costs of $0.6 million. These costs were recorded as a reduction in the carrying amount of the related liability and are being amortized over the life of the loan. In addition to paying interest on outstanding principal under the New Credit Agreement, the Company will be required to pay a commitment fee in respect of the unutilized portion of the commitments under the Revolving Credit Facility and the Delayed Draw Term Loan. The commitment fee rate ranges from 0.15% to 0.35% depending on NeoGenomics’ Consolidated Leverage Ratio. The Company will also pay customary letter of credit and agency fees. The Term Loan Facility contains various covenants including entering into certain indebtedness; ability to incur liens and encumbrances; make certain restricted payments, including paying dividends on its equity securities or payments to redeem, repurchase or retire its equity securities; enter into certain burdensome agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into certain sale and leaseback transactions; engage in transactions with its affiliates, and materially alter the business it conducts. In addition, the Company must meet certain maximum leverage ratios and fixed charge coverage ratios as of the end of each fiscal quarter. The Term Loan Facility requires the Company to mandatorily prepay the Term Loan Facility and amounts borrowed under the Revolving Credit Facility with (i) 100% of net cash proceeds from certain sales and dispositions, subject to certain reinvestment rights, and (ii) 100% of net cash proceeds from certain issuances or incurrences of additional debt. Financing Obligations The Company has entered into loans with various banks to finance the purchase of laboratory equipment, office equipment and leasehold improvements. These loans mature at various dates through 2022 and the weighted average interest rate under such loans was approximately 4.82% as of March 31, 2020 and 4.64% as of December 31, 2019. Maturities of Long-Term Debt Maturities of long-term debt as of March 31, 2020 are summarized as follows (in thousands): Term Loan Financing Obligations Total Long-Term Debt Remainder of 2020 $ 3,750 $ 3,893 $ 7,643 2021 6,250 2,732 8,982 2022 7,500 744 8,244 2023 8,750 — 8,750 2024 70,000 — 70,000 Total Debt 96,250 7,369 103,619 Less: Current portion of long-term debt (5,000) (4,941) (9,941) Less: Debt issuance costs (645) — (645) Long-term debt, net $ 90,605 $ 2,428 $ 93,033

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	3 Months Ended
	Mar. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging Activities In June of 2018, the Company entered into an interest rate swap agreement to reduce the Company ’ s exposure to interest rate fluctuations on the Company ’ s variable rate debt obligations. This derivative financial instrument is accounted for at fair value as a cash flow hedge, which effectively modifies the Company’s exposure to interest rate risk by converting a portion of its floating rate debt to a fixed rate obligation, thus reducing the impact of interest rate changes on future interest expense. Under the hedging agreement, the Company receives a variable rate of interest based on LIBOR and we pay a fixed rate of interest. The following table summarizes the interest rate swap agreements. June 2018 Hedge Notional Amount $ 70 million Effective Date June 29, 2018 Index One month LIBOR Maturity December 31, 2021 Fixed Rate 2.98 %

Stock Based Compensation

Stock Based Compensation	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Stock Based Compensation	Stock Based Compensation The Company recorded approximately $2.2 million and $2.1 million in stock based compensation expense for the three months ended March 31, 2020 and 2019, respectively. A summary of the stock option activity under the Company’s plans for the three months ended March 31, 2020 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2019 5,318,759 $ 9.97 Options granted 571,316 $ 28.36 Less: Options exercised 504,127 $ 7.58 Options canceled or expired 51,210 $ 14.61 Options outstanding at March 31, 2020 5,334,738 $ 12.14 Exercisable at March 31, 2020 2,535,621 $ 8.35 The fair value of each stock option award granted during the three months ended March 31, 2020 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Three Months Ended Expected term (in years) 4.0 - 5.5 Risk-free interest rate (%) 0.9% Expected volatility (%) 39.9% - 44.5% Dividend yield (%) — Weighted average fair value/share at grant date $8.90 As of March 31, 2020, there was approximately $8.2 million of unrecognized stock based compensation expense related to stock options that will be recognized over a weighted-average period of approximately 1.54 years. A summary of the restricted stock activity under the Company’s plans for the three months ended March 31, 2020 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2019 335,298 $ 15.75 Granted 88,736 $ 28.36 Vested (37,674) $ 19.29 Forfeited (4,585) $ 19.66 Nonvested at March 31, 2020 381,775 $ 18.29 As of March 31, 2020, there was approximately $4.4 million of unrecognized stock based compensation expense related to restricted stock that will be recognized over a weighted-average period of approximately 1.29 years. Employee Stock Purchase Plan (ESPP) The Company offers an ESPP through which eligible employees may purchase shares of our common stock at a discount of 15% of the fair market value of the Company’s common stock.

Related Party Transactions

Related Party Transactions	3 Months Ended
	Mar. 31, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Related Party TransactionsOn November 4, 2016, the Company entered into an amended and restated consulting agreement (the “Amended and Restated Consulting Agreement”) with Steven C. Jones, a director, officer and shareholder of the Company whereby Mr. Jones would provide consulting services to the Company in the capacity of Executive Vice President. The Amended and Restated Consulting Agreement has an initial term of November 4, 2016 through April 30, 2020, which automatically renews for additional one year periods unless either party provides notice of termination at least three months prior to the expiration of the initial term or any renewal term. On May 6, 2019, the Company and Mr. Jones entered into a letter agreement to modify certain provisions of the Amended and Restated Consulting Agreement which modifications included, by mutual agreement of the parties, the following: automatic expiration of the Amended and Restated Consulting Agreement on April 30, 2020 unless the parties mutually agree to renew it in writing; a description of consulting services to be provided to the Company (the “Services”) with a target of up to 15 hours per month of working time and attention to the Company; a fixed monthly cash consulting fee in the amount of $5,000 per month for the provision of the Services; and continuation of health insurance coverage at the levels currently in effect. In addition, Mr. Jones relinquished the title of Executive Vice President effective as of April 4, 2019. During the three months ended March 31, 2020 and 2019, Mr. Jones earned approximately $15,750 and $38,000, respectively, for consulting work performed and for reimbursement of related expenses. During the three months ended March 31, 2020 and 2019, Mr. Jones earned approximately $13,125 and $12,500, respectively, as compensation for his services on the Board. Mr. Jones also received approximately $0 and $58,000 during the three months ended March 31, 2020 and 2019, respectively, as payment of his annual bonus compensation for the previous fiscal years. The Company did not grant stock or restricted stock to any of its Board members, including Mr. Jones, during the three months ended March 31, 2020 or March 31, 2019.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Segment Information	Segment Information The Company has two operating segments for which it recognizes revenue; Clinical Services and Pharma Services. Our Clinical Services segment provides various clinical testing services to community-based pathology practices, hospital pathology labs and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and patients. Our Pharma Services segment supports pharmaceutical firms in their drug development programs by supporting various clinical trials and research. The financial information reviewed by the Chief Operating Decision Maker (“CODM”) includes revenues, cost of revenue and gross margin for each of the Company’s operating segments. Assets are not presented at the segment level as that information is not used by the CODM. The following table summarizes the segment information (in thousands): Three Months Ended March 31, 2020 2019 Net revenues: Clinical Services $ 92,982 $ 86,210 Pharma Services 13,048 9,367 Total revenue 106,030 95,577 Cost of revenue: Clinical Services 48,923 42,651 Pharma Services 10,738 5,811 Total cost of revenue 59,661 48,462 Gross Profit: Clinical Services 44,059 43,559 Pharma Services 2,310 3,556 Total gross profit 46,369 47,115 Operating expenses: General and administrative 36,344 32,142 Research and development 2,060 1,209 Sales and marketing 13,258 11,216 Total operating expenses 51,662 44,567 (Loss) income from operations (5,293) 2,548 Interest expense, net 819 1,826 Other (income) expense (223) 5,169 Loss before taxes (5,889) (4,447) Income tax expense (benefit) 1,089 (2,023) Net loss $ (6,978) $ (2,424)

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Event	Subsequent EventOn March 27, 2020, the President of the United States signed the Coronavirus Aid Relief, and Economic Security (“CARES”) Act into law. The Act includes several significant provisions for corporations, including the usage of net operating losses, interest deductions and payroll benefits. On April 13, 2020, the Company received a stimulus payment in the amount of $3.9 million related to the CARES Act which may partially offset losses in consolidated revenue due to the impact of the COVID-19 pandemic. The Company's ability to utilize the full amount received will depend on the guidelines and rules of the CARES Act, which have not yet been announced.

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Schedule of Future Minimum Lease Payments under Topic 842	As of March 31, 2020, the maturities of our operating lease liabilities and a reconciliation to the present value of lease liabilities were as follows (in thousands): Remaining Lease Payments Remainder of 2020 $ 4,850 2021 7,486 2022 5,358 2023 5,253 2024 5,309 Thereafter 37,340 Total remaining lease payments 65,596 Less: imputed interest (15,181) Total operating lease liabilities 50,415 Less: current portion (4,505) Long-term operating lease liabilities $ 45,910 Weighted-average remaining lease term (in years) 12.1 Weighted-average discount rate 4.4 %
Supplemental Operating Lease Information	The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended Operating lease costs $ 2,105 Three Months Ended Right-of-use assets obtained in exchange for operating lease liabilities $ 24,071 Cash paid for operating leases $ 1,553

Revenue Recognition and Contr_2

Revenue Recognition and Contractual Adjustments (Tables)	3 Months Ended
	Mar. 31, 2020
Revenue from Contract with Customer [Abstract]
Summary of Contract Assets and Liabilities	The following table summarizes the values of contract assets, capitalized commissions and contract liabilities as of March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Current pharma contract assets (1) $ 1,127 $ 1,000 Long-term pharma contract assets (2) 199 153 Total pharma contract assets $ 1,326 $ 1,153 Current pharma capitalized commissions (1) $ 141 $ 133 Long-term pharma capitalized commissions (2) 761 798 Total pharma capitalized commissions $ 902 $ 931 Current pharma contract liabilities $ 2,974 $ 1,610 Long-term pharma contract liabilities (3) 526 1,171 Total pharma contract liabilities $ 3,500 $ 2,781 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as “Other current assets” on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as “Other assets” on the Consolidated Balance Sheets.
Summary of Disaggregation of Revenue	The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended March 31, 2020 2019 Clinical Services: Client direct billing $ 54,292 $ 49,756 Commercial Insurance 21,993 20,433 Medicare and Medicaid 16,483 15,793 Self-Pay 214 228 Total Clinical Services $ 92,982 $ 86,210 Pharma Services: 13,048 9,367 Total Revenue $ 106,030 $ 95,577

Acquisition (Tables)

Acquisition (Tables)	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Acquisition Date (in thousands): January 10, 2020 Inventory $ 534 Prepaid assets 185 Property and equipment 16,839 Internally developed software 3,110 Customer relationships (1) 4,100 Long-term assets 346 Goodwill (2) 12,232 Total assets acquired $ 37,346 Long-term liabilities (346) Net assets acquired $ 37,000 (1) Acquired intangible assets consisted of customer relationships which are amortized over seven years. (2) The goodwill arising from the acquisition of HLI - Oncology is the amount the Company paid in excess of the fair value of the net assets acquired was primarily for (i) the expected future cash flows derived from the existing business capabilities and infrastructure, (ii) expanding the Company's scientific expertise as a leading provider of Pharma Services and Next Generational Sequencing and (iii) an enhanced Pharma Services menu including germline, whole exome and whole genome sequencing. All of the goodwill resulting from the acquisition of HLI - Oncology is expected to be deductible for income tax purposes.

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Classes of Intangible Assets	Intangible assets consisted of the following as of (in thousands): March 31, 2020 Amortization Cost Accumulated Net Customer Relationships 84-180 months 143,371 28,529 114,842 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,818 $ 28,529 $ 128,289 December 31, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,679 $ — Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 26,078 113,193 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 29,784 $ 126,640
Estimated Amortization Expense	The estimated amortization expense related to amortizable intangible assets for each of the four succeeding fiscal years and thereafter as of March 31, 2020 is as follows (in thousands): Remainder of 2020 $ 7,403 2021 9,870 2022 9,870 2023 9,870 2024 9,870 Thereafter 67,959 Total $ 114,842

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Summary of Long Term Debt	The following table summarizes the long term debt, net at March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 December 31, 2019 Term loan $ 96,250 $ 97,500 Financing obligations 7,369 8,631 Total debt $ 103,619 $ 106,131 Less: Debt issuance costs (645) (671) Less: Current portion of long-term debt and financing obligations (9,941) (10,432) Total long-term debt, net $ 93,033 $ 95,028
Summary of Maturities of Long-Term Debt	Maturities of long-term debt as of March 31, 2020 are summarized as follows (in thousands): Term Loan Financing Obligations Total Long-Term Debt Remainder of 2020 $ 3,750 $ 3,893 $ 7,643 2021 6,250 2,732 8,982 2022 7,500 744 8,244 2023 8,750 — 8,750 2024 70,000 — 70,000 Total Debt 96,250 7,369 103,619 Less: Current portion of long-term debt (5,000) (4,941) (9,941) Less: Debt issuance costs (645) — (645) Long-term debt, net $ 90,605 $ 2,428 $ 93,033

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	3 Months Ended
	Mar. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Interest Rate Derivative Instruments	The following table summarizes the interest rate swap agreements. June 2018 Hedge Notional Amount $ 70 million Effective Date June 29, 2018 Index One month LIBOR Maturity December 31, 2021 Fixed Rate 2.98 %

Stock Based Compensation (Table

Stock Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Summary of Stock Option Activity	A summary of the stock option activity under the Company’s plans for the three months ended March 31, 2020 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2019 5,318,759 $ 9.97 Options granted 571,316 $ 28.36 Less: Options exercised 504,127 $ 7.58 Options canceled or expired 51,210 $ 14.61 Options outstanding at March 31, 2020 5,334,738 $ 12.14 Exercisable at March 31, 2020 2,535,621 $ 8.35
Summary of Fair Value of Each Stock Option Award Granted	The fair value of each stock option award granted during the three months ended March 31, 2020 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Three Months Ended Expected term (in years) 4.0 - 5.5 Risk-free interest rate (%) 0.9% Expected volatility (%) 39.9% - 44.5% Dividend yield (%) — Weighted average fair value/share at grant date $8.90
Summary of Restricted Stock Activity	A summary of the restricted stock activity under the Company’s plans for the three months ended March 31, 2020 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2019 335,298 $ 15.75 Granted 88,736 $ 28.36 Vested (37,674) $ 19.29 Forfeited (4,585) $ 19.66 Nonvested at March 31, 2020 381,775 $ 18.29

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Summary of Segment Information	The following table summarizes the segment information (in thousands): Three Months Ended March 31, 2020 2019 Net revenues: Clinical Services $ 92,982 $ 86,210 Pharma Services 13,048 9,367 Total revenue 106,030 95,577 Cost of revenue: Clinical Services 48,923 42,651 Pharma Services 10,738 5,811 Total cost of revenue 59,661 48,462 Gross Profit: Clinical Services 44,059 43,559 Pharma Services 2,310 3,556 Total gross profit 46,369 47,115 Operating expenses: General and administrative 36,344 32,142 Research and development 2,060 1,209 Sales and marketing 13,258 11,216 Total operating expenses 51,662 44,567 (Loss) income from operations (5,293) 2,548 Interest expense, net 819 1,826 Other (income) expense (223) 5,169 Loss before taxes (5,889) (4,447) Income tax expense (benefit) 1,089 (2,023) Net loss $ (6,978) $ (2,424)

Nature of Business and Basis _2

Nature of Business and Basis of Presentation - Narrative (Details)	3 Months Ended
	Mar. 31, 2020segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	2
Percentage of consolidated assets net revenues and net income reported by reportable operating segment	100.00%

Recently Adopted and Issued A_2

Recently Adopted and Issued Accounting Guidance - Narrative (Details) $ in Millions	Mar. 31, 2020USD ($)
Accounting Changes and Error Corrections [Abstract]
Restricted Cash and Cash Equivalents	$ 38.7

Leases - Narrative (Details)

Leases - Narrative (Details) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	$ 33.8
Florida
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	25
Florida | Leasehold Improvements
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	$ 17
Minimum
Lessee, Lease, Description [Line Items]
Operating Lease, Remaining Lease Term	1 year
Lease renewal term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating Lease, Remaining Lease Term	15 years
Lease renewal term	5 years

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Leases [Abstract]
Remainder of 2020	$ 4,850
2021	7,486
2022	5,358
2023	5,253
2024	5,309
Thereafter	37,340
Total remaining lease payments	65,596
Less: imputed interest	(15,181)
Total operating lease liabilities	50,415
Less: current portion	(4,505)	$ (3,381)
Long-term portion of operating leases	$ 45,910	$ 24,034
Operating lease, weighted average remaining lease term	12 years 1 month 6 days
Operating lease, weighted average discount rate (as a percent)	4.40%

Leases - Summary of Supplementa

Leases - Summary of Supplemental Lease Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Leases [Abstract]
Operating lease cost	$ 2,105
Right of use asset obtained in exchange for operating lease liabilities	24,071
Cash paid for operating leases	$ 1,553

Revenue Recognition and Contr_3

Revenue Recognition and Contractual Adjustments - Narrative (Details)	3 Months Ended
	Mar. 31, 2020USD ($)segment	Mar. 31, 2019USD ($)	Dec. 31, 2019USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments | segment	2
Increase in Pharma contract assets	$ 200,000
Pharma contract asset, increase (as a percent)	15.00%
Increase in pharma contract liabilities	$ 700,000
Increase in pharma contract liabilities (as a percent)	26.00%
Capitalized contract costs	$ 902,000		$ 931,000
Pharma contract liability, revenue recognized	1,200,000	$ 1,300,000
Amortization of contract commissions	200,000	$ 200,000
Commissions
Disaggregation of Revenue [Line Items]
Increase (decrease) in capitalized contract costs	$ (29,000)
Capitalized contract costs (as a percent)	(3.00%)

Revenue Recognition and Contr_4

Revenue Recognition and Contractual Adjustments - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Contract with Customer, Asset, Net [Abstract]
Current pharma contract assets	$ 1,127	$ 1,000
Long-term pharma contract assets	199	153
Total pharma contract assets	1,326	1,153
Capitalized Contract Cost [Abstract]
Current pharma capitalized commissions	141	133
Long-term pharma capitalized commissions	761	798
Total pharma capitalized commissions	902	931
Contract with Customer, Liability [Abstract]
Current pharma contract liabilities	2,974	1,610
Long-term pharma contract liabilities	526	1,171
Total pharma contract liabilities	$ 3,500	$ 2,781

Revenue Recognition and Contr_5

Revenue Recognition and Contractual Adjustments - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 106,030	$ 95,577
Clinical Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	92,982	86,210
Clinical Services | Client direct billing
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	54,292	49,756
Clinical Services | Commercial Insurance
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	21,993	20,433
Clinical Services | Medicare and Medicaid
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	16,483	15,793
Clinical Services | Self-Pay
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	214	228
Pharma Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 13,048	$ 9,367

Acquisition - Narrative (Detail

Acquisition - Narrative (Details) - Human Longevity, Inc. $ in Millions	Jan. 10, 2020USD ($)
Business Acquisition [Line Items]
Payment for business acquisition	$ 37
Acquisition and integration costs	$ 1.3

Acquisition - Schedule of Provi

Acquisition - Schedule of Provisional Information (Details) - USD ($) $ in Thousands	Jan. 10, 2020	Mar. 31, 2020	Dec. 31, 2019	Dec. 10, 2018
Business Acquisition [Line Items]
Goodwill		$ 210,833	$ 198,601
Human Longevity, Inc.
Business Acquisition [Line Items]
Inventory	$ 534
Prepaid assets	185
Property and equipment	16,839
Long-term assets	346
Goodwill	12,232
Total assets acquired	37,346
Long-term liabilities				$ 346
Net assets acquired				$ 37,000
Internally Developed Software | Human Longevity, Inc.
Business Acquisition [Line Items]
Intangible assets	3,110
Customer Relationships | Human Longevity, Inc.
Business Acquisition [Line Items]
Intangible assets	$ 4,100
Customer relationships, useful life	7 years

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 210,833		$ 198,601
Amortization of intangibles	$ 2,452	$ 2,559

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Classes of Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Total cost of intangibles	$ 156,818	$ 156,424
Accumulated Amortization	28,529	29,784
Finite-lived intangibles, net	114,842
Intangible assets, net	128,289	126,640
Trade Name
Finite-Lived Intangible Assets [Line Items]
Trade Name - Indefinite-lived	13,447	13,447
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Cost	143,371	139,271
Accumulated Amortization	28,529	26,078
Finite-lived intangibles, net	$ 114,842	113,193
Trade Name
Finite-Lived Intangible Assets [Line Items]
Cost		3,679
Accumulated Amortization		3,679
Finite-lived intangibles, net		$ 0
Non-Compete Agreement
Finite-Lived Intangible Assets [Line Items]
Amortization Period		24 months
Cost		$ 27
Accumulated Amortization		27
Finite-lived intangibles, net		$ 0
Minimum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period	84 months
Minimum | Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period		12 months
Maximum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period	180 months	180 months
Maximum | Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period		24 months

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Estimated Amortization Expense (Detail) $ in Thousands	Mar. 31, 2020USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2020	$ 7,403
2021	9,870
2022	9,870
2023	9,870
2024	9,870
Thereafter	67,959
Total	$ 114,842

Debt - Summary of Long Term Deb

Debt - Summary of Long Term Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Financing obligations	$ 7,369	$ 8,631
Total debt	103,619	106,131
Less:  Debt issuance costs	(645)	(671)
Less:  Current portion of long-term debt and financing obligations	(9,941)	(10,432)
Long-term debt, net	93,033	95,028
Term Loan Facility
Debt Instrument [Line Items]
Long-term debt	$ 96,250	$ 97,500

Debt - Narrative (Detail)

Debt - Narrative (Detail) - USD ($)	Jun. 27, 2019	Mar. 31, 2020	Dec. 31, 2019
Line of Credit Facility [Line Items]
Debt issuance costs		$ (645,000)	$ (671,000)
Debt instrument, weighted average interest rates		4.82%	4.64%
New Credit Agreement | Federal Funds Rate
Line of Credit Facility [Line Items]
Debt instrument variable interest rate		0.50%
New Credit Agreement | LIBOR
Line of Credit Facility [Line Items]
Debt instrument variable interest rate		1.00%
New Credit Agreement | LIBOR | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin		1.25%
New Credit Agreement | LIBOR | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin		2.25%
New Credit Agreement | Base Rate | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin		0.25%
New Credit Agreement | Base Rate | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin		1.25%
New Credit Agreement | Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 100,000,000
Line of credit facility, swingline sublimit	$ 10,000,000
New Credit Agreement | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Commitment fee (as a percent)	0.15%
New Credit Agreement | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Commitment fee (as a percent)	0.35%
New Credit Agreement | Term Loan
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 100,000,000
Annual principal amortization, year one (as a percent)	5.00%
Annual principal amortization, year two (as a percent)	5.00%
Annual principal amortization, year three (as a percent)	7.50%
Annual principal amortization, year four (as a percent)	7.50%
Annual principal amortization, thereafter (as a percent)	10.00%
Line of credit facility, outstanding borrowings		$ 5,000,000
Long-term outstanding borrowings		90,600,000
Debt issuance costs		$ (600,000)
Debt instrument, percentage of net cash proceeds from sales and dispositions subject to certain reinvestment rights		100.00%
Debt instrument, percentage of net cash proceeds from issuances or incurrence of additional debt to be used for mandatory prepayment		100.00%
New Credit Agreement | Delayed Draw Term Loan
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 50,000,000

Debt - Schedule of Maturities o

Debt - Schedule of Maturities of Long Term Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Long-term Debt, by Current and Noncurrent [Abstract]
Less:  Debt issuance costs	$ (645)	$ (671)
Finance Obligations
Less: Current portion of long-term debt	(4,941)	(5,432)
Long-term portion of financing obligations	2,428	3,199
Total Long-Term Debt
Remainder of 2020	7,643
2021	8,982
2022	8,244
2023	8,750
2024	70,000
Long-term debt and finance obligations, including current maturities	103,619
Less: Current portion of long-term debt	(9,941)	(10,432)
Long-term debt, net	93,033	$ 95,028
Term Loan
Long-term Debt, by Current and Noncurrent [Abstract]
Remainder of 2020	3,750
2021	6,250
2022	7,500
2023	8,750
2024	70,000
Long-term Debt	96,250
Less:  Current portion of long-term debt	(5,000)
Less:  Debt issuance costs	(645)
Long-term debt, net	90,605
Financing Obligations
Finance Obligations
Remainder of 2020	3,893
2021	2,732
2022	744
2023	0
2024	0
Finance obligations, due	7,369
Less: Current portion of long-term debt	(4,941)
Long-term portion of financing obligations	$ 2,428

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities (Details) - Cash Flow Hedging - Designated as Hedging Instrument - Interest Rate Hedge June 2018 - USD ($)	Mar. 31, 2020	Dec. 31, 2019
Derivative [Line Items]
Notional amount	$ 70,000,000
Fixed interest rate	2.98%	2.98%
Other Noncurrent Assets
Derivative [Line Items]
Fair value of derivative instrument	$ 0	$ 0
Other Noncurrent Liabilities
Derivative [Line Items]
Fair value of derivative instrument	$ 3,300,000	$ 2,000,000

Stock Based Compensation - Narr

Stock Based Compensation - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense (gain)	$ 2,200	$ 2,100
Unrecognized stock-based compensation cost	$ 8,200
Unrecognized share-based compensation expense, weighted-average recognition period (in years)	1 year 6 months 14 days
Common stock issuance ESPP Plan	$ 796	$ 419
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation cost	$ 4,400
Unrecognized share-based compensation expense, weighted-average recognition period (in years)	1 year 3 months 14 days
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee stock purchase plan, discount rate (as a percent)	15.00%
Common stock issuance ESPP Plan (in shares)	34,330	36,154
Common stock issuance ESPP Plan	$ 200	$ 100

Stock Based Compensation - Summ

Stock Based Compensation - Summary of Stock Option Activity (Detail)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Number of shares
Beginning balance (in shares) | shares	5,318,759
Options granted (in shares) | shares	571,316
Less:
Options exercised (in shares) | shares	504,127
Options canceled or expired (in shares) | shares	51,210
Ending balance (in shares) | shares	5,334,738
Exercisable at March 31, 2020 (in shares) | shares	2,535,621
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in dollars per share) | $ / shares	$ 9.97
Weighted average exercise price, granted (in dollars per share) | $ / shares	28.36
Less:
Weighted average exercise price, exercised (in dollars per share) | $ / shares	7.58
Weighted average exercise price, canceled or expired (in dollars per share) | $ / shares	14.61
Weighted average exercise price, ending balance (in dollars per share) | $ / shares	12.14
Weighted average exercise price, exercisable, ending balance (in dollars per share) | $ / shares	$ 8.35

Stock Based Compensation - Fair

Stock Based Compensation - Fair Value of Each Stock Option Award Granted (Detail)	3 Months Ended
	Mar. 31, 2020$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate (%)	0.90%
Dividend yield (%)	0.00%
Weighted average fair value/share at grant date (in dollars per share)	$ 8.90
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	4 years
Expected volatility (%)	39.90%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 6 months
Expected volatility (%)	44.50%

Stock Based Compensation - Su_2

Stock Based Compensation - Summary of Restricted Stock Activity (Details) - Restricted Stock	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Number of shares
Beginning balance (in shares) | shares	335,298
Granted (in shares) | shares	88,736
Vested (in shares) | shares	(37,674)
Forfeited (in shares) | shares	(4,585)
Ending balance (in shares) | shares	381,775
Weighted average price
Beginning balance (in dollars per share) | $ / shares	$ 15.75
Granted (in dollars per share) | $ / shares	28.36
Vested (in dollars per share) | $ / shares	19.29
Forfeited (in dollars per share) | $ / shares	19.66
Ending balance (in dollars per share) | $ / shares	$ 18.29

Related Party Transactions (Det

Related Party Transactions (Detail) - Executive Vice President - USD ($)	May 06, 2019	Mar. 31, 2020	Mar. 31, 2019
Related Party Transaction [Line Items]
Related party retainer compensation	$ 5,000
Fees for performing duties		$ 15,750	$ 38,000
Related party transaction compensation for services on board		13,125	12,500
Payment of annual bonus compensation		$ 0	$ 58,000

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)segment	Mar. 31, 2019USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment	2
Segment Reporting Information [Line Items]
Total revenue	$ 106,030	$ 95,577
Total cost of revenue	59,661	48,462
GROSS PROFIT	46,369	47,115
General and administrative	36,344	32,142
Research and development	2,060	1,209
Sales and marketing	13,258	11,216
Total operating expenses	51,662	44,567
(LOSS) INCOME FROM OPERATIONS	(5,293)	2,548
Interest expense, net	819	1,826
Other (income) expense	(223)	5,169
Loss before taxes	(5,889)	(4,447)
Income tax expense (benefit)	1,089	(2,023)
NET LOSS	(6,978)	(2,424)
Clinical Services
Segment Reporting Information [Line Items]
Total revenue	92,982	86,210
Total cost of revenue	48,923	42,651
GROSS PROFIT	44,059	43,559
Pharma Services
Segment Reporting Information [Line Items]
Total revenue	13,048	9,367
Total cost of revenue	10,738	5,811
GROSS PROFIT	$ 2,310	$ 3,556

Subsequent Event (Details)

Subsequent Event (Details) $ in Millions	Apr. 13, 2020USD ($)
Subsequent Event
Subsequent Event [Line Items]
CARES Act, stimulus payment received	$ 3.9