CareDx (CDNA) 10-Q 30 Apr 20 2020 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2020	Apr. 28, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Transition Report	false
Entity File Number	001-36536
Entity Registrant Name	CAREDX, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	94-3316839
Entity Address, Address Line One	1 Tower Place
Entity Address, City or Town	South San Francisco
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94080
City Area Code	415
Local Phone Number	287-2300
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	CDNA
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		43,784,236
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001217234
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 32,191	$ 38,223
Accounts receivable	22,841	24,057
Inventory	6,947	6,014
Prepaid and other current assets	4,089	3,628
Total current assets	66,068	71,922
Property and equipment, net	5,501	4,430
Operating leases right-of-use assets	17,004	4,730
Intangible assets, net	43,112	45,541
Goodwill	23,857	23,857
Restricted cash	242	256
Other assets	1,000	1,000
Total assets	156,784	151,736
Current liabilities:
Accounts payable	6,621	5,506
Accrued compensation	6,127	12,484
Accrued and other liabilities	15,576	16,838
Total current liabilities	28,324	34,828
Deferred tax liability	1,502	1,973
Common stock warrant liability	1,017	6,607
Deferred payments for intangible assets	5,311	5,207
Operating lease liability, less current portion	17,503	2,370
Other liabilities	1,743	1,751
Total liabilities	55,400	52,736
Commitments and contingencies (Note 8)
Stockholders’ equity:
Preferred stock: $0.001 par value; 10,000,000 shares authorized at March 31, 2020 and December 31, 2019; no shares issued and outstanding at March 31, 2020 and December 31, 2019	0	0
Common stock: $0.001 par value; 100,000,000 shares authorized at March 31, 2020 and December 31, 2019; 43,019,547 shares and 42,498,430 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	42	42
Additional paid-in capital	447,888	437,976
Accumulated other comprehensive loss	(6,910)	(5,205)
Accumulated deficit	(339,636)	(333,813)
Total stockholders' equity	101,384	99,000
Total liabilities and stockholders’ equity	$ 156,784	$ 151,736

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	43,019,547	42,498,430
Common stock, shares outstanding (in shares)	43,019,547	42,498,430

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenue:
Total revenue	$ 38,380	$ 25,982
Cost of revenue	12,392	9,733
Gross profit	25,988	16,249
Operating expenses:
Research and development	10,013	5,614
Sales and marketing	11,723	6,925
General and administrative	10,003	9,106
Total operating expenses	31,739	21,645
Loss from operations	(5,751)	(5,396)
Other income (expense):
Interest income, net	96	342
Change in estimated fair value of common stock warrant liability	(405)	(3,009)
Other expense, net	(63)	(74)
Total other expense	(372)	(2,741)
Loss before income taxes	(6,123)	(8,137)
Income tax benefit	300	606
Net loss	$ (5,823)	$ (7,531)
Net loss per share (Note 3):
Basic (in dollars per share)	$ (0.14)	$ (0.18)
Diluted (in dollars per share)	$ (0.14)	$ (0.18)
Weighted-average shares used to compute net loss per share:
Basic (in shares)	42,823,427	41,611,399
Diluted (in shares)	42,823,427	41,611,399
Testing services revenue
Revenue:
Total revenue	$ 31,442	$ 21,518
Product revenue
Revenue:
Total revenue	4,695	4,433
Digital and other revenue
Revenue:
Total revenue	$ 2,243	$ 31

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net loss	$ (5,823)	$ (7,531)
Other comprehensive loss:
Foreign currency translation adjustments, net of tax	(1,705)	(724)
Net comprehensive loss	$ (7,528)	$ (8,255)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Loss	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2018		41,384,960
Beginning balance at Dec. 31, 2018	$ 95,928	$ 41	$ 412,010	$ (4,278)	$ (311,845)
Issuance of common stock under ESPP (in shares)		31,184
Issuance of common stock under ESPP	341		341
RSU settlements, net of shares withheld (in shares)		146,159
RSU settlements, net of shares withheld	(2,378)		(2,378)
Issuance of common stock for services (in shares)		2,112
Issuance of common stock for services	51		51
Issuance of common stock for cash upon exercise of stock options (in shares)		253,347
Issuance of common stock for cash upon exercise of stock options	1,365		1,365
Issuance of common stock for cash upon exercise of warrants (in shares)		94,707
Issuance of common stock for cash upon exercise of warrants	2,569		2,569
Employee share-based compensation expense	6,001		6,001
Foreign currency translation adjustment	(724)			(724)
Net loss	(7,531)				(7,531)
Ending balance (in shares) at Mar. 31, 2019		41,912,469
Ending balance at Mar. 31, 2019	95,622	$ 41	419,959	(5,002)	(319,376)
Beginning balance (in shares) at Dec. 31, 2019		42,498,430
Beginning balance at Dec. 31, 2019	99,000	$ 42	437,976	(5,205)	(333,813)
Issuance of common stock under ESPP (in shares)		38,147
Issuance of common stock under ESPP	699		699
RSU settlements, net of shares withheld (in shares)		139,552
RSU settlements, net of shares withheld	(1,507)		(1,507)
Issuance of common stock for services (in shares)		3,091
Issuance of common stock for services	$ 66		66
Issuance of common stock for cash upon exercise of stock options (in shares)	44,861	44,861
Issuance of common stock for cash upon exercise of stock options	$ 155		155
Issuance of common stock for cash upon exercise of warrants (in shares)		295,466
Issuance of common stock for cash upon exercise of warrants	6,299		6,299
Employee share-based compensation expense	4,200		4,200
Foreign currency translation adjustment	(1,705)			(1,705)
Net loss	(5,823)				(5,823)
Ending balance (in shares) at Mar. 31, 2020		43,019,547
Ending balance at Mar. 31, 2020	$ 101,384	$ 42	$ 447,888	$ (6,910)	$ (339,636)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net loss	$ (5,823)	$ (7,531)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation	4,259	6,053
Revaluation of common stock warrant liability to estimated fair value	405	3,009
Depreciation and amortization	1,619	1,161
Amortization of right-of-use assets	612	372
Revaluation of contingent consideration to estimated fair value	190	0
Changes in operating assets and liabilities:
Accounts receivable	2,346	(2,782)
Inventory	(1,343)	(372)
Prepaid and other assets	(545)	(541)
Operating leases liabilities, net	(344)	(475)
Accounts payable	1,757	(449)
Accrued compensation	(5,914)	(4,249)
Accrued and other liabilities	48	202
Change in deferred taxes	(322)	(265)
Net cash used in operating activities	(3,055)	(5,867)
Investing activities:
Purchase of property and equipment, net	(1,704)	(543)
Net cash used in investing activities	(1,704)	(543)
Financing activities:
Proceeds from issuance of common stock under employee stock purchase plan	358	341
Taxes paid related to net share settlement of restricted stock units	(1,507)	(2,378)
Proceeds from exercise of warrants	304	78
Proceeds from exercise of stock options	155	1,365
Principal payments on debt and finance lease obligations	(45)	(42)
Net cash used in financing activities	(735)	(688)
Effect of exchange rate changes on cash and cash equivalents	(552)	(87)
Net decrease in cash, cash equivalents and restricted cash	(6,046)	(7,185)
Cash, cash equivalents, and restricted cash at beginning of period	38,479	64,808
Cash, cash equivalents, and restricted cash at end of period	32,433	57,623
Cash, Cash Equivalents and Restricted Cash as of:
Total cash, cash equivalents and restricted cash at the end of period	32,433	57,623
Conexio
Financing activities:
Contingent payments related to the acquisition of Conexio Genomics Pty Ltd.	$ 0	$ (52)

Organization and Description of

Organization and Description of Business	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Description of Business	ORGANIZATION AND DESCRIPTION OF BUSINESS CareDx, Inc. (“CareDx” or the “Company”) together with its subsidiaries, is a leading precision medicine company focused on the discovery, development and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. The Company’s headquarters are in South San Francisco, California. The primary operations are in Brisbane, California; Omaha, Nebraska; Fremantle, Australia and Stockholm, Sweden. The Company’s commercially available testing services consist of AlloSure ® Kidney, which is a donor-derived cell-free DNA (“dd-cfDNA”) solution for kidney transplant patients, and AlloMap ® Heart, which is a gene expression solution for heart transplant patients. The Company has initiated several clinical studies to generate data on its existing and planned future testing services. The Company also offers high quality products that increase the chance of successful transplants by facilitating a better match between a donor and a recipient of stem cells and organs. In 2019, the Company began providing digital solutions to transplant centers following the acquisitions of Ottr Complete Transplant Management (“OttrCare”) and XynManagement, Inc. (“XynManagement”). Testing Services In October 2017, the Company commercially launched AlloSure Kidney, its proprietary next generation sequencing-based test that measures dd-cfDNA in kidney transplant recipients. The Medicare reimbursement rate for AlloSure Kidney is currently $2,841 . AlloSure Kidney has also received payment from private payers on a case-by-case basis, with the first private payer, BCBS of South Carolina, issuing a positive coverage decision in its October 2019 review. AlloMap Heart has been a covered service for Medicare beneficiaries since January 1, 2006. The Medicare reimbursement rate for AlloMap Heart is currently $3,240. Al loMap Heart has also received positive coverage decisions from many of the largest U.S. private payers. Clinical Studies In January 2018, the Company initiated the Kidney Allograft Outcomes AlloSure Kidney Registry study (“K-OAR”), to develop additional data on the clinical utility of AlloSure Kidney for surveillance of kidney transplant recipients. K-OAR is a multicenter, non-blinded, prospective observational cohort study which has enrolled more than 1,500 renal transplant patients who will receive AlloSure Kidney long-term surveillance. In September 2018, the Company initiated the Surveillance HeartCare ™ Outcomes Registry (“SHORE”). SHORE is a prospective, multi-center, observational registry of patients receiving HeartCare for surveillance. HeartCare combines the gene expression profiling technology of AlloMap Heart with the dd-cfDNA analysis of AlloSure ® Heart in one surveillance solution. In August 2019, AlloSure Heart received a positive draft Local Coverage Determination for Medicare coverage. In February 2019, AlloSure ® Lung was made available for lung transplant patients through a compassionate use program while the test is undergoing further studies. In September 2019, the Company announced the commencement of the Outcomes of KidneyCare on Renal Allografts (“OKRA”) study, which is an extension of K-OAR. OKRA is a prospective, multi-center, observational, registry of patients receiving KidneyCare for surveillance. KidneyCare combines the dd-cfDNA analysis of AlloSure Kidney with the gene expression profiling technology of AlloMap Kidney and the predictive artificial intelligence technology of KidneyCare iBox developing a multimodality surveillance solution. The Company has not yet made any applications to payers for reimbursement coverage of AlloMap Kidney or KidneyCare iBox. Products TruSight HLA is a next generation sequencing (“NGS”)-based high resolution typing solution that provides NGS-level resolution to Human Leukocyte Antigen (“HLA”) typing. The Company’s suite of AlloSeq products are commercial NGS-based kitted solutions that the Company acquired as a result of its license agreement with Illumina, Inc. (“Illumina”) . These products include: AlloSeq ™ Tx, a high-resolution HLA typing solution, AlloSeq ™ cfDNA, a surveillance solution designed to measure dd-cfDNA in blood to detect active rejection in transplant recipients, and AlloSeq ™ HCT, a solution for chimerism testing for stem cell transplant recipients. Olerup SSP ® is used to type HLA alleles, based on the sequence specific primer (“SSP”) technology. Olerup SBT ™ is a complete product range for sequence-based typing of HLA alleles. QTYPE ® enables HLA typing at a low to intermediate resolution for samples that require a fast turnaround time and uses real-time polymerase chain reaction, or PCR methodology. Digital and Other Following the acquisitions of both OttrCare and XynManagement, the Company is a leading provider of transplant patient tracking software (“Ottr software”), as well as of transplant quality tracking and waitlist management solutions. Ottr software provides comprehensive solutions for transplant patient management and enables integration with electronic medical record ("EMR") systems providing patient surveillance management tools and outcomes data to transplant centers. XynManagement provides two unique solutions, XynQAPI software (“XynQAPI”) and Waitlist Management. XynQAPI simplifies transplant quality tracking and Scientific Registry of Transplant Recipients (“SRTR”) reporting. Waitlist Management includes a team of transplant assistants who maintain regular contact with patients on the waitlist to help prepare for their transplant and maintain eligibility. COVID-19 Outbreak On January 30, 2020, the World Health Organization (the “WHO”) announced a global health emergency because of a new strain of coronavirus originating in Wuhan, China (the “COVID-19 outbreak”) and the risks to the international community as the virus spreads globally beyond its point of origin. In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally. The full impact of the COVID-19 outbreak, including the impact associated with preventative and precautionary measures that the Company, other businesses and governments are taking, continues to evolve as of the date of this report. As such, it is uncertain as to the full magnitude that the pandemic will have on the Company, but the pandemic may materially affect the Company's financial condition, liquidity and future results of operations. With hospitals increasingly caring for COVID-19 patients, hospital administrators have chosen to limit, or even defer, non-emergency procedures. Immunosuppressed transplant patients either self-prescribed or were asked to avoid transplant centers and caregiver visits to reduce the risk of contracting COVID-19. With transplant surveillance visits down, the Company experienced a slowdown in testing services volumes in the final weeks of March and during April 2020. As a response to the COVID-19 outbreak, and to enable immune-compromised transplant patients to continue to have their blood drawn, in late March 2020 the Company launched RemoTraC, a remote home-based blood draw solution using mobile phlebotomy for AlloSure and AlloMap surveillance tests, as well as for other standard monitoring tests. To date, more than 140 transplant centers can offer RemoTraC to their patients and over 2,000 kidney, heart, and lung transplant patients have enrolled. Based on existing and new relationships with partners, the Company has established a nationwide network of more than 10,000 mobile phlebotomists. In April 2020, the Company partnered with an international consortium, which includes the National Institutes of Health (NIH) and the European Society of Transplantation (ESOT), to initiate the C19TxR registry to provide real-time analytics and insights on transplant patients with COVID-19. The Company is maintaining its testing, manufacturing, and distribution facilities while implementing specific protocols to reduce contact among employees. In areas where COVID-19 impacts healthcare operations, the Company’s field-based sales and clinical support teams are supporting providers through telephone and online platforms. To reduce the risk to employees and their families from potential exposure to COVID-19, most of the Company’s employees have been required to work from home. The Company has also restricted non-essential business travel to protect the health and safety of its employees, patients, and customers. Liquidity and Going Concern The Company has incurred significant losses and negative cash flows from operations since its inception and had an accumulated deficit of $339.6 million at March 31, 2020. As of March 31, 2020, the Company had cash and cash equivalents of $32.2 million. The Company may require additional financing in the future to fund working capital and the Company's future product developments. Additional financing might include issuance of equity securities, debt, or cash. There can be no assurance that the Company will be successful in acquiring additional funding at levels sufficient to fund its operations or on terms favorable to the Company. The Company believes its existing cash balance and expected revenues will be sufficient to meet its anticipated cash requirements for the next 12 months. See Note 14, Subsequent Events, regarding certain liquidity events that occurred after March 31, 2020.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIESThe significant accounting policies and estimates used in preparation of the unaudited condensed consolidated financial statements are described in the Company’s audited consolidated financial statements as of and for the year ended December 31, 2019, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019. Material changes to the significant accounting policies previously disclosed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 are reflected below. Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”), and follow the requirements of the Securities and Exchange Commission (the “SEC”) for interim reporting. As permitted under those rules, certain notes and other financial information that are normally required by U.S. GAAP can be condensed or omitted. These unaudited condensed consolidated financial statements have been prepared on the same basis as the Company’s annual consolidated financial statements and, in the opinion of management, reflect all adjustments, consisting only of normal recurring adjustments that are necessary for a fair statement of the Company’s financial information. The condensed consolidated balance sheet as of December 31, 2019 has been derived from audited consolidated financial statements as of that date but does not include all of the financial information required by U.S. GAAP for complete financial statements. Operating results for the three months ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. Reclassifications and Changes in Presentation Certain prior period amounts have been reclassified to conform with the current period presentation, including: (i) combined presentation of cost of testing services, cost of product, and cost of digital, and (ii) separate presentation of gross profit. These reclassifications had no effect on the reported results of operations. Use of Estimates The preparation of unaudited condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities and the reported amounts of revenues and expenses in the unaudited condensed consolidated financial statements and accompanying notes. On an ongoing basis, management evaluates its estimates, including those related to transaction price estimates used for testing services revenue; standalone fair value of digital revenue performance obligations; accrued expenses for clinical studies; inventory valuation; the fair value of issued common stock warrants and embedded derivatives; the fair value of assets and liabilities acquired in a business combination or an assets acquisition (including identifiable intangible assets acquired); the fair value of contingent consideration recorded in connection with a business combination; the grant date fair value assumptions used to estimate stock-based compensation expense; income taxes; impairment of long-lived assets and indefinite-lived assets (including goodwill); and legal contingencies. Actual results could differ from those estimates. Concentrations of Credit Risk and Other Risks and Uncertainties For the three months ended March 31, 2020 and 2019, approximately 53% and 55% respectively, of total revenue was derived from Medicare. No other payers or customers represented more than 10% of total revenue for these periods. As of March 31, 2020 and December 31, 2019, approximately 20% and 36%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable on either March 31, 2020 or December 31, 2019. Leases Effective January 1, 2019, the Company adopted Accounting Standard Codification (“ASC”) Topic 842, Leases using the optional transition method and applied the standard only to leases that existed at that date. The Company determines if an arrangement is or contains a lease at contract inception. A right-of-use (“ROU”) asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the condensed consolidated balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the ROU asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. Short-term leases with an initial term of 12 months or less are not recorded on the balance sheet. The present value of lease payments is determined by using the interest rate implicit in the lease, if that rate is readily determinable; otherwise, the Company uses its incremental borrowing rate. The Company’s leases have remaining terms of 0.25 years to 8.92 years, some of which include options to extend the lease term. Recent Accounting Pronouncements In August 2018, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2018-15, Intangibles – Goodwill and Other – Internal – Use Software (ASC Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract (“ASU 2018-15”). ASU 2018-15 became effective for fiscal years beginning after December 15, 2019 and interim periods therein. Early adoption of ASU 2018-15 is permitted including adoption in any interim period. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a material impact on the Company’s condensed consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (ASC Topic 820) (“ASU 2018-13”), which modifies, removes and adds certain disclosure requirements on fair value measurements based on the FASB Concepts Statement, Conceptual Framework for Financial Reporting—Chapter 8: Notes to Financial Statements. ASU 2018-13 is effective for the Company’s interim and annual reporting periods during the year ending December 31, 2020, and all annual and interim reporting periods thereafter. The amendments on changes in unrealized gains and losses, the range and weighted-average of significant unobservable inputs used to develop Level 3 fair value measurements and the narrative description of measurement uncertainty should be applied prospectively for only the most recent interim or annual period presented in the initial fiscal year of adoption. All other amendments should be applied retrospectively to all periods presented upon their effective date. Early adoption is permitted upon issuance of ASU 2018-13. An entity is permitted to early adopt any removed or modified disclosures upon issuance of ASU 2018-13 and delay adoption of the additional disclosures until their effective date. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a significant impact on the Company's condensed consolidated financial statements. In March 2017, the FASB issued ASU No. 2016-13, Measurement of Credit Losses on Financial Instruments (ASC Topic 326) (“ASU 2016-13”) , which amends the FASB’s guidance on the impairment of financial instruments. The ASU adds to U.S. GAAP an impairment model known as the current expected credit loss (“CECL”) model, which is based on expected losses rather than incurred losses. Under the new guidance, an entity recognizes as an allowance its estimate of lifetime expected credit losses, which the FASB believes will result in more timely recognition of such losses. The new CECL standard is effective for public companies for annual reporting periods beginning after December 15, 2019, and interim periods therein. ASU 2016-13 has a greater impact on banks. However, nonbank entities that have financial instruments or other assets such as trade receivables, contract assets, lease receivables, financial guarantees, loans and loan commitments, and held-to-maturity debt securities are subject to the CECL model. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a significant impact on the Company's condensed consolidated financial statements.

Net Loss Per Share

Net Loss Per Share	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Net Loss Per Share	NET LOSS PER SHARE Basic and diluted net loss per share have been computed by dividing the net loss by the weighted-average number of common shares outstanding during the period, without consideration of common share equivalents as their effect would have been antidilutive. The following tables set forth the computation of the Company’s basic and diluted net loss per share (in thousands, except shares and per share data): Three Months Ended March 31, 2020 2019 Numerator: Net loss used to compute basic and diluted net loss per share $ (5,823) $ (7,531) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 42,823,427 41,611,399 Net loss per share: Basic and diluted $ (0.14) $ (0.18) The following potentially dilutive securities have been excluded from diluted net loss per share as at March 31, 2020 and 2019 because their effect would be antidilutive: Three Months Ended March 31, 2020 2019 Shares of common stock subject to outstanding options 2,845,862 2,536,412 Shares of common stock subject to outstanding common stock warrants 49,006 530,627 Restricted stock units 1,502,012 1,034,484 Total common stock equivalents 4,396,880 4,101,523

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTS The Company records its financial assets and liabilities at fair value. The carrying amounts of certain financial instruments of the Company, including cash and cash equivalents, prepaid expenses and other current assets, accounts payable and accrued liabilities, approximate fair value due to their relatively short maturities. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The accounting guidance establishes a three-tiered hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value as follows: • Level 1: Inputs that include quoted prices in active markets for identical assets and liabilities. • Level 2: Inputs other than Level 1 that are observable, either directly or indirectly, 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. • 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. The following table sets forth the Company’s financial assets and liabilities measured at fair value on a recurring basis, as of March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 22,761 $ — $ — $ 22,761 Liabilities Common stock warrant liability $ — $ — $ 1,017 $ 1,017 December 31, 2019 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 29,177 $ — $ — $ 29,177 Liabilities Common stock warrant liability $ — $ — $ 6,607 $ 6,607 The following table presents the issuances, exercises, changes in fair value and reclassifications of the Company’s Level 3 financial instruments that are measured at fair value on a recurring basis (in thousands): (Level 3) Common Stock Warrant Liability Balance as of December 31, 2019 $ 6,607 Exercise of warrants (5,995) Change in estimated fair value 405 Balance as of March 31, 2020 $ 1,017 The Company recognizes transfers between levels of the fair value hierarchy as of the end of the reporting period. There were no transfers between Level 1, Level 2 and Level 3 categories during the periods presented. In determining fair value, the Company uses various valuation approaches within the fair value measurement framework. The valuation methodologies used for the Company’s instruments measured at fair value and their classification in the valuation hierarchy are summarized below: • Money market funds – Investments in money market funds are classified within Level 1. Money market funds are valued at the closing price reported by the fund sponsor from an actively traded exchange. At March 31, 2020 and December 31, 2019, money market funds were included as cash and cash equivalents in the condensed consolidated balance sheets. • Common stock warrant liability – The Company utilizes a binomial-lattice pricing model (the “Monte Carlo Simulation Model”) that involves a market condition simulation to estimate the fair value of the warrants. The application of the Monte Carlo Simulation Model requires the use of a number of complex assumptions including the Company’s stock price, expected life of the warrants, stock price volatility determined from the Company’s historical stock prices and stock prices of peer companies in the diagnostics industry, and risk-free rates based on the implied yield currently available in the U.S. Treasury zero-coupon issues with a remaining term equal to the expected life of the warrants. Increases (decreases) in the assumptions discussed above result in a directionally similar impact to the fair value of the common stock warrant liability. Common Stock Warrant Liability Valuation Assumptions: March 31, 2020 December 31, 2019 Private Placement Common Stock Warrant Liability Stock Price $ 21.83 $ 21.57 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 3.04 3.29 Volatility 83.00% 81.00% Risk-free interest rate 0.29% 1.62%

Business Combinations

Business Combinations	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Business Combinations	BUSINESS COMBINATIONS OttrCare On May 7, 2019, the Company acquired 100% of the outstanding common stock of OttrCare for total consideration of $16.1 million. OttrCare was formed in 1993 and is a leading provider of organ transplant patient tracking software. The Ottr software provides comprehensive solutions for transplant patient management and enables integration with EMR systems providing patient surveillance management tools and outcomes data to transplant centers. The Company accounted for the transaction as a business combination using the acquisition method of accounting. Results of operations of OttrCare have been included with the Company’s results since the date of the acquisition. Acquisition-related costs of $0.6 million associated with the acquisition were expensed as incurred, and classified as part of general and administrative expenses in the condensed consolidated statement of operations. Goodwill of $10.2 million arising from the acquisition primarily consists of synergies from integrating the Ottr software with transplant center EMR systems and the current testing solutions offered by the Company. Goodwill synergies also arise from acquired workforce know-how of transplant centers workflow. None of the goodwill is expected to be deductible for income tax purposes. All of the goodwill has been assigned to the Company’s existing operating segment. The following table summarizes the consideration paid for OttrCare and the provisional amounts of the assets acquired and liabilities assumed recognized at their estimated fair value at the acquisition date (in thousands): Total Consideration Cash $ 16,037 Accrued purchase consideration 111 Total consideration $ 16,148 Recognized amounts of identifiable assets acquired and Current assets $ 1,525 Fixed assets 35 Identifiable intangible assets 6,600 Current liabilities (2,210) Total identifiable net assets acquired 5,950 Goodwill 10,198 Total consideration $ 16,148 The allocation of the purchase price to assets acquired and liabilities assumed was based on the Company’s best estimate of the fair value of such assets and liabilities as of the acquisition date. The fair value of the acquired current liabilities as of June 30, 2019 included a preliminary deferred revenue balance of $2.3 million. During the three months ended September 30, 2019, the Company recorded an adjustment of $0.5 million to the initial valuation amount of deferred revenue, decreasing its balance to $1.8 million as of the acquisition date. This change is a result of updated assumptions and methodologies for acquired software maintenance contracts. As part of this adjustment, goodwill decreased by approximately $0.5 million. At the acquisition date the Company estimated net deferred tax assets of approximately $0.2 million arising from temporary differences related to assets acquired and liabilities assumed. The Company estimated that OttrCare had net operating losses (“NOLs”) carryforward of approximately $6.9 million, $4.3 million of which will begin to expire in 2033, and the remaining $2.6 million will be carried forward indefinitely. A full valuation allowance of $0.2 million was recognized as of the acquisition date resulting in no impact from deferred taxes to OttrCare’s opening balance. An Internal Revenue Code Section 382 study for NOLs was finalized during the third quarter of 2019 and deferred taxes acquired are finalized as of December 31, 2019. The following table summarizes the fair values of the intangible assets acquired as of the acquisition date ($ in thousands): Estimated Fair Value Estimated Useful Lives (Years) Customer relationships $ 4,200 15 Developed technology 2,300 10 Trademark 100 2 Total $ 6,600 Customer relationships acquired by the Company represent the fair value of future projected revenue that is expected to be derived from sales of OttrCare’s products to existing customers. The customer relationships’ fair value has been estimated utilizing a multi-period excess earnings method under the income approach, which reflects the present value of the projected cash flows that are expected to be generated by the customer relationships, less charges representing the contribution of other assets to those cash flows that use projected cash flows with and without the intangible asset in place. The economic useful life was determined based on the distribution of the present value of the cash flows attributable to the intangible asset. The acquired developed technology represents the fair value of OttrCare’s proprietary software. The trademark acquired consists primarily of the OttrCare brand and markings. The fair value of both the developed technology and the trademark were determined using the relief-from-royalty method under the income approach. This method considers the value of the asset to be the value of the royalty payments from which the Company is relieved of due to its ownership of the asset. The royalty rates of 15.0% and 1.0% were used to estimate the fair value of the developed technology and the trademark, respectively. The Company utilized a discount rate of 14.5% in estimating the fair value of these three intangible assets. As of March 31, 2020 , OttrCare’s digital revenue of $1.7 million was included in the Company’s unaudited condensed consolidated statement of operations for the three months ended March 31, 2020 . Unaudited supplemental pro forma information is not disclosed because it is considered immaterial. XynManagement

Goodwill and Intangible Assets

Goodwill and Intangible Assets	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	GOODWILL AND INTANGIBLE ASSETS Goodwill Goodwill is recorded when the purchase price of an acquisition exceeds the fair value of the net tangible and identified intangible assets acquired. Goodwill is tested annually for impairment at the reporting unit level during the fourth quarter or earlier upon the occurrence of certain events or substantive changes in circumstances. There were no indicators of impairment in the three months ended March 31, 2020. The following table presents details of the Company's goodwill for the three months ended March 31, 2020 (in thousands): Total Balance as of January 1, 2020 $ 23,857 Goodwill acquired — Balance as of March 31, 2020 $ 23,857 Intangible Assets The following tables present details of the Company’s intangible assets as of March 31, 2020 ($ in thousands): March 31, 2020 Gross Accumulated Foreign Net Carrying Weighted Average Remaining Intangible assets with finite lives: Acquired and developed technology $ 29,106 $ (7,063) $ (2,480) $ 19,563 9.4 Customer relationships 18,168 (3,709) (2,051) 12,408 11.6 Commercialization rights 8,079 (433) — 7,646 9.4 Trademarks and tradenames 2,360 (663) (305) 1,392 10.4 Total intangible assets with finite lives $ 57,713 $ (11,868) $ (4,836) $ 41,009 Acquired in-process technology 2,103 — — 2,103 Total intangible assets $ 59,816 $ (11,868) $ (4,836) $ 43,112 The following table presents details of the Company’s intangible assets as of December 31, 2019 ($ in thousands): 12/31/2019 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life (In Years) Intangible assets with finite lives: Acquired and developed technology $ 29,106 $ (6,473) $ (1,852) $ 20,781 8.2 Customer relationships 18,168 (3,397) (1,498) 13,273 10.1 Commercialization rights 8,079 (231) — 7,848 9.7 Trademarks and tradenames 2,360 (618) (206) 1,536 9.1 Total intangible assets with finite lives $ 57,713 $ (10,719) $ (3,556) $ 43,438 Acquired in-process technology 2,103 — — 2,103 Total intangible assets $ 59,816 $ (10,719) $ (3,556) $ 45,541 Acquisition of intangible assets Cibiltech License and Commercialization Agreement Effective April 30, 2019, the Company entered into a license and commercialization agreement (the “Cibiltech Agreement”) with Cibiltech SAS (“Cibiltech”). Cibiltech is a French company engaged in the development and support of predictive medicine and artificial intelligence software, services and technology, with an emphasis on personalized patient care and clinical research, including its proprietary software and service offering known in the U.S. as KidneyCare iBox for the predictive analysis of post-transplantation kidney allograft loss. The Cibiltech Agreement provides the Company with an irrevocable, non-transferable right to commercialize Cibiltech’s proprietary software in the field of transplantation in the U.S. for a period of ten years. The Company estimated the fair value of the acquired commercialization rights intangible asset based on expected contractual payments discounted to present value using a discount rate of 6%. In September 2019, the Company initiated the OKRA clinical study, which incorporates KidneyCare iBox. On such date, the Company commenced amortization of the acquired commercialization intangible asset. On July 26, 2019, pursuant to the Cibiltech Agreement, the Company purchased $1.0 million of convertible preferred shares of Cibiltech, which is recorded in other assets. The Company does not have a significant influence on Cibiltech’s operations. The net carrying amount of intangible assets and the related amortization expense of intangible assets may change due to the effects of foreign currency fluctuations as a result of acquiring an entity with a functional currency other than the U.S. dollar. Amortization expense was $1.1 million and $0.6 million for the three months ended March 31, 2020 and 2019, respectively. For the three months ended March 31, 2020, expenses of $0.8 million and $0.3 million were amortized to cost of revenue and sales and marketing expense, respectively. For the three months ended March 31, 2019, expenses of $0.3 million and $0.3 million were amortized to cost of product and sales and marketing expense, respectively. The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of March 31, 2020 (in thousands): Years Ending December 31, Cost of Sales and Total Remainder of 2020 $ 2,341 $ 1,048 $ 3,389 2021 3,081 1,209 4,290 2022 3,081 1,192 4,273 2023 3,081 1,192 4,273 2024 3,081 1,192 4,273 Thereafter 12,547 7,964 20,511 Total future amortization expense $ 27,212 $ 13,797 $ 41,009

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	BALANCE SHEET COMPONENTS Inventory Inventory consisted of the following (in thousands): March 31, December 31, 2019 Finished goods $ 1,347 $ 1,236 Work in progress 1,685 1,189 Raw materials 3,915 3,589 Total inventory $ 6,947 $ 6,014 Accrued and other liabilities Accrued and other liabilities consisted of the following (in thousands): March 31, December 31, 2019 Deferred revenue $ 3,482 $ 3,686 Clinical studies 4,084 3,068 Deferred payments for intangible assets 2,038 2,098 Short-term lease liability 1,570 3,017 Test sample processing fees 884 835 Accrued royalty 562 547 Contingent consideration 970 810 Professional fees 609 766 Other accrued expenses 1,377 2,011 Total accrued and other liabilities $ 15,576 $ 16,838

Commitments

Commitments	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	COMMITMENTS AND CONTINGENCIES Leases The Company leases its operating and office facilities for various terms under long-term, non-cancelable operating lease agreements in South San Francisco, California; Brisbane, California; West Chester, Pennsylvania; Fremantle, Australia; and Stockholm, Sweden. The Company also leases equipment under finance lease agreements. The lease for the Company’s facility in Vienna, Austria is on a month-to-month basis. On January 2, 2020, the Company executed the second amendment to the operating lease agreement for the building located at Brisbane, California. The building is mainly utilized for laboratory operations and research and development. The lease will be extended for a period of eight years and two months starting on January 1, 2021. The Company has determined that the amendment constitutes a lease modification effective January 1, 2020. The Company's facility leases expire at various dates through 2029. In the normal course of business, it is expected that these leases will be renewed or replaced by leases on other properties. As of March 31, 2020, the carrying value of the ROU asset was $17.0 million. The related current and non-current liabilities as of March 31, 2020 were $1.6 million and $17.5 million, respectively. The current and non-current lease liabilities are included in accrued and other current liabilities and operating lease liability, less current portion, respectively, in the condensed consolidated balance sheets. The following table summarizes the lease cost for the three months ended March 31, 2020 and 2019 (in thousands): Three Months Ended 2020 2019 Operating lease cost $ 1,119 $ 435 Finance lease cost 53 56 Total lease cost $ 1,172 $ 491 Finance lease cost includes interest from the lease liability and amortization of the ROU asset. Other information: Weighted-average remaining lease term - Operating leases (in years) 7.07 Weighted-average remaining lease term - Finance leases (in years) 1.08 Weighted-average discount rate - Operating leases (%) 10.5% Weighted-average discount rate - Finance leases (%) 6.5% Rent expense under non-cancelable operating leases was $1.2 million and $0.4 million for the three months ended March 31, 2020 and 2019, respectively. Future minimum lease commitments under these operating and finance leases as of March 31, 2020, are as follows (in thousands): Year Ending December 31, Finance Operating Remainder of 2020 $ 157 $ 2,514 2021 71 3,511 2022 — 3,963 2023 — 2,811 2024 — $ 2,909 Thereafter — $ 13,267 Total future minimum lease payments $ 228 $ 28,975 The current portion of obligations under finance leases is included in accrued and other liabilities on the condensed consolidated balance sheets. The long-term portion is included in other liabilities on the condensed consolidated balance sheets. Royalty Commitments The Board of Trustees of the Leland Stanford Junior University (“Stanford”) In June 2014, the Company entered into a license agreement with Stanford (the “Stanford License”), which granted the Company an exclusive license to a patent relating to the diagnosis of rejection in organ transplant recipients using dd-cfDNA. Under the terms of the Stanford License, the Company is required to pay an annual license maintenance fee, six milestone payments and royalties in the low single digits of net sales of products incorporating the licensed technology. Illumina On May 4, 2018, the Company entered into a license agreement with Illumina (the “License Agreement”). The License Agreement requires the Company to pay royalties in the mid-single to low-double digits on sales of products covered by the License Agreement. Cibiltech Commitments Pursuant to the Cibiltech Agreement, the Company will share an agreed-upon percentage of revenue with Cibiltech, if and when revenues are generated from KidneyCare iBox. Other Commitments Pursuant to the License Agreement with Illumina, the Company is obligated to complete timely development and commercialization of other NGS product lines for use in the field of bone marrow and solid organ transplantation diagnostic testing, and has agreed to minimum purchase commitments of finished products and raw materials from Illumina through 2023. Litigation and Indemnification Obligations In response to the Company's false advertising suit filed against Natera Inc. (“Natera”), on April 10, 2019, Natera filed a counterclaim against the Company on February 18, 2020, in the U.S. District Court for the District of Delaware alleging the Company made false and misleading claims about the performance capabilities of AlloSure. In addition, in response to the Company's patent infringement suit filed against Natera on March 26, 2019, Natera filed suit against the Company on January 13, 2020, in the U.S. District Court for the District of Delaware alleging, among other things, that AlloSure infringes Natera’s U.S. Patent 10,526,658. On March 25, 2020, Natera filed an amendment to the suit alleging, among other things, that AlloSure infringes Natera’s U.S. Patent 10,597,724. The suit seeks a judgment that the Company has infringed Natera’s patents, an order preliminarily and permanently enjoining the Company from any further infringement of such patent and unspecified damages. The Company intends to defend both of these matters vigorously, and believes that the Company has good and substantial defenses to the claims alleged in the suits, but there is no guarantee that the Company will prevail. The Company has not recorded any liabilities for these suits. From time to time, the Company may become involved in litigation and other legal actions. The Company estimates the range of liability related to any pending litigation where the amount and range of loss can be estimated. The Company records its best estimate of a loss when the loss is considered probable. Where a liability is probable and there is a range of estimated loss with no best estimate in the range, the Company records a charge equal to at least the minimum estimated liability for a loss contingency when both of the following conditions are met: (i) information available prior to issuance of the condensed consolidated financial statements indicates that it is probable that a liability had been incurred at the date of the condensed consolidated financial statements and (ii) the range of loss can be reasonably estimated. In the normal course of business, the Company enters into contracts and agreements that contain a variety of representations and warranties and provide for indemnification for certain liabilities. The exposure under these agreements is unknown because it involves claims that may be made against the Company in the future but have not yet been made. To date, the Company has not paid any claims or been required to defend any action related to its indemnification obligations. However, the Company may record charges in the future as a result of these indemnification obligations. The Company also has indemnification obligations to its directors and executive officers for specified events or occurrences, subject to some limits, while they are serving at the Company’s request in such capacities. There have been no claims to date and the Company believes the fair value of these indemnification agreements is minimal. Accordingly, the Company has not recorded any liabilities for these agreements as of March 31, 2020 and as of December 31, 2019.

Plan 401(K)

Plan 401(K)	3 Months Ended
	Mar. 31, 2020
Retirement Benefits [Abstract]
Plan 401(K)	401(K) PLANThe Company sponsors a 401(k) defined contribution plan covering all U.S. employees under the Internal Revenue Code of 1986, as amended. Employee contributions are voluntary and are determined on an individual basis subject to the maximum allowable under federal tax regulations. On January 1, 2018, the Company began to make contributions to the employee plan.  The Company incurred expenses related to contributions to the plan of $0.3 million and $0.2 million for the three months ended March 31, 2020 and 2019, respectively.

Warrants

Warrants	3 Months Ended
	Mar. 31, 2020
Warrants and Rights Note Disclosure [Abstract]
Warrants	WARRANTS The Company has issued common stock warrants in connection with debt or equity financings to lenders, placement agents and investors. Issued warrants are considered standalone financial instruments and the terms of each warrant are analyzed for equity or liability classification in accordance with U.S. GAAP. Warrants that are classified as liabilities usually have various features that would require net-cash settlement by the Company. Warrants that are not liabilities, derivatives and/or meet the exception criteria are classified as equity. Warrants liabilities are remeasured at fair value at each period end with changes in fair value recorded in the condensed consolidated statements of operations until expired or exercised. Warrants that are classified as equity are valued at their relative fair value on the date of issuance, recorded in additional paid in capital and not remeasured. In the three months ended March 31, 2020, warrants to purchase approximately 272,000 shares of common stock were exercised for cash payments of $0.3 million. During the three months ended March 31, 2020, a warrant to purchase approximately 34,000 shares of common stock was exercised on a cashless basis and approximately 24,000 shares were issued pursuant to the exercise. In the three months ended March 31, 2019, warrants to purchase approximately 70,000 shares of common stock were exercised for cash proceeds of less than $0.1 million. The warrant liability was remeasured prior to the exercise and a change in fair value of $0.5 million was recorded in the condensed consolidated statement of operations. During the three months ended March 31, 2019 warrants to purchase approximately 56,000 shares of common stock were exercised on a cashless basis and approximately 25,000 shares were issued. As of March 31, 2020, outstanding warrants to purchase common stock were: Classified as Original Term Exercise Price Number of Shares Original issue date: April 2016 Liability 7 years $ 1.12 49,006 49,006

Stock Incentive Plans

Stock Incentive Plans	3 Months Ended
	Mar. 31, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Incentive Plans	STOCK INCENTIVE PLANS Stock Options and Restricted Stock Units (“RSU”) The following table summarizes option and RSU activity under the Company’s 2014 Equity Incentive Plan, 2016 Inducement Equity Incentive Plan, and 2019 Inducement Equity Incentive Plan, and related information: Shares Stock Weighted- Number of Weighted- Balance—December 31, 2019 504,775 2,609,848 $ 16.47 1,516,285 $ 22.51 Additional options authorized 1,699,549 — — — — Common stock awards for services (3,091) — — — — RSUs granted (294,481) — — 294,481 23.98 RSUs vested — — — (267,029) 23.12 Options granted (332,400) 334,900 24.00 — — Options exercised — (44,861) 3.46 — — Repurchase of common stock under employee incentive plans 67,477 — — — — RSUs forfeited 41,725 — — (41,725) 26.48 Options forfeited 43,762 (43,762) 25.75 — — Options expired 10,263 (10,263) 4.76 — — Balance—March 31, 2020 1,737,579 2,845,862 $ 17.46 1,502,012 $ 22.68 The total intrinsic value of options exercised was $0.7 million and $6.0 million in the three months ended March 31, 2020 and 2019, respectively. As of March 31, 2020, the total intrinsic value of outstanding RSUs was approximately $32.4 million and there were $26.2 million of unrecognized compensation costs related to RSUs, which are expected to be recognized over a weighted-average period of 2.77 years. Options outstanding that have vested and are expected to vest at March 31, 2020 are as follows: Number of Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Vested 1,144 $ 10.72 6.61 $ 13,952 Expected to vest 1,576 21.96 8.90 5,311 Total 2,720 $ 19,263 The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock at March 31, 2020 for stock options that were in-the-money. The total fair value of options that vested during the three month period ended March 31, 2020 was $2.4 million. As of March 31, 2020, there were approximately $20.1 million of unrecognized compensation costs related to stock options, which are expected to be recognized over a weighted-average period of 3.04 years. 2014 Employee Stock Purchase Plan The Company has an Employee Stock Purchase Plan (the “ESPP”), under which employees can purchase shares of its common stock based on a percentage of their compensation, but not greater than 15% of their respective earnings; provided, however, an eligible employee’s right to purchase shares of the Company’s common stock may not accrue at a rate which exceeds $25,000 of the fair market value of such shares for each calendar year in which such rights are outstanding. The ESPP has consecutive offering periods of approximately six months in length. The purchase price per share must be equal to the lower of 85% of the fair value of the common stock on the first day of the offering period or on the exercise date. During the offering period in 2019 that ended on December 31, 2019, 38,147 shares were purchased for aggregate proceeds of $0.7 million from the issuance of shares, which occurred on January 2, 2020. During the offering period in 2019 that ended on June 30, 2019, 20,528 shares were purchased for aggregate proceeds of $0.4 million from the issuance of shares, which occurred on July 1, 2019. Valuation Assumptions The estimated fair values of employee stock options and ESPP shares were estimated using the Black-Scholes option pricing model based on the following weighted average assumptions: Three Months Ended March 31, 2020 2019 Employee stock options Expected term (in years) 6.0 6.0 Expected volatility 74.00% 70.33% Risk-free interest rate 1.35% 2.57% Expected dividend yield —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 Expected volatility 62.56% 76.66% Risk-free interest rate 1.57% 2.51% Expected dividend yield —% —% Risk-free Interest Rate : The Company based the risk-free interest rate over the expected term of the award based on the constant maturity rate of U.S. Treasury securities with similar maturities as of the date of grant. Volatility: The Company used an average historical stock price volatility of its own stock and those comparable public companies that were deemed to be representative of future stock price trends. Expected Term: The expected term represents the period for which the Company’s stock-based compensation awards are expected to be outstanding and is based on analyzing the vesting and contractual terms of the awards and the holders’ historical exercise patterns and termination behavior. Expected Dividends: The Company has not paid and does not anticipate paying any dividends in the near future. Stock-based Compensation Expense The following table summarizes stock-based compensation expense relating to employee and nonemployee stock-based awards for the three months ended March 31, 2020 and 2019, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended March 31, 2020 2019 Cost of revenue $ 365 $ 776 Research and development 810 832 Sales and marketing 971 727 General and administrative 2,113 3,718 Total $ 4,259 $ 6,053 No tax benefit was recognized related to share-based compensation expense since the Company has never reported taxable income and has established a full valuation allowance to offset all of the potential tax benefits associated with its deferred tax assets. In addition, no amounts of stock-based compensation expense were capitalized for the periods presented.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	INCOME TAXESThe Company’s effective tax rate may vary from the U.S. federal statutory tax rate due to the change in the mix of earnings in tax jurisdictions with different statutory rates, benefits related to tax credits and the tax impact of non-deductible expenses and other permanent differences between income before income taxes and taxable income. For the three months ended March 31, 2020 and 2019, the Company recorded an income tax benefit of $0.3 million and $0.6 million, respectively. The income tax benefit of $0.3 million is primarily attributable to the recognition of deferred tax assets from foreign losses and acquired deferred tax liabilities that generate a source of income for the recognition of deferred tax assets previously not recognized. The Company assesses the realizability of its net deferred tax assets by evaluating all available evidence, both positive and negative, including (i) cumulative results of operations in recent years, (ii) sources of recent losses, (iii) estimates of future taxable income, and (iv) the length of net operating loss carryforward periods. The Company believes that based on the history of its U.S. losses and other factors, the weight of available evidence indicates that it is more likely than not that it will not be able to realize its U.S. net deferred tax assets. The Company has also placed a valuation allowance on the net deferred tax assets of its Australian operations. Accordingly, the U.S. and Australia net deferred tax assets have been offset by a full valuation allowance. Starting in 2018, companies may be subject to global intangible low tax income (“GILTI”), which is a tax on foreign income in excess of a deemed return on tangible assets of foreign corporations as well as the new base erosion anti-abuse tax (“BEAT”) under the Tax Act. GILTI will be effectively taxed at a tax rate of 10.5%. Due to the complexity of the GILTI tax rules, companies are allowed to make an accounting policy choice of either (1) treating taxes due on future U.S. inclusions in taxable income related to GILTI as a current-period expense when incurred or (2) factoring such amounts into a company’s measurement of its deferred taxes. The Company has not made an election with respect to GILTI and does not believe that GILTI will have a material impact on the Company’s 2020 taxes. The Company will continue to review the GILTI and BEAT rules to determine their applicability to the Company and the impact that the rules may have on the Company's results of operations and financial condition.

Segment Reporting

Segment Reporting	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Segment Reporting	SEGMENT REPORTING Operating segments are defined as components of an enterprise for which separate financial information is available that is evaluated regularly by the Company’s Chief Operating Decision Maker (“CODM”), or decision making group, whose function is to allocate resources to and assess the performance of the operating segments. The Company has identified its Chief Executive Officer as the CODM. In determining its reportable segments, the Company considered the markets and types of customers served and the products or services provided in those markets. The Company operates in a single reportable segment. Revenues by geographic regions are based upon the customers’ ship-to address for product revenue and the region of testing for testing services revenue. The following table summarizes reportable revenues by geographic regions (in thousands): Three Months Ended March 31, 2020 2019 Testing services revenue United States $ 31,329 $ 21,386 Rest of World 113 132 $ 31,442 $ 21,518 Product revenue United States $ 2,061 $ 1,832 Europe 2,002 1,943 Rest of World 632 658 $ 4,695 $ 4,433 Digital and other revenue United States $ 2,183 $ 22 Europe 30 9 Rest of World 30 — $ 2,243 $ 31 Total United States $ 35,573 $ 23,240 Total Europe $ 2,032 $ 1,952 Total Rest of World $ 775 $ 790 Total $ 38,380 $ 25,982 The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands): March 31, 2020 December 31, 2019 Long-lived assets: United States $ 4,583 $ 3,346 Europe 406 509 Rest of World 512 575 Total $ 5,501 $ 4,430

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS Accelerated and Advance Payment Program for Medicare Providers On March 27, 2020 the U.S. government enacted the Coronavirus Aid, Relief, and Economic Security (the “CARES Act”). Pursuant to the CARES Act, the Centers for Medicare & Medicaid Services (“CMS”) expanded its current Accelerated and Advance Payment Program in order to increase cash flow to providers of services and suppliers impacted by the COVID-19 outbreak. An accelerated/advance payment is a payment intended to provide necessary funds when there is a disruption in claims submission and/or claims processing. CMS is authorized to provide accelerated or advance payments during the period of the public health emergency to any Medicare provider who submits a request to the appropriate Medicare Administrative Contractor, and meets the required qualifications. During April 2020, the Company received an advance payment from CMS of approximately $20.5 million. The Company will continue to submit claims as usual after the issuance of the advance payment. The Company will receive full payments for its claims during the 120-day period from the date the advance payment was received. At the end of the 120-day period, the recoupment process will begin and every claim submitted by the Company will be offset to repay the advance payment. Thus, instead of receiving payment for newly submitted claims, the Company’s outstanding advance payment balance will be reduced by the claim payment amount. The Company will have up to 210 days for the repayment to be completed. At-the-Market Equity Offering Program On August 31, 2018, the Company entered into a sales agreement (the “Sales Agreement”) with Jefferies, LLC, (“Jefferies”), pursuant to which the Company may offer and sell, from time to time, through Jefferies, up to $50.0 million in shares of the Company's common stock, by any method permitted by law deemed to be an “at-the-market” offering as defined in Rule 415 promulgated under the Securities Act of 1933, as amended. During April 2020, the Company issued and sold 1,000,000 shares of the Company's common stock under the Sales Agreement. The shares were sold at an average price of $24.24 per share for aggregate net proceeds to the Company of approximately $23.5 million, after deducting sales commissions and offering costs payable by the Company. Provider Relief Fund for Medicare Providers Pursuant to the CARES Act, the U.S. Department of Health & Human Services will distribute an initial tranche of $30.0 billion in funds to healthcare providers that received Medicare fee-for-service (“FFS”) reimbursements in 2019. These payments to healthcare providers are not loans and will not be required to be repaid. Providers will be distributed a portion of the initial $30.0 billion based on their share of total Medicare FFS reimbursements made by the U.S. in 2019. During April 2020, the Company received a payment of approximately $4.8 million, representing the Company's portion of the initial tranche of funds.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Liquidity and Going Concern	Liquidity and Going Concern The Company has incurred significant losses and negative cash flows from operations since its inception and had an accumulated deficit of $339.6 million at March 31, 2020. As of March 31, 2020, the Company had cash and cash equivalents of $32.2 million. The Company may require additional financing in the future to fund working capital and the Company's future product developments. Additional financing might include issuance of equity securities, debt, or cash. There can be no assurance that the Company will be successful in acquiring additional funding at levels sufficient to fund its operations or on terms favorable to the Company. The Company believes its existing cash balance and expected revenues will be sufficient to meet its anticipated cash requirements for the next 12 months. See Note 14, Subsequent Events, regarding certain liquidity events that occurred after March 31, 2020.
Basis of Presentation	Basis of Presentation The accompanying unaudited condensed consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”), and follow the requirements of the Securities and Exchange Commission (the “SEC”) for interim reporting. As permitted under those rules, certain notes and other financial information that are normally required by U.S. GAAP can be condensed or omitted. These unaudited condensed consolidated financial statements have been prepared on the same basis as the Company’s annual consolidated financial statements and, in the opinion of management, reflect all adjustments, consisting only of normal recurring adjustments that are necessary for a fair statement of the Company’s financial information. The condensed consolidated balance sheet as of December 31, 2019 has been derived from audited consolidated financial statements as of that date but does not include all of the financial information required by U.S. GAAP for complete financial statements. Operating results for the three months ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020.
Reclassifications and Changes in Presentation	Reclassifications and Changes in Presentation Certain prior period amounts have been reclassified to conform with the current period presentation, including: (i) combined presentation of cost of testing services, cost of product, and cost of digital, and (ii) separate presentation of gross profit. These reclassifications had no effect on the reported results of operations.
Use of Estimates	Use of Estimates The preparation of unaudited condensed consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities and the reported amounts of revenues and expenses in the unaudited condensed consolidated financial statements and accompanying notes. On an ongoing basis, management evaluates its estimates, including those related to transaction price estimates used for testing services revenue; standalone fair value of digital revenue performance obligations; accrued expenses for clinical studies; inventory valuation; the fair value of issued common stock warrants and embedded derivatives; the fair value of assets and liabilities acquired in a business combination or an assets acquisition (including identifiable intangible assets acquired); the fair value of contingent consideration recorded in connection with a business combination; the grant date fair value assumptions used to estimate stock-based compensation expense; income taxes; impairment of long-lived assets and indefinite-lived assets (including goodwill); and legal contingencies. Actual results could differ from those estimates.
Concentrations of Credit Risk and Other Risks and Uncertainties	Concentrations of Credit Risk and Other Risks and Uncertainties For the three months ended March 31, 2020 and 2019, approximately 53% and 55% respectively, of total revenue was derived from Medicare. No other payers or customers represented more than 10% of total revenue for these periods. As of March 31, 2020 and December 31, 2019, approximately 20% and 36%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable on either March 31, 2020 or December 31, 2019.
Leases	Leases Effective January 1, 2019, the Company adopted Accounting Standard Codification (“ASC”) Topic 842, Leases using the optional transition method and applied the standard only to leases that existed at that date. The Company determines if an arrangement is or contains a lease at contract inception. A right-of-use (“ROU”) asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the condensed consolidated balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the ROU asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. Short-term leases with an initial term of 12 months or less are not recorded on the balance sheet. The present value of lease payments is determined by using the interest rate implicit in the lease, if that rate is readily determinable; otherwise, the Company uses its incremental borrowing rate.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In August 2018, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2018-15, Intangibles – Goodwill and Other – Internal – Use Software (ASC Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract (“ASU 2018-15”). ASU 2018-15 became effective for fiscal years beginning after December 15, 2019 and interim periods therein. Early adoption of ASU 2018-15 is permitted including adoption in any interim period. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a material impact on the Company’s condensed consolidated financial statements. In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (ASC Topic 820) (“ASU 2018-13”), which modifies, removes and adds certain disclosure requirements on fair value measurements based on the FASB Concepts Statement, Conceptual Framework for Financial Reporting—Chapter 8: Notes to Financial Statements. ASU 2018-13 is effective for the Company’s interim and annual reporting periods during the year ending December 31, 2020, and all annual and interim reporting periods thereafter. The amendments on changes in unrealized gains and losses, the range and weighted-average of significant unobservable inputs used to develop Level 3 fair value measurements and the narrative description of measurement uncertainty should be applied prospectively for only the most recent interim or annual period presented in the initial fiscal year of adoption. All other amendments should be applied retrospectively to all periods presented upon their effective date. Early adoption is permitted upon issuance of ASU 2018-13. An entity is permitted to early adopt any removed or modified disclosures upon issuance of ASU 2018-13 and delay adoption of the additional disclosures until their effective date. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a significant impact on the Company's condensed consolidated financial statements. In March 2017, the FASB issued ASU No. 2016-13, Measurement of Credit Losses on Financial Instruments (ASC Topic 326) (“ASU 2016-13”) , which amends the FASB’s guidance on the impairment of financial instruments. The ASU adds to U.S. GAAP an impairment model known as the current expected credit loss (“CECL”) model, which is based on expected losses rather than incurred losses. Under the new guidance, an entity recognizes as an allowance its estimate of lifetime expected credit losses, which the FASB believes will result in more timely recognition of such losses. The new CECL standard is effective for public companies for annual reporting periods beginning after December 15, 2019, and interim periods therein. ASU 2016-13 has a greater impact on banks. However, nonbank entities that have financial instruments or other assets such as trade receivables, contract assets, lease receivables, financial guarantees, loans and loan commitments, and held-to-maturity debt securities are subject to the CECL model. The Company adopted the standard on January 1, 2020. The adoption of the new standard did not have a significant impact on the Company's condensed consolidated financial statements.

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Loss Per Share	The following tables set forth the computation of the Company’s basic and diluted net loss per share (in thousands, except shares and per share data): Three Months Ended March 31, 2020 2019 Numerator: Net loss used to compute basic and diluted net loss per share $ (5,823) $ (7,531) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 42,823,427 41,611,399 Net loss per share: Basic and diluted $ (0.14) $ (0.18)
Potentially Dilutive Securities Excluded from Diluted Net Loss Per Share	The following potentially dilutive securities have been excluded from diluted net loss per share as at March 31, 2020 and 2019 because their effect would be antidilutive: Three Months Ended March 31, 2020 2019 Shares of common stock subject to outstanding options 2,845,862 2,536,412 Shares of common stock subject to outstanding common stock warrants 49,006 530,627 Restricted stock units 1,502,012 1,034,484 Total common stock equivalents 4,396,880 4,101,523

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2020
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities Measured on Recurring Basis	The following table sets forth the Company’s financial assets and liabilities measured at fair value on a recurring basis, as of March 31, 2020 and December 31, 2019 (in thousands): March 31, 2020 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 22,761 $ — $ — $ 22,761 Liabilities Common stock warrant liability $ — $ — $ 1,017 $ 1,017 December 31, 2019 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 29,177 $ — $ — $ 29,177 Liabilities Common stock warrant liability $ — $ — $ 6,607 $ 6,607
Summary of Issuances, Exercises, Changes in Fair Value and Reclassifications of Level 3 Financial Instruments	The following table presents the issuances, exercises, changes in fair value and reclassifications of the Company’s Level 3 financial instruments that are measured at fair value on a recurring basis (in thousands): (Level 3) Common Stock Warrant Liability Balance as of December 31, 2019 $ 6,607 Exercise of warrants (5,995) Change in estimated fair value 405 Balance as of March 31, 2020 $ 1,017
Summary of Common Stock Warrant Liability Valuation Assumptions	Common Stock Warrant Liability Valuation Assumptions: March 31, 2020 December 31, 2019 Private Placement Common Stock Warrant Liability Stock Price $ 21.83 $ 21.57 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 3.04 3.29 Volatility 83.00% 81.00% Risk-free interest rate 0.29% 1.62%

Business Combinations (Tables)

Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2020
Business Combinations [Abstract]
Summary of Consideration Paid and Preliminary Amounts of Assets Acquired and Liabilities Assumed Recognized	The following table summarizes the consideration paid for OttrCare and the provisional amounts of the assets acquired and liabilities assumed recognized at their estimated fair value at the acquisition date (in thousands): Total Consideration Cash $ 16,037 Accrued purchase consideration 111 Total consideration $ 16,148 Recognized amounts of identifiable assets acquired and Current assets $ 1,525 Fixed assets 35 Identifiable intangible assets 6,600 Current liabilities (2,210) Total identifiable net assets acquired 5,950 Goodwill 10,198 Total consideration $ 16,148
Summary of Identified Intangible Assets Acquired at Acquisition Date	The following table summarizes the fair values of the intangible assets acquired as of the acquisition date ($ in thousands): Estimated Fair Value Estimated Useful Lives (Years) Customer relationships $ 4,200 15 Developed technology 2,300 10 Trademark 100 2 Total $ 6,600

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Goodwill	The following table presents details of the Company's goodwill for the three months ended March 31, 2020 (in thousands): Total Balance as of January 1, 2020 $ 23,857 Goodwill acquired — Balance as of March 31, 2020 $ 23,857
Summary of Intangible Assets	The following tables present details of the Company’s intangible assets as of March 31, 2020 ($ in thousands): March 31, 2020 Gross Accumulated Foreign Net Carrying Weighted Average Remaining Intangible assets with finite lives: Acquired and developed technology $ 29,106 $ (7,063) $ (2,480) $ 19,563 9.4 Customer relationships 18,168 (3,709) (2,051) 12,408 11.6 Commercialization rights 8,079 (433) — 7,646 9.4 Trademarks and tradenames 2,360 (663) (305) 1,392 10.4 Total intangible assets with finite lives $ 57,713 $ (11,868) $ (4,836) $ 41,009 Acquired in-process technology 2,103 — — 2,103 Total intangible assets $ 59,816 $ (11,868) $ (4,836) $ 43,112 The following table presents details of the Company’s intangible assets as of December 31, 2019 ($ in thousands): 12/31/2019 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life (In Years) Intangible assets with finite lives: Acquired and developed technology $ 29,106 $ (6,473) $ (1,852) $ 20,781 8.2 Customer relationships 18,168 (3,397) (1,498) 13,273 10.1 Commercialization rights 8,079 (231) — 7,848 9.7 Trademarks and tradenames 2,360 (618) (206) 1,536 9.1 Total intangible assets with finite lives $ 57,713 $ (10,719) $ (3,556) $ 43,438 Acquired in-process technology 2,103 — — 2,103 Total intangible assets $ 59,816 $ (10,719) $ (3,556) $ 45,541
Summary of Estimated Future Amortization Expense of Intangible Assets	The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of March 31, 2020 (in thousands): Years Ending December 31, Cost of Sales and Total Remainder of 2020 $ 2,341 $ 1,048 $ 3,389 2021 3,081 1,209 4,290 2022 3,081 1,192 4,273 2023 3,081 1,192 4,273 2024 3,081 1,192 4,273 Thereafter 12,547 7,964 20,511 Total future amortization expense $ 27,212 $ 13,797 $ 41,009

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Inventory	Inventory consisted of the following (in thousands): March 31, December 31, 2019 Finished goods $ 1,347 $ 1,236 Work in progress 1,685 1,189 Raw materials 3,915 3,589 Total inventory $ 6,947 $ 6,014
Components of Accrued and Other Liabilities	Accrued and other liabilities consisted of the following (in thousands): March 31, December 31, 2019 Deferred revenue $ 3,482 $ 3,686 Clinical studies 4,084 3,068 Deferred payments for intangible assets 2,038 2,098 Short-term lease liability 1,570 3,017 Test sample processing fees 884 835 Accrued royalty 562 547 Contingent consideration 970 810 Professional fees 609 766 Other accrued expenses 1,377 2,011 Total accrued and other liabilities $ 15,576 $ 16,838

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Summary of Lease Cost	The following table summarizes the lease cost for the three months ended March 31, 2020 and 2019 (in thousands): Three Months Ended 2020 2019 Operating lease cost $ 1,119 $ 435 Finance lease cost 53 56 Total lease cost $ 1,172 $ 491 Finance lease cost includes interest from the lease liability and amortization of the ROU asset. Other information: Weighted-average remaining lease term - Operating leases (in years) 7.07 Weighted-average remaining lease term - Finance leases (in years) 1.08 Weighted-average discount rate - Operating leases (%) 10.5% Weighted-average discount rate - Finance leases (%) 6.5%
Future Minimum Lease Commitments under Operating and Finance Leases	Future minimum lease commitments under these operating and finance leases as of March 31, 2020, are as follows (in thousands): Year Ending December 31, Finance Operating Remainder of 2020 $ 157 $ 2,514 2021 71 3,511 2022 — 3,963 2023 — 2,811 2024 — $ 2,909 Thereafter — $ 13,267 Total future minimum lease payments $ 228 $ 28,975

Warrants (Tables)

Warrants (Tables)	3 Months Ended
	Mar. 31, 2020
Warrants and Rights Note Disclosure [Abstract]
Components of Warrants Outstanding	As of March 31, 2020, outstanding warrants to purchase common stock were: Classified as Original Term Exercise Price Number of Shares Original issue date: April 2016 Liability 7 years $ 1.12 49,006 49,006

Stock Incentive Plans (Tables)

Stock Incentive Plans (Tables)	3 Months Ended
	Mar. 31, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Summary of Option, Unvested RSU Activity under 2014 Equity Incentive Plan and 2016 Inducement Equity Incentive Plan and Related Information	The following table summarizes option and RSU activity under the Company’s 2014 Equity Incentive Plan, 2016 Inducement Equity Incentive Plan, and 2019 Inducement Equity Incentive Plan, and related information: Shares Stock Weighted- Number of Weighted- Balance—December 31, 2019 504,775 2,609,848 $ 16.47 1,516,285 $ 22.51 Additional options authorized 1,699,549 — — — — Common stock awards for services (3,091) — — — — RSUs granted (294,481) — — 294,481 23.98 RSUs vested — — — (267,029) 23.12 Options granted (332,400) 334,900 24.00 — — Options exercised — (44,861) 3.46 — — Repurchase of common stock under employee incentive plans 67,477 — — — — RSUs forfeited 41,725 — — (41,725) 26.48 Options forfeited 43,762 (43,762) 25.75 — — Options expired 10,263 (10,263) 4.76 — — Balance—March 31, 2020 1,737,579 2,845,862 $ 17.46 1,502,012 $ 22.68
Summary of Options Outstanding and Exercisable Vested or Expected to Vest	Options outstanding that have vested and are expected to vest at March 31, 2020 are as follows: Number of Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Vested 1,144 $ 10.72 6.61 $ 13,952 Expected to vest 1,576 21.96 8.90 5,311 Total 2,720 $ 19,263
Weighted-Average Assumptions Used to Estimate Fair Values of Share-Based Awards	The estimated fair values of employee stock options and ESPP shares were estimated using the Black-Scholes option pricing model based on the following weighted average assumptions: Three Months Ended March 31, 2020 2019 Employee stock options Expected term (in years) 6.0 6.0 Expected volatility 74.00% 70.33% Risk-free interest rate 1.35% 2.57% Expected dividend yield —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 Expected volatility 62.56% 76.66% Risk-free interest rate 1.57% 2.51% Expected dividend yield —% —%
Summary of Expense Relating to Employee and Nonemployee Stock-Based Payment Awards from Stock Options and RSUs	The following table summarizes stock-based compensation expense relating to employee and nonemployee stock-based awards for the three months ended March 31, 2020 and 2019, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended March 31, 2020 2019 Cost of revenue $ 365 $ 776 Research and development 810 832 Sales and marketing 971 727 General and administrative 2,113 3,718 Total $ 4,259 $ 6,053

Segment Reporting (Tables)

Segment Reporting (Tables)	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Reportable Revenues by Geographic Regions	Revenues by geographic regions are based upon the customers’ ship-to address for product revenue and the region of testing for testing services revenue. The following table summarizes reportable revenues by geographic regions (in thousands): Three Months Ended March 31, 2020 2019 Testing services revenue United States $ 31,329 $ 21,386 Rest of World 113 132 $ 31,442 $ 21,518 Product revenue United States $ 2,061 $ 1,832 Europe 2,002 1,943 Rest of World 632 658 $ 4,695 $ 4,433 Digital and other revenue United States $ 2,183 $ 22 Europe 30 9 Rest of World 30 — $ 2,243 $ 31 Total United States $ 35,573 $ 23,240 Total Europe $ 2,032 $ 1,952 Total Rest of World $ 775 $ 790 Total $ 38,380 $ 25,982
Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions	The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands): March 31, 2020 December 31, 2019 Long-lived assets: United States $ 4,583 $ 3,346 Europe 406 509 Rest of World 512 575 Total $ 5,501 $ 4,430

Organization and Description _2

Organization and Description of Business - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2020USD ($)patientcenteruniqueSolutionphlebotomist	Dec. 31, 2019USD ($)	Jan. 31, 2018patient
Schedule of Capitalization, Equity [Line Items]
Number of renal transplant patients | patient			1,500
Accumulated deficit	$ 339,636,000	$ 333,813,000
Cash and cash equivalents	$ 32,191,000	$ 38,223,000
Number of transplant centers offering RemoTraC | center	140
Number of patients enrolled in RemoTraC | patient	2,000
Number of mobile phlebotomists | phlebotomist	10,000
Medicare | AlloSure Kidney
Schedule of Capitalization, Equity [Line Items]
Reimbursement rate	$ 2,841
Medicare | AlloMap Heart
Schedule of Capitalization, Equity [Line Items]
Reimbursement rate	$ 3,240
XynManagement, Inc.
Schedule of Capitalization, Equity [Line Items]
Number of unique solutions | uniqueSolution	2

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Concentration of Credit Risk (Detail) - Medicare	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Revenues | Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage	53.00%	55.00%
Accounts Receivable | Credit Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage	20.00%		36.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Leases (Detail)	Jan. 01, 2019
Minimum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	3 months
Maximum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	8 years 11 months 1 day

Net Loss Per Share - Computatio

Net Loss Per Share - Computation of Basic and Diluted Net Loss Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Numerator:
Net loss	$ (5,823)	$ (7,531)
Denominator:
Weighted average number of shares outstanding basic and diluted (in shares)	42,823,427	41,611,399
Net loss per share:
Basic and diluted (in dollars per share)	$ (0.14)	$ (0.18)

Net Loss Per Share - Potentiall

Net Loss Per Share - Potentially Dilutive Securities Excluded from Diluted Net Loss Per Share (Detail) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential dilutive securities excluded from diluted net loss per share attributable to common stockholders (in shares)	4,396,880	4,101,523
Shares of common stock subject to outstanding options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential dilutive securities excluded from diluted net loss per share attributable to common stockholders (in shares)	2,845,862	2,536,412
Shares of common stock subject to outstanding common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential dilutive securities excluded from diluted net loss per share attributable to common stockholders (in shares)	49,006	530,627
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential dilutive securities excluded from diluted net loss per share attributable to common stockholders (in shares)	1,502,012	1,034,484

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Recurring - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Assets
Money market funds	$ 22,761	$ 29,177
Liabilities
Common stock warrant liability	1,017	6,607
Fair Value Measured Using - (Level 1)
Assets
Money market funds	22,761	29,177
Liabilities
Common stock warrant liability	0	0
Fair Value Measured Using - (Level 2)
Assets
Money market funds	0	0
Liabilities
Common stock warrant liability	0	0
Fair Value Measured Using - (Level 3)
Assets
Money market funds	0	0
Liabilities
Common stock warrant liability	$ 1,017	$ 6,607

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Issuances, Exercises, Changes in Fair Value and Reclassifications of Level 3 Financial Instruments (Detail) - Common Stock Warrants Liability - (Level 3) - Common Stock Warrant Liability $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Significant Unobservable Inputs (Level 3) [Line Items]
Beginning balance	$ 6,607
Exercise of warrants	(5,995)
Change in estimated fair value	405
Ending balance	$ 1,017

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of Common Stock Warrant Liability Valuation Assumptions (Detail) - Private Placement Common Stock Warrant Liability	3 Months Ended	12 Months Ended
	Mar. 31, 2020$ / shares	Dec. 31, 2019$ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Stock price (in dollars per share)	$ 21.83	$ 21.57
Exercise Price
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Exercise price (in dollars per share)	$ 1.12	$ 1.12
Remaining Term (in years)
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Remaining term (in years)	3 years 14 days	3 years 3 months 14 days
Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input	83	81
Risk Free Interest Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input	0.29	1.62

Business Combinations - Additio

Business Combinations - Additional Information (Detail) - USD ($)	Aug. 26, 2019	May 07, 2019	Mar. 31, 2020	Sep. 30, 2019	Dec. 31, 2019	Jun. 30, 2019
Business Acquisition [Line Items]
Goodwill		$ 10,200,000	$ 23,857,000		$ 23,857,000
Royalty Rate | Developed Technology
Business Acquisition [Line Items]
Rate used in estimating fair value		15
Royalty Rate | Trademarks
Business Acquisition [Line Items]
Rate used in estimating fair value		1
Discount Rate
Business Acquisition [Line Items]
Rate used in estimating fair value		14.5
OTTR Complete Transplant Management
Business Acquisition [Line Items]
Percentage of outstanding equity acquired		100.00%
Total consideration		$ 16,148,000
Goodwill		10,198,000
Goodwill expected to be deductible for income tax purposes		0
Deferred revenue				$ 1,800,000		$ 2,300,000
Deferred revenue adjustment				500,000
Goodwill decrease				$ 500,000
Net deferred tax assets related to assets acquired and liabilities assumed		200,000
Net operating losses carryforward		6,900,000
Net operating losses carryforward expires in future		4,300,000
Operating loss carry forwards with indefinite carry forward period		2,600,000
Valuation allowance		200,000
OTTR Complete Transplant Management | Digital and other revenue
Business Acquisition [Line Items]
Digital revenue			$ 1,700,000
OTTR Complete Transplant Management | General and Administrative Expense
Business Acquisition [Line Items]
Acquisition related costs		$ 600,000
XynManagement, Inc.
Business Acquisition [Line Items]
Percentage of outstanding equity acquired	100.00%
Total consideration	$ 2,000,000
Goodwill	1,700,000
Contingent consideration	1,400,000
Intangible assets	$ 2,100,000

Business Combinations - Summary

Business Combinations - Summary of Consideration Paid and Provisional Amounts of Assets Acquired and Liabilities Assumed Recognized at Their Estimated Fair Value (Detail) - USD ($) $ in Thousands	May 07, 2019	Mar. 31, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill	$ 10,200	$ 23,857	$ 23,857
OTTR Complete Transplant Management
Business Acquisition [Line Items]
Cash	16,037
Accrued purchase consideration	111
Total consideration	16,148
Current assets	1,525
Fixed assets	35
Identifiable intangible assets	6,600
Current liabilities	(2,210)
Total identifiable net assets acquired	5,950
Goodwill	10,198
Total consideration	$ 16,148

Business Combinations - Summa_2

Business Combinations - Summary of Identified Intangible Assets Acquired at Acquisition Date (Detail) - USD ($) $ in Thousands	May 07, 2019	Mar. 31, 2020	Dec. 31, 2019
OTTR Complete Transplant Management
Business Acquisition [Line Items]
Estimated Fair Value	$ 6,600
Customer Relationships
Business Acquisition [Line Items]
Estimated Useful Lives (Years)		11 years 7 months 6 days	10 years 1 month 6 days
Customer Relationships | OTTR Complete Transplant Management
Business Acquisition [Line Items]
Estimated Fair Value	$ 4,200
Estimated Useful Lives (Years)	15 years
Developed Technology | OTTR Complete Transplant Management
Business Acquisition [Line Items]
Estimated Fair Value	$ 2,300
Estimated Useful Lives (Years)	10 years
Trademarks | OTTR Complete Transplant Management
Business Acquisition [Line Items]
Estimated Fair Value	$ 100
Estimated Useful Lives (Years)	2 years

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Summary of Goodwill (Detail) $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill beginning balance	$ 23,857
Goodwill acquired	0
Goodwill ending balance	$ 23,857

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Intangible assets with finite lives:
Gross Carrying Amount	$ 57,713	$ 57,713
Accumulated Amortization	(11,868)	(10,719)
Foreign Currency Translation	(4,836)	(3,556)
Total	41,009	43,438
Intangible Assets, Net (Excluding Goodwill)
Total intangible assets - gross carrying amount	59,816	59,816
Total intangible assets, net	43,112	45,541
Acquired and developed technology
Intangible assets with finite lives:
Gross Carrying Amount	29,106	29,106
Accumulated Amortization	(7,063)	(6,473)
Foreign Currency Translation	(2,480)	(1,852)
Total	$ 19,563	$ 20,781
Weighted Average Remaining Useful Life (In Years)	9 years 4 months 24 days	8 years 2 months 12 days
Customer relationships
Intangible assets with finite lives:
Gross Carrying Amount	$ 18,168	$ 18,168
Accumulated Amortization	(3,709)	(3,397)
Foreign Currency Translation	(2,051)	(1,498)
Total	$ 12,408	$ 13,273
Weighted Average Remaining Useful Life (In Years)	11 years 7 months 6 days	10 years 1 month 6 days
Commercialization rights
Intangible assets with finite lives:
Gross Carrying Amount	$ 8,079	$ 8,079
Accumulated Amortization	(433)	(231)
Foreign Currency Translation	0	0
Total	$ 7,646	$ 7,848
Weighted Average Remaining Useful Life (In Years)	9 years 4 months 24 days	9 years 8 months 12 days
Trademarks and tradenames
Intangible assets with finite lives:
Gross Carrying Amount	$ 2,360	$ 2,360
Accumulated Amortization	(663)	(618)
Foreign Currency Translation	(305)	(206)
Total	$ 1,392	$ 1,536
Weighted Average Remaining Useful Life (In Years)	10 years 4 months 24 days	9 years 1 month 6 days
Acquired in-process technology
Intangible assets with indefinite lives
Net carrying amount	$ 2,103	$ 2,103

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Additional Information (Detail) $ in Millions	Apr. 30, 2019	Mar. 31, 2020USD ($)	Mar. 31, 2019USD ($)	Jul. 26, 2019USD ($)	May 07, 2019
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets		$ 1.1	$ 0.6
Cost of Product
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets		0.8	0.3
Sales and Marketing Expense
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets		$ 0.3	$ 0.3
Cibiltech Agreement | Cibiltech
Goodwill And Intangible Assets [Line Items]
Commercialization rights of intangible assets term	10 years
Cibiltech Agreement | Cibiltech | Convertible Preferred Shares
Goodwill And Intangible Assets [Line Items]
Purchases under license and commercialization agreement				$ 1
Discount Rate
Goodwill And Intangible Assets [Line Items]
Rate used in estimating fair value					14.5
Discount Rate | Commercialization rights | Cibiltech Agreement | Cibiltech
Goodwill And Intangible Assets [Line Items]
Rate used in estimating fair value	0.06

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of Estimated Future Amortization Expense of Intangible Assets with Finite Lives (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	$ 3,389
2021	4,290
2022	4,273
2023	4,273
2024	4,273
Thereafter	20,511
Total	41,009	$ 43,438
Cost of Revenue
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	2,341
2021	3,081
2022	3,081
2023	3,081
2024	3,081
Thereafter	12,547
Total	27,212
Sales and Marketing
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	1,048
2021	1,209
2022	1,192
2023	1,192
2024	1,192
Thereafter	7,964
Total	$ 13,797

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Inventory (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Finished goods	$ 1,347	$ 1,236
Work in progress	1,685	1,189
Raw materials	3,915	3,589
Total inventory	$ 6,947	$ 6,014

Balance Sheet Components - Comp

Balance Sheet Components - Components of Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Deferred revenue	$ 3,482	$ 3,686
Clinical studies	4,084	3,068
Deferred payments for intangible assets	2,038	2,098
Short-term lease liability	1,570	3,017
Test sample processing fees	884	835
Accrued royalty	562	547
Contingent consideration	970	810
Professional fees	609	766
Other accrued expenses	1,377	2,011
Total accrued and other liabilities	$ 15,576	$ 16,838

Commitments and Contingencies -

Commitments and Contingencies - Summary of Lease Cost (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Operating lease cost	$ 1,119	$ 435
Finance lease cost	53	56
Total lease cost	$ 1,172	$ 491

Commitments and Contingencies_2

Commitments and Contingencies - Summary of Other Information Related to Lease (Detail)	Mar. 31, 2020
Other information:
Weighted-average remaining lease term - Operating leases (in years)	7 years 25 days
Weighted-average remaining lease term - Finance leases (in years)	1 year 29 days
Weighted-average discount rate - Operating leases	10.50%
Weighted-average discount rate - Finance leases	6.50%

Commitments and Contingencies_3

Commitments and Contingencies - Additional Information (Detail) $ in Thousands	1 Months Ended	3 Months Ended
	Jun. 30, 2014milestone_payment	Mar. 31, 2020USD ($)	Mar. 31, 2019USD ($)	Jan. 02, 2020	Dec. 31, 2019USD ($)
Commitments and Contingencies Disclosure [Abstract]
Lease extension term period				8 years 2 months
Operating leases right-of-use assets		$ 17,004			$ 4,730
Current lease liabilities		1,570			3,017
Operating lease liability, less current portion		17,503			$ 2,370
Rent expense under non-cancelable operating leases		$ 1,200	$ 400
Number of milestone payments | milestone_payment	6

Commitments and Contingencies_4

Commitments and Contingencies - Future Minimum Lease Commitments under Operating and Finance Leases (Detail) $ in Thousands	Mar. 31, 2020USD ($)
Finance Leases
Remainder of 2020	$ 157
2021	71
2022	0
2023	0
2024	0
Thereafter	0
Total future minimum lease payments	228
Operating Leases
Remainder of 2020	2,514
2021	3,511
2022	3,963
2023	2,811
2024	2,909
Thereafter	13,267
Total future minimum lease payments	$ 28,975

Plan 401(K) - Additional Inform

Plan 401(K) - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Retirement Benefits [Abstract]
Expense incurred related to plan	$ 0.3	$ 0.2

Warrants - Additional Informati

Warrants - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Warrants and Rights Note Disclosure [Abstract]
Purchase of common stock warrants exercised (in shares)	272,000	70,000
Proceeds from exercise of warrants	$ 304	$ 78
Estimated fair value of warrant liability remeasurement expense		$ 500
Number of warrants exercised on cashless basis (in shares)	34,000	56,000
Shares issued (in shares)	24,000	25,000

Warrants - Outstanding Warrants

Warrants - Outstanding Warrants To Purchase Common Stock Warrants (Detail) - Common Stock	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Class of Warrant or Right [Line Items]
Number of shares underlying warrants (in shares)	49,006
Original issue date of April 2016
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share) | $ / shares	$ 1.12
Number of shares underlying warrants (in shares)	49,006
Original issue date of April 2016 | Remaining Term (in years)
Class of Warrant or Right [Line Items]
Original Term	7 years

Stock Incentive Plans - Summary

Stock Incentive Plans - Summary of Option, Unvested RSU Activity under 2014 Equity Incentive Plan and 2016 Inducement Equity Incentive Plan and Related Information (Detail)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Shares Available for Grant
Shares available for grant beginning balance (in shares)	504,775
Additional options authorized (in shares)	1,699,549
Common stock awards for services (in shares)	(3,091)
RSUs granted (in shares)	(294,481)
Options granted (in shares)	(332,400)
Repurchase of common stock under employee incentive plans (in shares)	67,477
RSUs forfeited (in shares)	41,725
Options forfeited (in shares)	43,762
Options expired (in shares)	10,263
Shares available for grant ending balance (in shares)	1,737,579
Stock Options Outstanding
Stock options outstanding beginning balance (in shares)	2,609,848
Options granted (in shares)	334,900
Stock option exercised (in shares)	(44,861)
Options forfeited (in shares)	(43,762)
Options expired (in shares)	(10,263)
Stock options outstanding ending balance (in shares)	2,845,862
Weighted Average Exercise Price
Weighted average exercise price beginning balance (in dollars per share) | $ / shares	$ 16.47
Weighted average exercise price - options granted (in dollars per share) | $ / shares	24
Weighted average exercise price - options exercised (in dollars per share) | $ / shares	3.46
Weighted average exercise price - options forfeited (in dollars per share) | $ / shares	25.75
Weighted average exercise price - options expired (in dollars per share) | $ / shares	4.76
Weighted average exercise price ending balance (in dollars per share) | $ / shares	$ 17.46
Number of RSU Shares
RSUs granted (in shares)	294,481
RSUs forfeited (in shares)	(41,725)
Restricted Stock Units
Shares Available for Grant
RSUs granted (in shares)	(294,481)
RSUs forfeited (in shares)	41,725
Number of RSU Shares
Number of RSU shares beginning balance (in shares)	1,516,285
RSUs granted (in shares)	294,481
RSUs vested (in shares)	(267,029)
RSUs forfeited (in shares)	(41,725)
Number of RSU shares ending balance (in shares)	1,502,012
Weighted Average Grant Date Fair Value
Weighted average grant date fair value beginning balance (in dollars per share) | $ / shares	$ 22.51
Weighted average grant date fair value - RSUs granted (in dollars per share) | $ / shares	23.98
Weighted average grant date fair value - RSUs vested (in dollars per share) | $ / shares	23.12
Weighted average grant date fair value - RSUs forfeited (in dollars per share) | $ / shares	26.48
Weighted average grant date fair value ending balance (in dollars per share) | $ / shares	$ 22.68

Stock Incentive Plans - Additio

Stock Incentive Plans - Additional Information (Detail) - USD ($)	Jan. 02, 2020	Jul. 01, 2019	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total intrinsic value of options exercised			$ 700,000	$ 6,000,000
Share-based compensation expense tax benefit recognized			0
Share-based compensation expense capitalized			$ 0
2014 Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum portion of employee ESPP plan contribution			15.00%
Maximum value of employee purchased shares per calendar year			$ 25,000
Offering period for employee stock purchases			6 months
Applicable exercise date an offering period shall be equal to percentage of the lower of fair market value of common stock			85.00%
Issuance of common stock under ESPP (in shares)	38,147	20,528
Aggregate proceeds from the issuance of shares	$ 700,000	$ 400,000
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Intrinsic value of RSUs			$ 32,400,000
Total unrecognized compensation costs related to stock options and RSUs			$ 26,200,000
Stock options and RSUs expected weighted average period			2 years 9 months 7 days
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options and RSUs expected weighted average period			3 years 14 days
Total fair value of options vested during period			$ 2,400,000
Total unrecognized compensation costs related to stock options			$ 20,100,000

Stock Incentive Plans - Summa_2

Stock Incentive Plans - Summary of Options Outstanding Vested and Expected to Vest (Detail) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Number of vested shares (in shares) | shares	1,144
Number of shares expected to vest (in shares) | shares	1,576
Number of shares total (in shares) | shares	2,720
Weighted-average exercise price vested (in dollars per share) | $ / shares	$ 10.72
Weighted-average exercise price expected to vest (in dollars per share) | $ / shares	$ 21.96
Weighted-average remaining contractual life vested (in years)	6 years 7 months 9 days
Weighted-average remaining contractual life expected to vest (in years)	8 years 10 months 24 days
Aggregate intrinsic value vested | $	$ 13,952,000
Aggregate intrinsic value expected to vest | $	5,311,000
Aggregate intrinsic value total | $	$ 19,263,000

Stock Incentive Plans - Weighte

Stock Incentive Plans - Weighted-Average Assumptions Used to Estimated Fair Values of Share-Based Awards (Detail)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Shares of common stock subject to outstanding options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 years	6 years
Expected volatility	74.00%	70.33%
Risk-free interest rate	1.35%	2.57%
Expected dividend yield	0.00%	0.00%
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 months	6 months
Expected volatility	62.56%	76.66%
Risk-free interest rate	1.57%	2.51%
Expected dividend yield	0.00%	0.00%

Stock Incentive Plans - Summa_3

Stock Incentive Plans - Summary of Expense Relating to Employee and Nonemployee Stock-Based Payment Awards from Stock Options and RSUs (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	$ 4,259	$ 6,053
Cost of Revenue
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	365	776
Cost of revenue
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	810	832
Sales and Marketing
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	971	727
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	$ 2,113	$ 3,718

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income tax benefit	$ 300	$ 606

Segment Reporting - Reportable

Segment Reporting - Reportable Revenues by Geographic Regions (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Total revenue	$ 38,380	$ 25,982
United States
Segment Reporting Information [Line Items]
Total revenue	35,573	23,240
Rest of World
Segment Reporting Information [Line Items]
Total revenue	775	790
Europe
Segment Reporting Information [Line Items]
Total revenue	2,032	1,952
Testing services revenue
Segment Reporting Information [Line Items]
Total revenue	31,442	21,518
Testing services revenue | United States
Segment Reporting Information [Line Items]
Total revenue	31,329	21,386
Testing services revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	113	132
Product revenue
Segment Reporting Information [Line Items]
Total revenue	4,695	4,433
Product revenue | United States
Segment Reporting Information [Line Items]
Total revenue	2,061	1,832
Product revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	632	658
Product revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	2,002	1,943
Digital and other revenue
Segment Reporting Information [Line Items]
Total revenue	2,243	31
Digital and other revenue | United States
Segment Reporting Information [Line Items]
Total revenue	2,183	22
Digital and other revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	30	0
Digital and other revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	$ 30	$ 9

Segment Reporting - Long-Lived

Segment Reporting - Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions (Detail) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Long-lived assets	$ 5,501	$ 4,430
United States
Segment Reporting Information [Line Items]
Long-lived assets	4,583	3,346
Europe
Segment Reporting Information [Line Items]
Long-lived assets	406	509
Rest of World
Segment Reporting Information [Line Items]
Long-lived assets	$ 512	$ 575

Subsequent Events (Details)

Subsequent Events (Details) - USD ($)	1 Months Ended
	Apr. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Aug. 31, 2018
Subsequent Event [Line Items]
Weighted average price (in usd per share)		$ 0.001	$ 0.001
Sales Agreement
Subsequent Event [Line Items]
Sale of stock amount maximum				$ 50,000,000
Subsequent Event
Subsequent Event [Line Items]
Accelerated and advanced payment	$ 20,500,000
Medicare fee-for-service reimbursements proceeds, initial tranche	$ 4,800,000
Subsequent Event | Sales Agreement
Subsequent Event [Line Items]
Shares issued and sold (in shares)	1,000,000
Weighted average price (in usd per share)	$ 24.24
Aggregate net proceeds	$ 23,500,000