Genomic Health (GHDX) 10-Q 9 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 30, 2019
Document and Entity Information
Entity Registrant Name	GENOMIC HEALTH INC
Entity Central Index Key	0001131324
Document Type	10-Q
Document Period End Date	Mar. 31, 2019
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		37,072,397
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1
Entity Small Business	false
Entity Emerging Growth Company	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 101,406	$ 61,645
Short-term marketable securities	104,551	148,149
Accounts receivable	59,248	51,531
Prepaid expenses and other current assets	15,446	13,511
Total current assets	280,651	274,836
Property and equipment, net	39,913	39,532
Operating lease right-of-use assets	53,295
Long-term marketable securities		4,066
Other assets	18,931	15,938
Total assets	392,790	334,372
Current liabilities:
Accounts payable	9,290	8,849
Accrued compensation and employee benefits	22,039	34,457
Accrued expenses and other current liabilities	13,404	15,870
Current portion of operating lease liabilities	4,495
Other current liabilities	258	600
Total current liabilities	49,486	59,776
Operating lease liabilities	53,482
Other liabilities	1,941	4,436
Commitments and contingencies
Stockholders’ equity:
Common stock	3	3
Additional paid-in capital	511,265	506,679
Accumulated other comprehensive income (loss)	49	(87)
Accumulated deficit	(193,326)	(206,325)
Treasury stock, at cost	(30,110)	(30,110)
Total stockholders’ equity	287,881	270,160
Total liabilities and stockholders’ equity	$ 392,790	$ 334,372

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Revenues:
Total revenues	$ 108,769	$ 92,625
Operating expenses:
Cost of product revenues	17,008	18,733
Research and development	15,054	16,807
Selling and marketing	45,348	41,755
General and administrative	19,820	19,718
Total operating expenses	97,230	97,013
Income (loss) from operations	11,539	(4,388)
Interest income	1,151	417
Unrealized gain on equity securities	449	127
Other income, net	127	309
Income (loss) before income taxes	13,266	(3,535)
Income tax expense	267	240
Net income (loss)	$ 12,999	$ (3,775)
Basic net income (loss) per share (in dollars per share)	$ 0.35	$ (0.11)
Diluted net income (loss) per share (in dollars per share)	$ 0.34	$ (0.11)
Shares used in computing basic net income (loss) per share (in shares)	36,719	35,198
Shares used in computing diluted net income (loss) per share (in shares)	38,764	35,198
Product
Revenues:
Total revenues	$ 108,757	$ 92,625
Contract
Revenues:
Total revenues	$ 12

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Condensed Consolidated Statements of Comprehensive Income (Loss)
Net income (loss)	$ 12,999	$ (3,775)
Other comprehensive income (loss):
Unrealized gain (loss), net, on available-for-sale marketable securities, net of tax of $0 for the three months ended March 31, 2019 and 2018, respectively	136	(34)
Comprehensive income (loss)	$ 13,135	$ (3,809)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Comprehensive Income (Loss) (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Condensed Consolidated Statements of Comprehensive Income (Loss)
Unrealized gain (loss), net, on available-for-sale marketable securities, tax	$ 0	$ 0

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit	Treasury Stock at Cost	Total
Increase (Decrease) in Stockholders' Equity
Cumulative effect of change in accounting policies (1)			$ 180	$ 13,943		$ 14,123
Balance at Dec. 31, 2017	$ 3	$ 464,637	(294)	(245,945)	$ (30,110)	188,291
Balance (in shares) at Dec. 31, 2017	35,049
Increase (Decrease) in Stockholders' Equity
Issuance of common stock upon exercise of stock options for cash and vesting of restricted stock units, net of taxes		(3,449)				(3,449)
Issuance of common stock upon exercise of stock options for cash and vesting of restricted stock units (in shares)	307
Issuance of restricted stock to directors in lieu of fees		50				50
Issuance of restricted stock to directors in lieu of fees (in shares)	1
Stock-based compensation expense related to employee stock options, restricted stock units and employee stock purchase plan		5,186				5,186
Net income (loss)				(3,775)		(3,775)
Unrealized gain (loss) on investments, net of tax			(34)			(34)
Balance at Mar. 31, 2018	$ 3	466,424	(148)	(235,777)	(30,110)	200,392
Balance (in shares) at Mar. 31, 2018	35,357
Balance at Dec. 31, 2018	$ 3	506,679	(87)	(206,325)	(30,110)	270,160
Balance (in shares) at Dec. 31, 2018	36,407
Increase (Decrease) in Stockholders' Equity
Issuance of common stock upon exercise of stock options for cash and vesting of restricted stock units, net of taxes		(1,745)				(1,745)
Issuance of common stock upon exercise of stock options for cash and vesting of restricted stock units (in shares)	645
Issuance of restricted stock to directors in lieu of fees		50				50
Issuance of restricted stock to directors in lieu of fees (in shares)	1
Stock-based compensation expense related to employee stock options, restricted stock units and employee stock purchase plan		6,281				6,281
Net income (loss)				12,999		12,999
Unrealized gain (loss) on investments, net of tax			136			136
Balance at Mar. 31, 2019	$ 3	$ 511,265	$ 49	$ (193,326)	$ (30,110)	$ 287,881
Balance (in shares) at Mar. 31, 2019	37,053

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Operating activities
Net income (loss)	$ 12,999	$ (3,775)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	3,412	3,155
Employee stock-based compensation	6,281	5,186
Write-off of previously capitalized software costs		2,368
Impairment of long-lived assets		2,154
Loss on disposal of property and equipment	709
Outside director restricted stock awarded in lieu of fees	50	50
Gain on sale of corporate debt securities	(13)
Discount on convertible promissory note		(62)
Unrealized net gain on revaluation of equity investments	(449)	(127)
Changes in assets and liabilities:
Accounts receivable	(7,717)	(1,283)
Prepaid expenses and other assets	(3,136)	(786)
Accounts payable	(563)	4,591
Accrued compensation and employee benefits	(12,418)	(3,040)
Accrued expenses and other liabilities	(2,703)	(2,151)
Deferred revenues	(121)
Net cash (used in) provided by operating activities	(3,669)	6,280
Investing activities
Purchases of property and equipment	(2,978)	(2,236)
Purchases of marketable securities	(39,991)	(24,043)
Maturities of marketable securities	64,887	20,019
Proceeds from sales of corporate debt securities	23,305
Net cash provided by (used in) investing activities	45,223	(6,260)
Financing activities
Proceeds from issuance of common stock under stock plans	9,873	1,152
Withholding taxes related to restricted stock units net share settlement	(11,618)	(4,601)
Payments on finance lease liabilities	(51)
Net cash used in financing activities	(1,796)	(3,449)
Net increase (decrease) in cash, cash equivalents and restricted cash	39,758	(3,429)
Cash, cash equivalents and restricted cash at the beginning of period	61,917	45,708
Cash, cash equivalents and restricted cash at the end of period	101,675	42,279
Non-cash investing and financing activities
Accrued purchases of property and equipment	2,411	533
Change in fair value of investments	$ 449	$ 200

Organization and Summary of Sig

Organization and Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2019
Organization and Summary of Significant Accounting Policies
Organization and Summary of Significant Accounting Policies	Note 1. Organization and Summary of Significant Accounting Policies The Company Genomic Health, Inc. (the “Company”) is a global healthcare company that provides actionable genomic information to personalize cancer treatment decisions. The Company develops and globally commercializes genomic based clinical laboratory services that analyze the underlying biology of cancer, allowing physicians and patients to make individualized treatment decisions. The Company was incorporated in Delaware in August 2000. The Company’s first product, the Oncotype DX breast cancer test, was launched in 2004 and is used for early stage invasive breast cancer patients to predict the likelihood of breast cancer recurrence and the likelihood of chemotherapy benefit. In January 2010, the Company launched its second product, the Oncotype DX colon cancer test, which is used to predict the likelihood of colon cancer recurrence in patients with stage II disease. The tests for invasive breast and colon cancer result in a quantitative score referred to as a Recurrence Score. In December 2011, the Company made Oncotype DX available for patients with ductal carcinoma in situ (“DCIS”), a pre-invasive form of breast cancer. This test provides a DCIS Score that is used to predict the likelihood of local disease recurrence. In June 2012, the Company began offering the Oncotype DX colon cancer test for use in patients with stage III disease treated with oxaliplatin containing adjuvant therapy. In May 2013, the Company launched the Oncotype DX prostate cancer test, which provides a Genomic Prostate Score (“GPS”) to predict disease aggressiveness in men with low risk prostate cancer and to improve treatment decisions for prostate cancer patients, in conjunction with the Gleason score, or tumor grading. In February 2018, the Oncotype DX AR-V7 Nucleus Detect test for men with metastatic castration-resistant prostate cancer (“mCRPC”) became commercially available. Principles of Consolidation The accompanying condensed consolidated financial statements include all the accounts of the Company and its wholly-owned subsidiaries. The Company had two wholly-owned subsidiaries at March 31, 2019: Genomic Health International Holdings, LLC, which was established in Delaware in 2010 and supports the Company’s international sales and marketing efforts; and Oncotype Laboratories, Inc., which was established in 2012, and is inactive. Genomic Health International Holdings, LLC has eight wholly-owned subsidiaries. The functional currency for the Company’s wholly-owned subsidiaries incorporated outside the United States is the U.S. dollar. All significant intercompany balances and transactions have been eliminated. The Company assesses whether it is the primary beneficiary of a variable interest entity (“VIE”) at the inception of the arrangement and at each reporting date. This assessment is based on the power to direct the activities of the VIE that most significantly impact the VIE’s economic performance and the Company’s obligation to absorb losses or the right to receive benefits from the VIE that could potentially be significant to the VIE. The Company continuously performs this assessment, as changes to existing relationships or future transactions may result in the consolidation or deconsolidation of a VIE. Basis of Presentation and Use of Estimates The accompanying interim period condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). The condensed consolidated balance sheet as of March 31, 2019, condensed consolidated statements of operations, comprehensive income (loss), stockholders’ equity, and cash flows for the three months ended March 31, 2019 and 2018 are unaudited, but include all adjustments, consisting only of normal recurring adjustments, which the Company considers necessary for a fair presentation of its financial position, operating results and cash flows for the periods presented. The condensed consolidated balance sheet at December 31, 2018 has been derived from audited financial statements, but it does not include certain information and notes required by GAAP for complete consolidated financial statements. The preparation of financial statements in conformity with GAAP requires management to make judgments, assumptions and estimates that affect the reported amounts of assets, liabilities, revenues and expenses, and related disclosures in the Company’s condensed consolidated financial statements and accompanying notes. Actual results could differ materially from those estimates. The accompanying interim period condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018. During the first quarter of 2019, the Company adopted new accounting guidance related to leases which is described below. There have been no other significant changes in the Company’s accounting policies during the three months ended March 31, 2019 as compared to the significant accounting policies described in its Annual Report on Form 10-K for the year ended December 31, 2018. Revenue Recognition Revenues are recognized when control of the promised goods or services is transferred to customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services. To determine revenue recognition for the arrangements that the Company determines are within the scope of Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers , the Company performs the following five steps: (1) identify the contract(s) with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract and (5) recognize revenue when (or as) the entity satisfies a performance obligation. See Note 2 “Revenues” for further discussion on Revenues. Concentration of Risk The Company is subject to credit risk from its portfolio of cash equivalents and marketable securities. The Company invests in money market funds through a major U.S. bank and is exposed to credit risk in the event of default by the financial institution to the extent of amounts recorded on the consolidated balance sheets. The Company invests in short term, investment grade debt instruments and by policy limits the amount in any one type of investment, except for securities issued or guaranteed by the U.S. government. Under its investment policy, the Company limits amounts invested in such securities by credit rating, maturity, industry group, investment type and issuer, except for securities issued by the U.S. government. The Company is not exposed to any significant concentrations of credit risk from these financial instruments. The goals of the Company’s investment policy, in order of priority, are as follows: safety and preservation of principal and diversification of risk; liquidity of investments sufficient to meet cash flow requirements; and a competitive after tax rate of return. The Company is also subject to credit risk from its accounts receivable related to its product sales. The majority of the Company’s accounts receivable arise from product sales in the United States. Reimbursement on behalf of patients covered by Medicare accounted for 24% of the Company’s product revenues for the three months ended March 31, 2019 and 26% for the three months ended March 31, 2018. Accounts receivable on behalf of patients directly covered by Medicare represented 17% of the Company’s total accounts receivable at March 31, 2019 and December 31, 2018. No other third party payor represented more than 10% of the Company’s product revenues or accounts receivable balances for these periods. Non-Marketable Investments The carrying values of the Company’s non-marketable equity securities without readily determinable market values are initially measured at cost and adjusted to fair value for observable transactions for identical or similar investments of the same issuer or impairment. All gains and losses on non-marketable equity securities, realized and unrealized, are recognized in other income (expense), net. As of March 31, 2019 and December 31, 2018, the carrying value of the preferred stock of Epic Sciences, Inc. (“Epic Sciences”) was $10.8 million. The Company did not adjust the carrying value of the preferred stock during the three months ended March 31, 2019 and 2018. The preferred stock of Epic Sciences is classified within Level 3 in the fair value hierarchy because the Company estimated the value utilizing an option pricing model that considered the most recent observable transaction and other unobservable inputs including volatility and long-term plans of Epic Sciences. The preferred stock represents a variable interest in the investee. The Company has concluded it is not the primary beneficiary and thus has not consolidated the investee pursuant to the requirements of FASB ASC 810, Consolidation. Additionally, as the Company does not have the ability to exercise significant influence, the equity method was not used to account for the investment. Derivative Financial Instruments The Company hedges a portion of its foreign currency exposure related to outstanding monetary assets and liabilities using foreign currency forward contracts. The foreign currency forward contracts, included in prepaid and other current assets or in accrued liabilities, depending on the contracts’ net position, the Company uses to hedge the exposure are not designated as hedges, and as a result, changes in their fair value of $42,000 for the three month ended March 31, 2019 are recorded in other income (expense). As of March 31, 2019 and December 31, 2018, the Company had foreign currency forward contracts with notional amounts of $15.3 million and $17.1 million, respectively. Impairment of Long Lived Assets The Company reviews long lived assets, which include property and equipment, intangible assets and investments in privately held companies, for impairment whenever events or changes in business circumstances indicate that the carrying amounts of the assets may not be fully recoverable. For property and equipment and intangible assets, an impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition are less than its carrying amount. Impairment, if any, is assessed using undiscounted cash flows. For investments in non-marketable equity securities, evidence of impairment might include the absence of an ability to recover the carrying amount of the investment or the inability of the investee to sustain an earnings capacity which would justify the carrying amount of the investment. If the fair value of the investment is determined to be less than the carrying value, the asset is written down to its fair value. During the three months ended March 31, 2018, the Company wrote off $2.2 million and $2.4 million of previously capitalized equipment and software development costs, respectively, due to disposal activities. There was no impairment of long lived assets during the three months ended March 31, 2019. Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The new guidance requires lessees to recognize a right-of-use asset and a lease liability for almost all leases on the balance sheet. The Company adopted the new standard as of January 1, 2019 using a modified retrospective approach and did not restate comparative periods. The Company elected the package of practical expedients permitted under the transition guidance, which allowed the Company to carryforward the assessment of whether its contracts contain or are leases, classification of its leases and remaining lease terms. The Company also elected to combine its lease and non-lease components and to keep leases with an initial term of 12 months or less off the balance sheet and recognize the associated lease payments in the condensed statements of operation on a straight-line basis over the lease term. Based on the Company’s portfolio of leases as of December 31, 2018, the adoption of ASU 2016-02 on January 1, 2019 resulted in the recognition of operating lease right-of-use (“ROU”) assets of $17.9 million and lease liabilities of $22.5 million, of which $6.1 million was recorded as current portion of operating lease liabilities, and the elimination of $4.5 million of straight-line lease liabilities, of which $1.1 million was recorded as accrued expenses and other current liabilities. There was no material impact to its condensed consolidated statements of operations. See Note 7 “Commitments and Contingencies” for additional information and disclosures. Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments-Credit Losses: Measurement of Credit Losses on Financial Instruments (ASU 2016-13). ASU 2016-13 requires measurement and recognition of expected credit losses for financial assets. This guidance will become effective for the Company beginning January 1, 2020 with early adoption permitted. The Company is evaluating the impact of the adoption of this standard on its consolidated financial statements.

Revenues

Revenues	3 Months Ended
	Mar. 31, 2019
Revenues
Revenues	Note 2. Revenues Revenue Recognition Revenues are recognized when control of the promised goods or services is transferred to customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services. The estimated uncollectible amounts that were historically classified as bad debt expense are now generally considered implicit price concessions that are a direct reduction to accounts receivable rather than allowance for doubtful accounts. The majority of the Company’s historical product revenues have been derived from the sale of its Oncotype DX breast cancer test. For product revenues, the Company estimates the transaction price which is the amount of consideration it expects to be entitled to receive in exchange for providing services based on its historical collection experience using a portfolio approach as a practical expedient to account for patient contracts as collective groups rather than individually. The Company monitors its estimates of transaction price to depict conditions that exist at each reporting date. If the Company subsequently determines that it will collect more consideration than it originally estimated for a contract with a patient, it will account for the change as an increase in the estimate of the transaction price in the period identified. Similarly, if the Company subsequently determines that the amount it expects to collect from a patient is less than it originally estimated, it will generally account for the change as a decrease in the estimate of the transaction price, provided that such downward adjustment does not result in a significant reversal of cumulative revenue recognized. The Company’s performance obligations are satisfied at one point in time when test reports are delivered. The Company also provides services to patients with whom the Company does not have contracts as defined in Topic 606. The Company recognizes revenue for these patients when contracts as defined in Topic 606 are established at the amount of consideration to which it expects to be entitled or when the Company receives substantially all of the consideration subsequent to the performance obligations being satisfied. The following table presents the Company’s product revenues disaggregated by revenue source: Three Months Ended March 31, United States Outside of the United States Total 2019 (In thousands) Invasive breast cancer test $ 79,794 $ 17,574 $ 97,368 Prostate cancer test 8,511 79 8,590 Other 2,701 98 2,799 Total product revenues 91,006 17,751 108,757 Contract revenues 12 — 12 Total revenues $ 91,018 $ 17,751 $ 108,769 2018 Invasive breast cancer test $ 70,931 $ 13,620 $ 84,551 Prostate cancer test 5,806 34 5,840 Other 2,130 104 2,234 Total revenues $ 78,867 $ 13,758 $ 92,625 Contract revenues are generally derived from studies conducted with biopharmaceutical and pharmaceutical companies. The specific methodology for revenue recognition is determined on a case-by-case basis according to the facts and circumstances applicable to a given contract. The Company typically uses an input method that recognizes revenue based on the Company’s efforts to satisfy the performance obligation relative to the total expected inputs to the satisfaction of that performance obligation. Advance payments received in excess of revenues recognized are classified as deferred revenue until such time as the revenue recognition criteria have been met.

Net Income (Loss) Per Share

Net Income (Loss) Per Share	3 Months Ended
	Mar. 31, 2019
Net Income (Loss) Per Share
Net Income (Loss) Per Share	Note 3. Net Income (Loss) Per Share Basic net income (loss) per share is calculated by dividing net income (loss) for the period by the weighted-average number of common shares outstanding for the period without consideration of potential common shares. Diluted earnings per share is calculated using the weighted-average number of common shares outstanding including the dilutive effect of stock awards as determined under the treasury stock method. In periods when the Company has a net loss, stock awards are excluded from the calculation of diluted net loss per share as their inclusion would have an antidilutive effect. Three Months Ended March 31, 2019 2018 (In thousands, except per share amounts) Numerator: Net income (loss) $ 12,999 $ (3,775) Denominator: Weighted-average shares of common stock outstanding used in the calculation of basic net income (loss) per share 36,719 35,198 Effect of dilutive securities: Options to purchase common stock 1,592 — Restricted stock units 453 — Total 2,045 — Weighted-average shares of common stock outstanding used in the calculation of diluted net income (loss) per share 38,764 35,198 Basic net income (loss) per share $ 0.35 $ (0.11) Diluted net income (loss) per share $ 0.34 $ (0.11) The Company excluded stock awards of 367,000 for the three months ended March 31, 2019 from the computation of diluted net income per share because their effect was anti-dilutive. The Company excluded potentially dilutive stock awards of 790,000 for the three months ended March 31, 2018 from the computation of diluted net loss per share because their effect was anti-dilutive.

Cash, Cash Equivalents, Restric

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities	3 Months Ended
	Mar. 31, 2019
Cash, Cash Equivalents, Restricted Cash, and Marketable Securities
Cash, Cash Equivalents and Restricted Cash, and Marketable Securities	Note 4. Cash and Cash Equivalents, Restricted Cash, and Marketable Securities The following tables set forth the Company’s cash and cash equivalents, restricted cash, and marketable securities as of the dates indicated: March 31, December 31, 2019 2018 (In thousands) Cash, cash equivalents, and restricted cash Cash $ 97,728 $ 49,046 Money market deposits 3,129 10,364 Commercial paper 549 2,235 Restricted cash (1) 269 272 Total cash, cash equivalents and restricted cash 101,675 61,917 Marketable securities Commercial paper 37,281 70,162 Corporate debt securities 63,810 78,981 Corporate equity securities 3,460 3,072 Total marketable securities 104,551 152,215 Total cash and cash equivalents, restricted cash and marketable securities $ 206,226 $ 214,132 (1) Restricted cash is included in Other assets on the consolidated balance sheet. The following tables summarize the Company’s available-for-sale securities that are measured at fair value as of the dates indicated: March 31, 2019 Cost or Gross Gross Total Amortized Unrealized Unrealized Estimated Cost Gains Losses Fair Value (In thousands) Commercial paper $ 37,824 $ 7 $ (1) $ 37,830 Corporate debt securities 63,767 47 (4) 63,810 Total $ 101,591 $ 54 $ (5) $ 101,640 December 31, 2018 Cost or Gross Gross Total Amortized Unrealized Unrealized Estimated Cost Gains Losses Fair Value (In thousands) Commercial paper $ 72,455 $ — $ (58) $ 72,397 Corporate debt securities 79,009 18 (46) 78,981 Total $ 151,464 $ 18 $ (104) $ 151,378 The following table provides the breakdown of the available-for-sale marketable securities with unrealized losses as of the dates indicated: In a Loss Position for Less Than 12 Months Gross Unrealized Estimated Losses Fair Value (In thousands) As of March 31, 2019: Commercial paper $ (1) $ 17,657 Corporate debt securities (4) 19,163 Total $ (5) $ 36,820 As of December 31, 2018: Commercial paper $ (58) $ 59,423 Corporate debt securities (46) 37,608 Total $ (104) $ 97,031 The following table provides the amortized cost and fair value of fixed maturity securities available for sale by contractual maturity: March 31, 2019 December 31, 2018 Amortized Estimated Amortized Estimated Cost Fair Value Cost Fair Value (In thousands) Due in one year or less $ 101,591 $ 101,640 $ 147,398 $ 147,312 Due in more than one year but less than five years — — 4,066 4,066 Total $ 101,591 $ 101,640 $ 151,464 $ 151,378 Marketable Equity Securities In December 2017, the Company invested €3.4 million or $4.0 million in 270,000 shares of the common stock of Biocartis N.V. (Biocartis), a public company listed on the Euronext exchange. This corporate equity security investment was accounted for as an available-for-sale marketable security and valued at €3.1 million or $3.5 million and €2.7 million or $3.1 million at March 31, 2019 and December 31, 2018, respectively. During the three months ended March 31, 2019, the Company recorded an increase in fair value of $449,000 and a foreign currency revaluation loss of $61,000, in other income, net for the three months ended March 31, 2019, respectively. During the three months ended March 31, 2018, the Company recorded an increase in fair value of $127,000 and a foreign currency revaluation gain of $139,000, in other income, net.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2019
Fair Value Measurements
Fair Value Measurements	Note 5. Fair Value Measurements Fair Value Hierarchy The Company measures certain financial assets, including cash equivalents and marketable securities, at their fair value on a recurring basis. The fair value of these financial assets was determined based on a hierarchy of three levels of inputs, of which the first two are considered observable and the last unobservable, as follows: Level 1: Quoted prices in active markets for identical assets or liabilities; Level 2: Observable inputs other than Level 1 inputs, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities; and Level 3: Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and consider factors specific to the asset or liability. The Company did not have any non-financial assets or liabilities that were measured or disclosed at fair value on a recurring basis at either March 31, 2019 or December 31, 2018. The following tables set forth the Company’s financial instruments that were measured at fair value on a recurring basis at March 31, 2019 and December 31, 2018 by level within the fair value hierarchy: Actively Quoted Significant Markets for Other Significant Identical Observable Unobservable Balance at Assets Inputs Inputs March 31, Level 1 Level 2 Level 3 2019 (In thousands) As of March 31, 2019: Assets Money market deposits $ 3,129 $ — $ — $ 3,129 Commercial paper — 37,830 — 37,830 Corporate debt securities — 63,810 — 63,810 Corporate equity securities 3,460 — — 3,460 Foreign exchange derivative instruments 212 212 Total $ 6,589 $ 101,852 $ — $ 108,441 Actively Quoted Significant Markets for Other Significant Identical Observable Unobservable Balance at Assets Inputs Inputs December 31, Level 1 Level 2 Level 3 2018 (In thousands) As of December 31, 2018: Assets Money market deposits $ 10,364 $ — $ — $ 10,364 Commercial paper — 72,397 — 72,397 Corporate debt securities — 78,981 — 78,981 Corporate equity securities 3,072 — — 3,072 Total $ 13,436 $ 151,378 $ — $ 164,814 Liabilities Foreign exchange derivative instruments $ — $ 135 — $ 135 Total $ — $ 135 $ — $ 135 The Company’s commercial paper and corporate debt securities are classified as Level 2 as they are valued using multi-dimensional relational pricing models that use observable market inputs, including benchmark yields, reported trades, broker-dealer quotes, issuer spreads, benchmark securities, bids, offers and reference data. Not all inputs listed are available for use in the evaluation process on any given day for each security evaluation. In addition, market indicators and industry and economic events are monitored and may serve as a trigger to acquire further corroborating market data. The Company’s corporate equity securities are classified as Level 1. There were no transfers between Level 1 and Level 2 categories during the three months March 31, 2019.

Collaboration and Commercial Te

Collaboration and Commercial Technology Licensing Agreements	3 Months Ended
	Mar. 31, 2019
Collaboration and Commercial Technology Licensing Agreements
Collaboration and Commercial Technology Licensing Agreements	Note 6. Collaboration and Commercial Technology Licensing Agreements The Company has entered into agreements with third parties for the development and commercialization of certain products and product candidates. Epic Sciences In June 2016, the Company entered into a collaboration agreement with Epic Sciences, which was superseded and replaced in March 2019 by a license agreement and laboratory services agreement with Epic Sciences, under which the Company was granted an exclusive license and distribution rights to commercialize Epic Sciences’ AR-V7 test in the United States, which is marketed under the Company’s trademark as the Oncotype DX AR-V7 Nucleus Detect test. The Company has primary responsibility, in accordance with applicable laws and regulations, for marketing and promoting the test, order fulfillment, billing and collections of receivables, claims appeals, customer support, and providing and maintaining order management systems for the test. Epic Sciences is responsible for performing all tests, performing studies, including analytic, clinical utility and clinical validation studies, and seeking Medicare coverage and a Medicare payment rate from the Centers for Medicare and Medicaid Services (“CMS”) for the test. The license and laboratory service agreement has a term of 10 years from June 2016, unless terminated earlier under certain circumstances. The Oncotype DX AR-V7 Nucleus Detect test became commercially available in February 2018. In October 2018, Palmetto GBA (“Palmetto”), the Medicare Administrative Contractor that sets Medicare coverage policies, approved coverage for the use of the Oncotype DX AR-V7 test through its final local coverage determination (“LCD”), providing initial coverage for eligible Medicare patients for dates of service on or after December 10, 2018. The Company recognizes revenues for the test performed under this arrangement and Epic Sciences receives a fee per test performed that represents the fair market value for the testing services they perform. Under collaboration agreement, in 2016 and 2017, the Company invested $7.5 million in subordinated convertible promissory notes of Epic Sciences that converted into shares of Epic Sciences preferred stock in March 2017. The subordinated convertible promissory notes had been recognized at fair value, which the Company estimated to be approximately $7.1 million while the difference of $375,000 was deferred as of December 31, 2017 and has been recognized as an additional cost of purchases of Oncotype DX AR-V7 Nucleus Detect tests, which the Company believes would be at a discount to fair value. In June 2018, the Company invested an additional $2.5 million in Epic Sciences preferred stock. Additional terms of the original agreement included the Company’s obligation to pay Epic Sciences $4.0 million upon achievement of certain milestones. In December 2018 and January 2019, the milestones were achieved and, the Company recorded the payments of $2.0 million for each in other assets, which are being recognized as cost of product revenue over the term of the agreement. Biocartis In September 2017, the Company entered into an exclusive license and development agreement with Biocartis, a molecular diagnostics company based in Belgium, to develop and commercialize an in vitro diagnostic (“IVD”) version of the Oncotype DX breast cancer test on Biocartis’ Idylla platform that can be performed locally by laboratory partners and in hospitals around the world. Under the terms of the license and development agreement, the Company has an exclusive, worldwide, royalty-bearing license to develop and commercialize an IVD version of the Oncotype DX breast cancer test on the Biocartis Idylla platform, and an option to expand the collaboration to include additional tests in oncology and urology. The Company has primary responsibility for developing, validating and obtaining regulatory authorizations and registrations for IVD Oncotype DX tests to be performed on the Idylla platform. The Company is also responsible for manufacturing and commercialization activities with respect to such tests. In December 2017, the Company purchased 270,000 ordinary shares of Biocartis at the market price of €12.50 for a total cost of €3.4 million or $4.0 million. The investment has been recognized at fair value, which the Company believes to be $3.5 million and $3.1 million at March 31, 2019 and December 31, 2018, respectively. In September 2018, the Company extended its option to expand the collaboration to include urology, and recorded a €1.0 million, or $1.2 million, expense. In November 2018, the Company and Biocartis signed an addendum to the license and development agreement in which the Company exercised the option to expand the collaboration to include the urology field and recorded a €2.0 million, or $2.3 million, expense. In addition, the Company obtained a right of first refusal to add an additional test, a non-invasive detection of prostate cancer in a pre-biopsy setting, and recorded a €500,000, or $575,000, expense. Additional terms of the license and development agreement include the Company’s obligation to pay Biocartis an aggregate of €3.5 million in cash upon achievement of certain milestones and €3.0 million for the expansion of the collaboration to include additional tests in oncology and urology. In addition, the Company will pay royalties based primarily on the future sales volumes of the Company’s test performed on the Idylla platform.

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies
Commitments and Contingencies	Note 7. Commitments and Contingencies Leases The Company has operating for office and laboratory facilities, data centers and certain equipment, some of which include options to extend for 5 years and finance leases for certain equipment. The Company's leases have remaining lease terms of 1 to 9 years. Under Topic 842, the Company determines if an arrangement is a lease at inception. ROU assets and liabilities are recognized at commencement date based on the present value of remaining lease payments over the lease term. As the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date or remeasurement date in determining the present value of lease payments. The incremental borrowing rate is a hypothetical rate based on the Company’s understanding of what its credit rating was as of such date. Leases with an initial term of 12 months or less ("short-term leases") and leases deemed immaterial are not recorded on the condensed consolidated balance sheet. Certain of the Company’s lease contracts include obligations to pay for other services, such as operations and maintenance. The Company accounts for these other services as a component of the lease when related payments are fixed or vary depending on an index or a rate. During the three months ended March 31, 2019, the Company considered that it is reasonably certain that the Company will exercise the option to extend the lease term of leases for its office and laboratory facilities in Redwood City, California. The Company included the extended term of 5 years and remeasured the ROU assets and lease liabilities for the related leases. The remeasurement resulted in the recognition of $34.0 million of ROU assets and lease liabilities. In January 2019, the Company entered into an operating lease for an office facility and recognized ROU assets and liabilities of $2.7 million. The following table represents the Company’s ROU assets and lease liabilities and the balance sheet classification at March 31, 2019: March 31, 2019 Lease activity Balance sheet classification (In thousands) Operating lease Operating lease ROU assets Operating lease right-of-use assets $ 53,295 Operating lease liabilities - current portion Current portion of operating lease liabilities 4,495 Operating lease liabilities - non-current portion Operating lease liabilities 53,482 Total operating lease liabilities $ 57,977 Finance leases Finance lease ROU assets Other assets $ 405 Finance lease liabilities - current portion Other current liabilities 208 Finance lease liabilities - non-current portion Other liabilities 199 Total finance lease liabilities $ 407 The following table represents lease costs and other lease information: Three Months Ended March 31, 2019 (In thousands) Lease cost Operating lease cost $ 1,830 Finance lease cost: Amortization of right-of-use assets 53 Interest on lease liabilities 5 Short-term lease cost 16 Variable lease cost 380 Total lease cost $ 2,284 Other information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,689 Operating cash flows from finance leases 5 Financing cash flows from finance leases 51 Right-of-use assets obtained in exchange for new operating lease liabilities 54,634 Right-of-use assets obtained in exchange for new finance lease liabilities 457 March 31, 2019 Weighted-average remaining lease term — operating leases 7.9 years Weighted-average remaining lease term — finance leases 1.9 years Weighted-average discount rate — operating leases Weighted-average discount rate — finance leases Maturities of lease liabilities were as follows: Operating Finance lease payments lease payments (In thousands) Years Ending December 31, 2019 (remainder of year) $ 5,807 $ 166 2020 7,795 221 2021 8,630 37 2022 8,951 — 2023 10,001 — 2024 and thereafter 32,755 — Total lease payments $ 73,939 $ 424 Less imputed interest (15,962) (17) Total lease liabilities $ 57,977 $ 407 Operating lease payments include $48.2 million related to options to extend lease terms that are reasonably certain of being exercised. Contingencies From time to time, the Company may be subject to various legal proceedings and claims arising in the ordinary course of business. The Company assesses contingencies to determine the degree of probability and range of possible loss for potential accrual in its consolidated financial statements. An estimated loss contingency is accrued in the consolidated financial statements if it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Legal proceedings, including litigation, government investigations and enforcement actions, could result in material costs, occupy significant management resources and entail civil and criminal penalties, even if the Company ultimately prevails. Any of the foregoing consequences could result in serious harm to the Company’s business, results of operations and financial condition.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2019
Stock-Based Compensation
Stock-Based Compensation	Note 8. Stock-Based Compensation Stock Options The following table summarizes the activities for stock options for the three months ended March 31,2019: Weighted-Average Outstanding Options Remaining Aggregate Number of Weighted-Average Contractual Intrinsic Shares Exercise Price Life Value (In thousands) (In years) (In thousands) Balance at December 31, 2018 3,083 $ 29.03 Options granted 301 $ 72.42 Options exercised (413) $ 23.90 Options forfeited (32) $ 41.80 Options expired — $ — Balance at March 31, 2019 2,939 $ 34.06 6.8 $ 106,537 Exercisable at March 31, 2019 1,809 $ 28.75 5.7 $ 74,704 Vested and expected to vest at March 31, 2019 2,852 $ 33.65 6.8 $ 104,478 Restricted Stock Units The following table summarizes the activities for restricted stock units (“RSU”s) for the three months ended March 31, 2019: Weighted-Average Number of Grant Date Fair Shares Value (In thousands) Balance at December 31, 2018 843 $ 31.70 RSUs granted 275 $ 75.64 RSUs vested (1) (373) $ 29.74 RSUs cancelled (29) $ 42.68 Balance at March 31, 2019 716 $ 49.15 (1) Includes 140,277 shares withheld to cover taxes. Restricted Stock in Lieu of Directors’ Fees Outside members of the Company’s Board of Directors may elect to receive fully-vested restricted stock in lieu of cash compensation for services as a director. During the three months ended March 31, 2019, the Company issued 775 shares of restricted stock to outside directors, with a grant date fair value of $50,000 and a weighted-average grant date fair value of $64.41 per share. Employee Stock Purchase Plan There were no shares issued pursuant to the Employee Stock Purchase Plan (“ESPP”) during the three months ended March 31, 2019. As of March 31, 2019, there was $366,000 of unrecognized compensation expense related to the ESPP, which is expected to be recognized over a period of two months. Employee Stock-Based Compensation Expense The Company recognized employee stock-based compensation expense of $6.3 million and $5.2 million for the three months ended March 31, 2019 and 2018, respectively.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2019
Segment Information
Segment Information	Note 9. Segment Information The Company operates in one business segment, which primarily focuses on the development and global commercialization of genomic-based clinical laboratory services that analyze the underlying biology of cancer, allowing physicians and patients to make individualized treatment decisions. The Company’s Oncotype DX breast, colon and prostate cancer tests have similar economic and other characteristics, including the nature of the products and production processes, type of customers, distribution methods and regulatory environment. As of March 31, 2019, the majority of the Company’s product revenues have been derived from sales of one product, the Oncotype DX breast cancer test. The following table summarizes total revenue from customers by geographic region. Product revenues are attributed to countries based on ship-to location. Three Months Ended March 31, 2019 2018 (In thousands) United States $ 91,018 78,867 Outside of the United States 17,751 13,758 Total revenues $ 108,769 $ 92,625

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Taxes
Income Taxes	Note 10. Income Taxes The Company recognized income tax expense of $267,000 and $240,000 for the three months ended March 31, 2019 and 2018, respectively, which was computed using the “discrete” (or “cut-off”) method. The income tax expense for the three months ended March 31, 2019 and 2018 was primarily comprised of foreign income tax expense. Based on all available objective evidence, the Company believes that it is more likely than not that its deferred tax assets will not be fully realized. Accordingly, the Company maintains a valuation allowance against all of its deferred tax assets as of both March 31, 2019 and December 31, 2018. The Company will continue to maintain a full valuation allowance until there is sufficient evidence to support recoverability of its deferred tax assets. The Company had $6.7 million and $6.4 million of unrecognized tax benefits at March 31, 2019 and December 31, 2018, respectively. The Company does not anticipate a material change to its unrecognized tax benefits over the next 12 months that would affect its effective tax rate. Unrecognized tax benefits may change during the next 12 months for items that arise in the ordinary course of business. Accrued interest and penalties related to unrecognized tax benefits are recognized as part of the Company’s income tax provision in its condensed consolidated statements of operations. The statute of limitations remains open for the years 2001 through 2019 in U.S. federal and state jurisdictions, and for the years 2013 through 2019 in foreign jurisdictions.

Restructuring

Restructuring	3 Months Ended
	Mar. 31, 2019
Restructuring
Restructuring	Note 11. Restructuring In March 2018, the Company announced its decision to no longer provide its commercial offering of Oncotype SEQ Liquid Select or any further investment in next generation sequencing (NGS) panels due to a decision to focus the Company’s efforts to develop IVD test solutions and other tests with more predictable reimbursement, higher proprietary value and better prospects for global adoption. With this shift in strategic direction, the Company announced a reduction of its workforce of approximately 10% and recorded charges of $8.5 million consisting of $4.8 million in non-cash asset impairments and $3.7 million in employee separation charges, all of which were recorded as operating expenses in the consolidated statements of operations. The Company paid all of the employee separation charges during 2018. There were no restructuring costs during the three months ended March 31, 2019.

Organization and Summary of S_2

Organization and Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2019
Organization and Summary of Significant Accounting Policies
Principles of Consolidation	Principles of Consolidation The accompanying condensed consolidated financial statements include all the accounts of the Company and its wholly-owned subsidiaries. The Company had two wholly-owned subsidiaries at March 31, 2019: Genomic Health International Holdings, LLC, which was established in Delaware in 2010 and supports the Company’s international sales and marketing efforts; and Oncotype Laboratories, Inc., which was established in 2012, and is inactive. Genomic Health International Holdings, LLC has eight wholly-owned subsidiaries. The functional currency for the Company’s wholly-owned subsidiaries incorporated outside the United States is the U.S. dollar. All significant intercompany balances and transactions have been eliminated. The Company assesses whether it is the primary beneficiary of a variable interest entity (“VIE”) at the inception of the arrangement and at each reporting date. This assessment is based on the power to direct the activities of the VIE that most significantly impact the VIE’s economic performance and the Company’s obligation to absorb losses or the right to receive benefits from the VIE that could potentially be significant to the VIE. The Company continuously performs this assessment, as changes to existing relationships or future transactions may result in the consolidation or deconsolidation of a VIE.
Basis of Presentation and Use of Estimates	Basis of Presentation and Use of Estimates The accompanying interim period condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States (“GAAP”). The condensed consolidated balance sheet as of March 31, 2019, condensed consolidated statements of operations, comprehensive income (loss), stockholders’ equity, and cash flows for the three months ended March 31, 2019 and 2018 are unaudited, but include all adjustments, consisting only of normal recurring adjustments, which the Company considers necessary for a fair presentation of its financial position, operating results and cash flows for the periods presented. The condensed consolidated balance sheet at December 31, 2018 has been derived from audited financial statements, but it does not include certain information and notes required by GAAP for complete consolidated financial statements. The preparation of financial statements in conformity with GAAP requires management to make judgments, assumptions and estimates that affect the reported amounts of assets, liabilities, revenues and expenses, and related disclosures in the Company’s condensed consolidated financial statements and accompanying notes. Actual results could differ materially from those estimates. The accompanying interim period condensed consolidated financial statements and related financial information should be read in conjunction with the audited consolidated financial statements and the related notes thereto included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018. During the first quarter of 2019, the Company adopted new accounting guidance related to leases which is described below. There have been no other significant changes in the Company’s accounting policies during the three months ended March 31, 2019 as compared to the significant accounting policies described in its Annual Report on Form 10-K for the year ended December 31, 2018.
Revenue Recognition	Revenue Recognition Revenues are recognized when control of the promised goods or services is transferred to customers, in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services. To determine revenue recognition for the arrangements that the Company determines are within the scope of Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 606, Revenue from Contracts with Customers , the Company performs the following five steps: (1) identify the contract(s) with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract and (5) recognize revenue when (or as) the entity satisfies a performance obligation. See Note 2 “Revenues” for further discussion on Revenues.
Concentration of Risk	Concentration of Risk The Company is subject to credit risk from its portfolio of cash equivalents and marketable securities. The Company invests in money market funds through a major U.S. bank and is exposed to credit risk in the event of default by the financial institution to the extent of amounts recorded on the consolidated balance sheets. The Company invests in short term, investment grade debt instruments and by policy limits the amount in any one type of investment, except for securities issued or guaranteed by the U.S. government. Under its investment policy, the Company limits amounts invested in such securities by credit rating, maturity, industry group, investment type and issuer, except for securities issued by the U.S. government. The Company is not exposed to any significant concentrations of credit risk from these financial instruments. The goals of the Company’s investment policy, in order of priority, are as follows: safety and preservation of principal and diversification of risk; liquidity of investments sufficient to meet cash flow requirements; and a competitive after tax rate of return. The Company is also subject to credit risk from its accounts receivable related to its product sales. The majority of the Company’s accounts receivable arise from product sales in the United States. Reimbursement on behalf of patients covered by Medicare accounted for 24% of the Company’s product revenues for the three months ended March 31, 2019 and 26% for the three months ended March 31, 2018. Accounts receivable on behalf of patients directly covered by Medicare represented 17% of the Company’s total accounts receivable at March 31, 2019 and December 31, 2018. No other third party payor represented more than 10% of the Company’s product revenues or accounts receivable balances for these periods.
Non-Marketable Investments	Non-Marketable Investments The carrying values of the Company’s non-marketable equity securities without readily determinable market values are initially measured at cost and adjusted to fair value for observable transactions for identical or similar investments of the same issuer or impairment. All gains and losses on non-marketable equity securities, realized and unrealized, are recognized in other income (expense), net. As of March 31, 2019 and December 31, 2018, the carrying value of the preferred stock of Epic Sciences, Inc. (“Epic Sciences”) was $10.8 million. The Company did not adjust the carrying value of the preferred stock during the three months ended March 31, 2019 and 2018. The preferred stock of Epic Sciences is classified within Level 3 in the fair value hierarchy because the Company estimated the value utilizing an option pricing model that considered the most recent observable transaction and other unobservable inputs including volatility and long-term plans of Epic Sciences. The preferred stock represents a variable interest in the investee. The Company has concluded it is not the primary beneficiary and thus has not consolidated the investee pursuant to the requirements of FASB ASC 810, Consolidation. Additionally, as the Company does not have the ability to exercise significant influence, the equity method was not used to account for the investment.
Derivative Financial Instruments	Derivative Financial Instruments The Company hedges a portion of its foreign currency exposure related to outstanding monetary assets and liabilities using foreign currency forward contracts. The foreign currency forward contracts, included in prepaid and other current assets or in accrued liabilities, depending on the contracts’ net position, the Company uses to hedge the exposure are not designated as hedges, and as a result, changes in their fair value of $42,000 for the three month ended March 31, 2019 are recorded in other income (expense). As of March 31, 2019 and December 31, 2018, the Company had foreign currency forward contracts with notional amounts of $15.3 million and $17.1 million, respectively.
Impairment of Long-Lived Assets	Impairment of Long Lived Assets The Company reviews long lived assets, which include property and equipment, intangible assets and investments in privately held companies, for impairment whenever events or changes in business circumstances indicate that the carrying amounts of the assets may not be fully recoverable. For property and equipment and intangible assets, an impairment loss would be recognized when estimated undiscounted future cash flows expected to result from the use of the asset and its eventual disposition are less than its carrying amount. Impairment, if any, is assessed using undiscounted cash flows. For investments in non-marketable equity securities, evidence of impairment might include the absence of an ability to recover the carrying amount of the investment or the inability of the investee to sustain an earnings capacity which would justify the carrying amount of the investment. If the fair value of the investment is determined to be less than the carrying value, the asset is written down to its fair value. During the three months ended March 31, 2018, the Company wrote off $2.2 million and $2.4 million of previously capitalized equipment and software development costs, respectively, due to disposal activities. There was no impairment of long lived assets during the three months ended March 31, 2019.
Recently Issued Accounting Pronouncements	Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) . The new guidance requires lessees to recognize a right-of-use asset and a lease liability for almost all leases on the balance sheet. The Company adopted the new standard as of January 1, 2019 using a modified retrospective approach and did not restate comparative periods. The Company elected the package of practical expedients permitted under the transition guidance, which allowed the Company to carryforward the assessment of whether its contracts contain or are leases, classification of its leases and remaining lease terms. The Company also elected to combine its lease and non-lease components and to keep leases with an initial term of 12 months or less off the balance sheet and recognize the associated lease payments in the condensed statements of operation on a straight-line basis over the lease term. Based on the Company’s portfolio of leases as of December 31, 2018, the adoption of ASU 2016-02 on January 1, 2019 resulted in the recognition of operating lease right-of-use (“ROU”) assets of $17.9 million and lease liabilities of $22.5 million, of which $6.1 million was recorded as current portion of operating lease liabilities, and the elimination of $4.5 million of straight-line lease liabilities, of which $1.1 million was recorded as accrued expenses and other current liabilities. There was no material impact to its condensed consolidated statements of operations. See Note 7 “Commitments and Contingencies” for additional information and disclosures. Recently Issued Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments-Credit Losses: Measurement of Credit Losses on Financial Instruments (ASU 2016-13). ASU 2016-13 requires measurement and recognition of expected credit losses for financial assets. This guidance will become effective for the Company beginning January 1, 2020 with early adoption permitted. The Company is evaluating the impact of the adoption of this standard on its consolidated financial statements.

Revenues (Tables)

Revenues (Tables)	3 Months Ended
	Mar. 31, 2019
Revenues
Schedule of product revenues disaggregated by revenue source and geographic region	Three Months Ended March 31, United States Outside of the United States Total 2019 (In thousands) Invasive breast cancer test $ 79,794 $ 17,574 $ 97,368 Prostate cancer test 8,511 79 8,590 Other 2,701 98 2,799 Total product revenues 91,006 17,751 108,757 Contract revenues 12 — 12 Total revenues $ 91,018 $ 17,751 $ 108,769 2018 Invasive breast cancer test $ 70,931 $ 13,620 $ 84,551 Prostate cancer test 5,806 34 5,840 Other 2,130 104 2,234 Total revenues $ 78,867 $ 13,758 $ 92,625

Net Income (Loss) Per Share (Ta

Net Income (Loss) Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
Net Income (Loss) Per Share
Schedule of reconciliation of numerator and denominator used in calculation of basic and diluted net income (loss) per share	Three Months Ended March 31, 2019 2018 (In thousands, except per share amounts) Numerator: Net income (loss) $ 12,999 $ (3,775) Denominator: Weighted-average shares of common stock outstanding used in the calculation of basic net income (loss) per share 36,719 35,198 Effect of dilutive securities: Options to purchase common stock 1,592 — Restricted stock units 453 — Total 2,045 — Weighted-average shares of common stock outstanding used in the calculation of diluted net income (loss) per share 38,764 35,198 Basic net income (loss) per share $ 0.35 $ (0.11) Diluted net income (loss) per share $ 0.34 $ (0.11)

Cash, Cash Equivalents, Restr_2

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities (Tables)	3 Months Ended
	Mar. 31, 2019
Cash, Cash Equivalents, Restricted Cash, and Marketable Securities
Schedule of cash, cash equivalents, restricted cash and marketable securities	March 31, December 31, 2019 2018 (In thousands) Cash, cash equivalents, and restricted cash Cash $ 97,728 $ 49,046 Money market deposits 3,129 10,364 Commercial paper 549 2,235 Restricted cash (1) 269 272 Total cash, cash equivalents and restricted cash 101,675 61,917 Marketable securities Commercial paper 37,281 70,162 Corporate debt securities 63,810 78,981 Corporate equity securities 3,460 3,072 Total marketable securities 104,551 152,215 Total cash and cash equivalents, restricted cash and marketable securities $ 206,226 $ 214,132 (1) Restricted cash is included in Other assets on the consolidated balance sheet.
Summary of available-for-sale securities	March 31, 2019 Cost or Gross Gross Total Amortized Unrealized Unrealized Estimated Cost Gains Losses Fair Value (In thousands) Commercial paper $ 37,824 $ 7 $ (1) $ 37,830 Corporate debt securities 63,767 47 (4) 63,810 Total $ 101,591 $ 54 $ (5) $ 101,640 December 31, 2018 Cost or Gross Gross Total Amortized Unrealized Unrealized Estimated Cost Gains Losses Fair Value (In thousands) Commercial paper $ 72,455 $ — $ (58) $ 72,397 Corporate debt securities 79,009 18 (46) 78,981 Total $ 151,464 $ 18 $ (104) $ 151,378
Schedule of the breakdown of available-for-sale marketable securities with unrealized losses	In a Loss Position for Less Than 12 Months Gross Unrealized Estimated Losses Fair Value (In thousands) As of March 31, 2019: Commercial paper $ (1) $ 17,657 Corporate debt securities (4) 19,163 Total $ (5) $ 36,820 As of December 31, 2018: Commercial paper $ (58) $ 59,423 Corporate debt securities (46) 37,608 Total $ (104) $ 97,031
Summary of fixed maturity securities by contractual maturity	March 31, 2019 December 31, 2018 Amortized Estimated Amortized Estimated Cost Fair Value Cost Fair Value (In thousands) Due in one year or less $ 101,591 $ 101,640 $ 147,398 $ 147,312 Due in more than one year but less than five years — — 4,066 4,066 Total $ 101,591 $ 101,640 $ 151,464 $ 151,378

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2019
Fair Value Measurements
Schedule of financial instruments measured at fair value on recurring basis	Actively Quoted Significant Markets for Other Significant Identical Observable Unobservable Balance at Assets Inputs Inputs March 31, Level 1 Level 2 Level 3 2019 (In thousands) As of March 31, 2019: Assets Money market deposits $ 3,129 $ — $ — $ 3,129 Commercial paper — 37,830 — 37,830 Corporate debt securities — 63,810 — 63,810 Corporate equity securities 3,460 — — 3,460 Foreign exchange derivative instruments 212 212 Total $ 6,589 $ 101,852 $ — $ 108,441 Actively Quoted Significant Markets for Other Significant Identical Observable Unobservable Balance at Assets Inputs Inputs December 31, Level 1 Level 2 Level 3 2018 (In thousands) As of December 31, 2018: Assets Money market deposits $ 10,364 $ — $ — $ 10,364 Commercial paper — 72,397 — 72,397 Corporate debt securities — 78,981 — 78,981 Corporate equity securities 3,072 — — 3,072 Total $ 13,436 $ 151,378 $ — $ 164,814 Liabilities Foreign exchange derivative instruments $ — $ 135 — $ 135 Total $ — $ 135 $ — $ 135

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2019
Commitments and Contingencies
Summary of ROU assets and lease liabilities	March 31, 2019 Lease activity Balance sheet classification (In thousands) Operating lease Operating lease ROU assets Operating lease right-of-use assets $ 53,295 Operating lease liabilities - current portion Current portion of operating lease liabilities 4,495 Operating lease liabilities - non-current portion Operating lease liabilities 53,482 Total operating lease liabilities $ 57,977 Finance leases Finance lease ROU assets Other assets $ 405 Finance lease liabilities - current portion Other current liabilities 208 Finance lease liabilities - non-current portion Other liabilities 199 Total finance lease liabilities $ 407
Summary of components of our lease cost and supplemental cash flow information	Three Months Ended March 31, 2019 (In thousands) Lease cost Operating lease cost $ 1,830 Finance lease cost: Amortization of right-of-use assets 53 Interest on lease liabilities 5 Short-term lease cost 16 Variable lease cost 380 Total lease cost $ 2,284 Other information Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,689 Operating cash flows from finance leases 5 Financing cash flows from finance leases 51 Right-of-use assets obtained in exchange for new operating lease liabilities 54,634 Right-of-use assets obtained in exchange for new finance lease liabilities 457 March 31, 2019 Weighted-average remaining lease term — operating leases 7.9 years Weighted-average remaining lease term — finance leases 1.9 years Weighted-average discount rate — operating leases Weighted-average discount rate — finance leases
Summary of maturities of our lease liabilities	Operating Finance lease payments lease payments (In thousands) Years Ending December 31, 2019 (remainder of year) $ 5,807 $ 166 2020 7,795 221 2021 8,630 37 2022 8,951 — 2023 10,001 — 2024 and thereafter 32,755 — Total lease payments $ 73,939 $ 424 Less imputed interest (15,962) (17) Total lease liabilities $ 57,977 $ 407
Summary of maturities of our lease liabilities	Operating Finance lease payments lease payments (In thousands) Years Ending December 31, 2019 (remainder of year) $ 5,807 $ 166 2020 7,795 221 2021 8,630 37 2022 8,951 — 2023 10,001 — 2024 and thereafter 32,755 — Total lease payments $ 73,939 $ 424 Less imputed interest (15,962) (17) Total lease liabilities $ 57,977 $ 407

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2019
Stock-Based Compensation
Summary of option activity	Weighted-Average Outstanding Options Remaining Aggregate Number of Weighted-Average Contractual Intrinsic Shares Exercise Price Life Value (In thousands) (In years) (In thousands) Balance at December 31, 2018 3,083 $ 29.03 Options granted 301 $ 72.42 Options exercised (413) $ 23.90 Options forfeited (32) $ 41.80 Options expired — $ — Balance at March 31, 2019 2,939 $ 34.06 6.8 $ 106,537 Exercisable at March 31, 2019 1,809 $ 28.75 5.7 $ 74,704 Vested and expected to vest at March 31, 2019 2,852 $ 33.65 6.8 $ 104,478
Summary of RSU activity	Weighted-Average Number of Grant Date Fair Shares Value (In thousands) Balance at December 31, 2018 843 $ 31.70 RSUs granted 275 $ 75.64 RSUs vested (1) (373) $ 29.74 RSUs cancelled (29) $ 42.68 Balance at March 31, 2019 716 $ 49.15 (1) Includes 140,277 shares withheld to cover taxes.

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2019
Segment Information
Summary of total revenue from customers by geographic region	Three Months Ended March 31, 2019 2018 (In thousands) United States $ 91,018 78,867 Outside of the United States 17,751 13,758 Total revenues $ 108,769 $ 92,625

Organization and Summary of S_3

Organization and Summary of Significant Accounting Policies (Principles of Consolidation) (Details)	3 Months Ended
	Mar. 31, 2019subsidiary
Principles of Consolidation
Number of wholly-owned subsidiaries	2
Genomic Health International Holdings, LLC
Principles of Consolidation
Number of wholly-owned subsidiaries	8

Organization and Summary of S_4

Organization and Summary of Significant Accounting Policies (Concentration of Risk) (Details) - Medicare	3 Months Ended		12 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Product revenues | Third-party payor
Concentration of Risk
Concentration risk percentage	24.00%	26.00%
Net accounts receivable | Credit
Concentration of Risk
Concentration risk percentage	17.00%		17.00%

Organization and Summary of S_5

Organization and Summary of Significant Accounting Policies (Non-Marketable Investments) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Investments in Privately Held Companies
Marketable Securities	$ 104,551	$ 152,215
Corporate equity securities
Investments in Privately Held Companies
Marketable Securities	3,460	3,072
Epic Sciences, Inc. | Corporate equity securities
Investments in Privately Held Companies
Marketable Securities	$ 10,800	$ 10,800

Organization and Summary of S_6

Organization and Summary of Significant Accounting Policies (Derivative Financial Instruments) (Details) - Foreign exchange forward contract - USD ($)	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Derivative Financial Instruments
Changes in fair value	$ 42,000
Notional amount	$ 15,300,000	$ 17,100,000

Organization and Summary of S_7

Organization and Summary of Significant Accounting Policies (Impairment of Long-Lived Assets) (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2019	Mar. 31, 2018
Impairment of Long-lived Assets
Impairments	$ 4.8	$ 0
Equipment
Impairment of Long-lived Assets
Impairments			$ 2.2
Software development costs
Impairment of Long-lived Assets
Impairments			$ 2.4

Organization and Summary of S_8

Organization and Summary of Significant Accounting Policies (Recently Issued Accounting Pronouncements) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Jan. 01, 2019	Dec. 31, 2018
Recently Issued Accounting Pronouncements
Operating lease right-of-use assets	$ 53,295
Lease liabilities	57,977
Current portion of operating lease liabilities	4,495
Accrued expenses and other current liabilities	$ 13,404		$ 15,870
Restatement adjustment | ASU 2016-02
Recently Issued Accounting Pronouncements
Operating lease right-of-use assets		$ 17,900
Lease liabilities		22,500
Current portion of operating lease liabilities		6,100
Elimination of straight-line lease liabilities		(4,500)
Accrued expenses and other current liabilities		$ 1,100

Revenues (Disaggregation of Rev

Revenues (Disaggregation of Revenue) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Disaggregation of Revenue
Total revenues	$ 108,769	$ 92,625
Product
Disaggregation of Revenue
Total revenues	108,757	92,625
Invasive breast cancer test
Disaggregation of Revenue
Total revenues	97,368	84,551
Prostate cancer test
Disaggregation of Revenue
Total revenues	8,590	5,840
Other
Disaggregation of Revenue
Total revenues	2,799	2,234
Contract
Disaggregation of Revenue
Total revenues	12
United States
Disaggregation of Revenue
Total revenues	91,018	78,867
United States | Product
Disaggregation of Revenue
Total revenues	91,006
United States | Invasive breast cancer test
Disaggregation of Revenue
Total revenues	79,794	70,931
United States | Prostate cancer test
Disaggregation of Revenue
Total revenues	8,511	5,806
United States | Other
Disaggregation of Revenue
Total revenues	2,701	2,130
United States | Contract
Disaggregation of Revenue
Total revenues	12
Outside of the United States
Disaggregation of Revenue
Total revenues	17,751	13,758
Outside of the United States | Product
Disaggregation of Revenue
Total revenues	17,751
Outside of the United States | Invasive breast cancer test
Disaggregation of Revenue
Total revenues	17,574	13,620
Outside of the United States | Prostate cancer test
Disaggregation of Revenue
Total revenues	79	34
Outside of the United States | Other
Disaggregation of Revenue
Total revenues	$ 98	$ 104

Net Income (Loss) Per Share (Ca

Net Income (Loss) Per Share (Calculation) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Numerator:
Net income (loss)	$ 12,999	$ (3,775)
Denominator:
Weighted-average shares of common stock outstanding used in the calculation of basic net income (loss) per share	36,719	35,198
Effect of dilutive securities:
Effect of dilutive securities (in shares)	2,045
Weighted-average shares of common stock outstanding used in the calculation of diluted net income (loss) per share	38,764	35,198
Basic net income (loss) per share (in dollars per share)	$ 0.35	$ (0.11)
Diluted net income (loss) per share (in dollars per share)	$ 0.34	$ (0.11)
Stock Options
Effect of dilutive securities:
Effect of dilutive securities (in shares)	1,592
Restricted stock units
Effect of dilutive securities:
Effect of dilutive securities (in shares)	453

Net Income (Loss) Per Share (Di

Net Income (Loss) Per Share (Dilutive stock awards excluded) (Details) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Net Income (Loss) Per Share
Stock awards excluded from the computation (in shares)	367,000	790,000

Cash and Cash Equivalents, Rest

Cash and Cash Equivalents, Restricted Cash, and Marketable Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017
Marketable Securities
Total cash, cash equivalents and restricted cash	$ 101,675	$ 61,917	$ 42,279	$ 45,708
Total marketable securities	104,551	152,215
Total cash and cash equivalents, restricted cash and marketable securities	206,226	214,132
Commercial paper
Marketable Securities
Total marketable securities	37,281	70,162
Corporate debt securities
Marketable Securities
Total marketable securities	63,810	78,981
Corporate equity securities
Marketable Securities
Total marketable securities	3,460	3,072
Cash
Marketable Securities
Total cash, cash equivalents and restricted cash	97,728	49,046
Money market deposits
Marketable Securities
Total cash, cash equivalents and restricted cash	3,129	10,364
Commercial paper
Marketable Securities
Total cash, cash equivalents and restricted cash	549	2,235
Restricted cash
Marketable Securities
Total cash, cash equivalents and restricted cash	$ 269	$ 272

Cash, Cash Equivalents, Restr_3

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities (Available-for-sale Securities) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Debt securities
Total	$ 101,591	$ 151,464
Gross Unrealized Gains, Debt Securities	54	18
Gross Unrealized Losses, Debt Securities	(5)	(104)
Debt securities	101,640	151,378
Commercial paper
Debt securities
Total	37,824	72,455
Gross Unrealized Gains, Debt Securities	7
Gross Unrealized Losses, Debt Securities	(1)	(58)
Debt securities	37,830	72,397
Corporate debt securities
Debt securities
Total	63,767	79,009
Gross Unrealized Gains, Debt Securities	47	18
Gross Unrealized Losses, Debt Securities	(4)	(46)
Debt securities	$ 63,810	$ 78,981

Cash, Cash Equivalents, Restr_4

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities (Available-For-Sale Marketable Securities with Unrealized losses) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Marketable Securities [Line Items]
In a Loss Position for Less Than 12 Months, Gross Unrealized Losses	$ (5)	$ (104)
In a Loss Position for Less Than 12 Months, Estimated Fair Value	36,820	97,031
Commercial paper
Marketable Securities [Line Items]
In a Loss Position for Less Than 12 Months, Gross Unrealized Losses	(1)	(58)
In a Loss Position for Less Than 12 Months, Estimated Fair Value	17,657	59,423
Corporate debt securities
Marketable Securities [Line Items]
In a Loss Position for Less Than 12 Months, Gross Unrealized Losses	(4)	(46)
In a Loss Position for Less Than 12 Months, Estimated Fair Value	$ 19,163	$ 37,608

Cash, Cash Equivalents, Restr_5

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities (Contractual Maturity) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Amortized Cost
Due in one year or less	$ 101,591	$ 147,398
Due in more than one year but less than five years		4,066
Total	101,591	151,464
Estimated Fair Value
Due in one year or less	101,640	147,312
Due in more than one year but less than five years		4,066
Total	$ 101,640	$ 151,378

Cash, Cash Equivalents, Restr_6

Cash, Cash Equivalents, Restricted Cash, and Marketable Securities (Biocartis) (Details) € in Millions	1 Months Ended		3 Months Ended
	Dec. 31, 2017EUR (€)shares	Dec. 31, 2017USD ($)shares	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)	Mar. 31, 2019EUR (€)	Mar. 31, 2019USD ($)	Dec. 31, 2018EUR (€)	Dec. 31, 2018USD ($)
Marketable Securities
Retained earnings (deficit)						$ (193,326,000)		$ (206,325,000)
Unrealized gain on equity securities			$ 449,000	$ 127,000
Biocartis N.V.
Marketable Securities
Amount invested in shares of common stock	€ 3.4	$ 4,000,000
Estimated fair value, equity securities					€ 3.1	$ 3,500,000	€ 2.7	$ 3,100,000
Unrealized gain on equity securities			449,000	127,000
Foreign currency revaluation gain (loss)			$ (61,000)	$ 139,000
Biocartis N.V. | Common Stock
Marketable Securities
Number of shares purchased | shares	270,000	270,000

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Assets
Debt securities	$ 101,640	$ 151,378
Liabilities
Transfer of assets from level 1 to level 2	0
Transfer of assets from level 2 to level 1	0
Transfer of liabilities from level 1 to level 2	0
Transfer of liabilities from level 2 to level 1	0
Commercial paper
Assets
Debt securities	37,830	72,397
Corporate debt securities
Assets
Debt securities	63,810	78,981
Recurring basis
Assets
Money market deposits	3,129	10,364
Corporate equity securities	3,460	3,072
Foreign exchange derivative instruments	212
Total assets at fair value	108,441	164,814
Liabilities
Foreign exchange derivative instruments		135
Total		135
Recurring basis | Commercial paper
Assets
Debt securities	37,830	72,397
Recurring basis | Corporate debt securities
Assets
Debt securities	63,810	78,981
Recurring basis | Actively Quoted Markets for Identical Assets Level 1
Assets
Money market deposits	3,129	10,364
Corporate equity securities	3,460	3,072
Total assets at fair value	6,589	13,436
Recurring basis | Significant Other Observable Inputs Level 2
Assets
Foreign exchange derivative instruments	212
Total assets at fair value	101,852	151,378
Liabilities
Foreign exchange derivative instruments		135
Total		135
Recurring basis | Significant Other Observable Inputs Level 2 | Commercial paper
Assets
Debt securities	37,830	72,397
Recurring basis | Significant Other Observable Inputs Level 2 | Corporate debt securities
Assets
Debt securities	$ 63,810	$ 78,981

Collaboration and Commercial _2

Collaboration and Commercial Technology Licensing Agreements (Epic) (Details) - USD ($)	1 Months Ended	3 Months Ended		24 Months Ended
	Jan. 31, 2019	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2017	Dec. 31, 2018	Jun. 30, 2018	Jun. 30, 2016
Collaboration agreements
Debt securities fair value		$ 101,640,000			$ 151,378,000
Amount invested		$ 39,991,000	$ 24,043,000
Oncotype DX colon cancer test and Oncotype DX prostate cancer test
Collaboration agreements
Amount invested in notes				$ 7,500,000
Debt securities fair value				7,100,000
Deferred cost				$ 375,000
Obligation upon achievement of certain future milestones							$ 4,000,000
Term of agreement		10 years
Oncotype DX colon cancer test and Oncotype DX prostate cancer test | Corporate equity securities
Collaboration agreements
Investment in preferred stock per collaboration agreement						$ 2,500,000
Oncotype DX colon cancer test and Oncotype DX prostate cancer test | Corporate equity securities | Other Assets
Collaboration agreements
Amount invested	$ 2,000,000
Obligation upon achievement of certain future milestones	$ 2,000,000				$ 2,000,000

Collaboration and Commercial _3

Collaboration and Commercial Technology Licensing Agreements (Biocartis) (Details)	1 Months Ended						3 Months Ended
	Nov. 30, 2018EUR (€)	Nov. 30, 2018USD ($)	Sep. 30, 2018EUR (€)	Sep. 30, 2018USD ($)	Dec. 31, 2017EUR (€)	Dec. 31, 2017USD ($)$ / sharesshares	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2018USD ($)
Collaboration agreements
Amount invested | $							$ 39,991,000	$ 24,043,000
Exclusive license and development agreement with Biocartis NV
Collaboration agreements
Number of shares purchased | shares						270,000
Market price | $ / shares						$ 12.50
Amount invested					€ 3,400,000	$ 4,000,000
Estimated fair value | $							$ 3,500,000		$ 3,100,000
Cash obligation upon achievement of certain milestones | €	€ 3,500,000
Investment expense			€ 1,000,000	$ 1,200,000
Cash obligation for the expansion of the collaboration | €	3,000,000
Addendum to license and development agreement to include urology
Collaboration agreements
Investment expense	2,000,000	$ 2,300,000
Collaborative arrangement first right to additional test prostate cancer
Collaboration agreements
Investment expense	€ 500,000	$ 575,000

Commitments and Contingencies -

Commitments and Contingencies - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Jan. 31, 2019
Lessee, Lease, Description [Line Items]
Option to extend - Operating	true
Option to extend period - Operating	5 years
Operating lease right-of-use assets	$ 53,295
Lease liabilities	$ 57,977
Minimum
Lessee, Lease, Description [Line Items]
Remaining lease term - Operating	1 year
Remaining lease term - Finance	1 year
Maximum
Lessee, Lease, Description [Line Items]
Remaining lease term - Operating	9 years
Remaining lease term - Finance	9 years
Operating lease for office facility
Lessee, Lease, Description [Line Items]
Operating lease right-of-use assets		$ 2,700
Lease liabilities		$ 2,700
Operating lease for office and laboratory facility
Lessee, Lease, Description [Line Items]
Operating lease right-of-use assets	$ 34,000
Lease liabilities	$ 34,000

Commitments and Contingencies_2

Commitments and Contingencies - ROU Assets and Lease Liabilities (Details) $ in Thousands	Mar. 31, 2019USD ($)
Operating Lease
Operating lease ROU assets	$ 53,295
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Operating lease ROU assets
Operating lease liabilities - current portion	$ 4,495
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other Liabilities, Current
Operating lease liabilities - non-current portion	$ 53,482
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Operating lease liabilities - non-current portion
Total operating lease liabilities	$ 57,977
Finance Lease
Finance lease ROU assets	$ 405
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Other Assets, Noncurrent
Finance lease liabilities - current portion	$ 208
Finance Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other Liabilities, Current
Finance lease liabilities - non-current portion	$ 199
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Other Liabilities, Noncurrent
Total finance lease liabilities	$ 407

Commitments and Contingencies_3

Commitments and Contingencies - Lease cost (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Lease cost
Operating lease cost	$ 1,830
Finance lease cost:
Amortization of right-of-use assets	53
Interest on lease liabilities	5
Short-term lease cost	16
Variable lease cost	380
Total lease cost	2,284
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases	1,689
Operating cash flows from finance leases	5
Financing cash flows from finance leases	51
Right-of-use assets obtained in exchange for new operating lease liabilities	54,634
Right-of-use assets obtained in exchange for new finance lease liabilities	$ 457
Weighted-average remaining lease term - operating leases	7 years 10 months 24 days
Weighted-average remaining lease term - finance leases	1 year 10 months 24 days
Weighted-average discount rate — operating leases	5.90%
Weighted-average discount rate — finance leases	4.50%

Commitments and Contingencies_4

Commitments and Contingencies - Maturity of lease liabilities (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Operating lease payments
2019 (remainder of year)	$ 5,807
2020	7,795
2021	8,630
2022	8,951
2023	10,001
2024 and thereafter	32,755
Total lease payments	73,939
Less imputed interest	(15,962)
Total lease liabilities	57,977
Finance lease payments
2019 (remainder of year)	166
2020	221
2021	37
Total lease payments	424
Less imputed interest	(17)
Total lease liabilities	407
Operating lease payments for options to extend lease terms that are reasonably certain of being exercised	$ 48,200

Stock-Based Compensation - (Sto

Stock-Based Compensation - (Stock Option Activity) (Details) - Stock Options $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)$ / sharesshares
Number of Shares
Options outstanding at the beginning of the period (in shares) | shares	3,083
Options granted (in shares) | shares	301
Options exercised (in shares) | shares	(413)
Options forfeited (in shares) | shares	(32)
Options outstanding at the end of the period (in shares) | shares	2,939
Exercisable at the end of the period (in shares) | shares	1,809
Vested and expected to vest at the end of the period (in shares) | shares	2,852
Weighted-Average Exercise Price
Options outstanding at the beginning of the period (in dollars per share) | $ / shares	$ 29.03
Options granted (in dollars per share) | $ / shares	72.42
Options exercised (in dollars per share) | $ / shares	23.90
Options forfeited (in dollars per share) | $ / shares	41.80
Options outstanding at the end of the period (in dollars per share) | $ / shares	34.06
Exercisable at the end of the period (in dollars per share) | $ / shares	28.75
Vested and expected to vest at the end of the period (in dollars per share) | $ / shares	$ 33.65
Weighted-Average Remaining Contractual Life
Options outstanding at the end of the period	6 years 9 months 18 days
Exercisable at the end of the period	5 years 8 months 12 days
Vested and expected to vest at the end of the period	6 years 9 months 18 days
Aggregate Intrinsic Value
Options outstanding at the end of the period (in dollars) | $	$ 106,537
Exercisable at the end of the period (in dollars) | $	74,704
Vested and expected to vest at the end of the period (in dollars) | $	$ 104,478

Stock-Based Compensation - (RSU

Stock-Based Compensation - (RSU Activity) (Details)	3 Months Ended
	Mar. 31, 2019$ / sharesshares
Weighted-Average Grant Date Fair Value
Shares Paid for Tax Withholding for Share Based Compensation	140,277
Restricted stock units
Number of Shares
Balance at the beginning of the period (in shares)	843,000
Granted (in shares)	275,000
Vested (in shares)	(373,000)
Cancelled (in shares)	(29,000)
Balance at the end of the period (in shares)	716,000
Weighted-Average Grant Date Fair Value
Balance at the beginning of the period (in dollars per share) | $ / shares	$ 31.70
Granted (in dollars per share) | $ / shares	75.64
Vested (in dollars per share) | $ / shares	29.74
Cancelled (in dollars per share) | $ / shares	42.68
Balance at the end of the period (in dollars per share) | $ / shares	$ 49.15

Stock-Based Compensation - (R_2

Stock-Based Compensation - (RSU Directors' Fees) (Details) - Restricted stock units	3 Months Ended
	Mar. 31, 2019USD ($)$ / sharesshares
Stock based compensation
Granted (in shares) | shares	275,000
Granted (in dollars per share) | $ / shares	$ 75.64
Outside directors
Stock based compensation
Granted (in shares) | shares	775
Fair value (in dollars) | $	$ 50,000
Granted (in dollars per share) | $ / shares	$ 64.41

Stock-Based Compensation - (Emp

Stock-Based Compensation - (Employee Stock Purchase Plan) (Details) - Employee Stock Purchase Plan	3 Months Ended
	Mar. 31, 2019USD ($)shares
Employee Stock Purchase Plan
Number of shares issued | shares	0
Unrecognized compensation expense (in dollars) | $	$ 366,000
Weighted-average period of recognition of unrecognized stock-based compensation expense	2 months

Stock-Based Compensation - (E_2

Stock-Based Compensation - (Employee Stock-Based Compensation Expense) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Stock-Based Compensation
Stock-based compensation expense (in dollars)	$ 6.3	$ 5.2

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)segmentproduct	Mar. 31, 2018USD ($)
Segment information
Number of business segments in which the entity operates | segment	1
Number of products from which the majority of the entity's product revenues have been derived | product	1
Total revenues	$ 108,769	$ 92,625
United States
Segment information
Total revenues	91,018	78,867
Outside of the United States
Segment information
Total revenues	$ 17,751	$ 13,758

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Income Taxes
Income tax expense	$ 267	$ 240
Unrecognized tax benefits	$ 6,700		$ 6,400

Restructuring (Details)

Restructuring (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2019
Restructuring
Reduction of workforce (as a percent)	10.00%
Non-cash asset impairments	$ 4.8	$ 0
Employee separation charges	3.7
Restructuring costs	$ 8.5	$ 0