CareDx (CDNA) 10-Q 4 Aug 20 2020 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2020	Jul. 31, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 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		48,963,851
Amendment Flag	false
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001217234
Current Fiscal Year End Date	--12-31

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 211,409	$ 38,223
Accounts receivable	27,111	24,057
Inventory	8,741	6,014
Prepaid and other current assets	4,286	3,628
Total current assets	251,547	71,922
Property and equipment, net	7,313	4,430
Operating leases right-of-use assets	16,416	4,730
Intangible assets, net	44,356	45,541
Goodwill	23,857	23,857
Restricted cash	253	256
Other assets	1,000	1,000
Total assets	344,742	151,736
Current liabilities:
Accounts payable	8,675	5,506
Accrued compensation	11,089	12,484
Accrued and other liabilities	16,682	16,838
Deferred revenue - CMS advance payment	20,496	0
Total current liabilities	56,942	34,828
Deferred tax liability	1,313	1,973
Common stock warrant liability	1,681	6,607
Deferred payments for intangible assets	5,400	5,207
Operating lease liability, less current portion	17,025	2,370
Other liabilities	1,614	1,751
Total liabilities	83,975	52,736
Commitments and contingencies (Note 8)
Stockholders’ equity:
Preferred stock: $0.001 par value; 10,000,000 shares authorized at June 30, 2020 and December 31, 2019; no shares issued and outstanding at June 30, 2020 and December 31, 2019	0	0
Common stock: $0.001 par value; 100,000,000 shares authorized at June 30, 2020 and December 31, 2019; 48,862,296 shares and 42,498,430 shares issued and outstanding at June 30, 2020 and December 31, 2019, respectively	47	42
Additional paid-in capital	612,228	437,976
Accumulated other comprehensive loss	(5,314)	(5,205)
Accumulated deficit	(346,194)	(333,813)
Total stockholders' equity	260,767	99,000
Total liabilities and stockholders’ equity	$ 344,742	$ 151,736

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 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)	48,862,296	42,498,430
Common stock, shares outstanding (in shares)	48,862,296	42,498,430

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Revenue:
Total revenue	$ 41,801	$ 31,454	$ 80,181	$ 57,436
Cost of revenue	15,025	11,512	27,417	21,245
Gross profit	26,776	19,942	52,764	36,191
Operating expenses:
Research and development	13,129	7,630	23,142	13,244
Sales and marketing	12,134	10,644	23,857	17,569
General and administrative	12,316	8,512	22,319	17,618
Total operating expenses	37,579	26,786	69,318	48,431
Loss from operations	(10,803)	(6,844)	(16,554)	(12,240)
Other income (expense):
Interest income, net	21	300	117	642
Change in estimated fair value of common stock warrant liability	(664)	(1,351)	(1,069)	(4,360)
CARES Act Provider Relief Fund	4,813	0	4,813	0
Other expense, net	(255)	(172)	(318)	(246)
Total other income (expense)	3,915	(1,223)	3,543	(3,964)
Loss before income taxes	(6,888)	(8,067)	(13,011)	(16,204)
Income tax benefit	330	220	630	826
Net loss	$ (6,558)	$ (7,847)	$ (12,381)	$ (15,378)
Net loss per share (Note 3):
Basic (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.28)	$ (0.37)
Diluted (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.28)	$ (0.37)
Weighted-average shares used to compute net loss per share:
Basic (in shares)	44,708,037	42,132,396	43,765,732	41,873,337
Diluted (in shares)	44,708,037	42,132,396	43,765,732	41,873,337
Testing services revenue
Revenue:
Total revenue	$ 36,293	$ 25,677	$ 67,735	$ 47,195
Product revenue
Revenue:
Total revenue	3,291	4,593	7,986	9,026
Digital and other revenue
Revenue:
Total revenue	$ 2,217	$ 1,184	$ 4,460	$ 1,215

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement of Comprehensive Income [Abstract]
Net loss	$ (6,558)	$ (7,847)	$ (12,381)	$ (15,378)
Other comprehensive loss:
Foreign currency translation adjustments, net of tax	1,596	(69)	(109)	(793)
Net comprehensive loss	$ (4,962)	$ (7,916)	$ (12,490)	$ (16,171)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Public Offering	At The Market Equity Offering	Common Stock	Common StockPublic Offering	Common StockAt The Market Equity Offering	Additional Paid-In Capital	Additional Paid-In CapitalPublic Offering	Additional Paid-In CapitalAt The Market Equity Offering	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)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
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, 2018				41,384,960
Beginning balance at Dec. 31, 2018	95,928			$ 41			412,010			(4,278)	(311,845)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Foreign currency translation adjustment	(793)
Net loss	(15,378)
Ending balance (in shares) at Jun. 30, 2019				42,306,432
Ending balance at Jun. 30, 2019	93,166			$ 42			425,418			(5,071)	(327,223)
Beginning balance (in shares) at Mar. 31, 2019				41,912,469
Beginning balance at Mar. 31, 2019	95,622			$ 41			419,959			(5,002)	(319,376)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Change in estimated offering costs	50						50
RSU settlements, net of shares withheld (in shares)				112,760
RSU settlements, net of shares withheld	(1,597)						(1,597)
Issuance of common stock for services (in shares)				1,663
Issuance of common stock for services	52						52
Issuance of common stock for cash upon exercise of stock options (in shares)				240,734
Issuance of common stock for cash upon exercise of stock options	1,405			$ 1			1,404
Issuance of common stock for cash upon exercise of warrants (in shares)				38,806
Issuance of common stock for cash upon exercise of warrants	612						612
Employee share-based compensation expense	4,938						4,938
Foreign currency translation adjustment	(69)									(69)
Net loss	(7,847)										(7,847)
Ending balance (in shares) at Jun. 30, 2019				42,306,432
Ending balance at Jun. 30, 2019	93,166			$ 42			425,418			(5,071)	(327,223)
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)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
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
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)
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)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for cash upon exercise of stock options (in shares)	246,830
Foreign currency translation adjustment	$ (109)
Net loss	(12,381)
Ending balance (in shares) at Jun. 30, 2020				48,862,296
Ending balance at Jun. 30, 2020	260,767			$ 47			612,228			(5,314)	(346,194)
Beginning balance (in shares) at Mar. 31, 2020				43,019,547
Beginning balance at Mar. 31, 2020	101,384			$ 42			447,888			(6,910)	(339,636)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common shares, net of commissions and offering costs (in shares)					4,492,187	1,000,000
Issuance of common shares, net of commissions and offering costs		$ 134,584	$ 23,451		$ 4	$ 1		$ 134,580	$ 23,450
RSU settlements, net of shares withheld (in shares)				143,101
RSU settlements, net of shares withheld	(2,030)						(2,030)
Issuance of common stock for services (in shares)				2,992
Issuance of common stock for services	58						58
Issuance of common stock for cash upon exercise of stock options (in shares)				204,469
Issuance of common stock for cash upon exercise of stock options	1,962						1,962
Employee share-based compensation expense	6,320						6,320
Foreign currency translation adjustment	1,596									1,596
Net loss	(6,558)										(6,558)
Ending balance (in shares) at Jun. 30, 2020				48,862,296
Ending balance at Jun. 30, 2020	$ 260,767			$ 47			$ 612,228			$ (5,314)	$ (346,194)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) $ in Thousands	3 Months Ended
	Jun. 30, 2020USD ($)
At The Market Equity Offering
Common stock, commissions and offering costs	$ 785
Public Offering
Common stock, commissions and offering costs	$ 9,166

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Operating activities:
Net loss	$ (12,381)	$ (15,378)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Stock-based compensation	10,676	11,045
Revaluation of common stock warrant liability to estimated fair value	1,069	4,360
Depreciation and amortization	3,249	2,380
Loss on the write-off of fixed assets	0	150
Amortization of right-of-use assets	1,256	201
Revaluation of contingent consideration to estimated fair value	266	0
Changes in operating assets and liabilities:
Accounts receivable	(1,900)	(5,956)
Inventory	(2,682)	(551)
Prepaid and other assets	(665)	(219)
Operating leases liabilities, net	(721)	(418)
Accounts payable	2,569	3,285
Accrued compensation	(1,283)	(1,881)
Accrued and other liabilities	1,724	1,208
Deferred revenue - CMS advance payment	20,496	0
Change in deferred taxes	(630)	(517)
Net cash provided by (used in) operating activities	21,043	(2,291)
Investing activities:
Acquisition of business	0	(16,037)
Acquisition of intangible assets	(2,250)	(1,124)
Additions of capital expenditures, net	(3,434)	(561)
Net cash used in investing activities	(5,684)	(17,722)
Financing activities:
Proceeds from issuance of common stock under employee stock purchase plan	602	341
Taxes paid related to net share settlement of restricted stock units	(3,537)	(3,975)
Proceeds from exercise of warrants	304	105
Proceeds from exercise of stock options	2,117	2,769
Principal payments on debt and finance lease obligations	(90)	(84)
Contingent payments related to the acquisition of Conexio Genomics Pty Ltd.	0	(116)
Net cash provided by (used in) financing activities	157,961	(960)
Effect of exchange rate changes on cash and cash equivalents	(137)	(111)
Net increase (decrease) in cash, cash equivalents and restricted cash	173,183	(21,084)
Cash, cash equivalents, and restricted cash at beginning of period	38,479	64,808
Cash, cash equivalents, and restricted cash at end of period	211,662	43,724
Cash, Cash Equivalents and Restricted Cash as of:
Total cash, cash equivalents and restricted cash at the end of period	38,479	43,724
Public Offering
Financing activities:
Proceeds from issuance of common shares	135,099	0
At The Market Equity Offering
Financing activities:
Proceeds from issuance of common shares	$ 23,466	$ 0

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 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 diagnostic 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. In April 2020, the Company announced its first biopharma research partnership for AlloCell, a surveillance solution that monitors the level of engraftment and persistence of allogeneic cells for patients who have received cell therapy transplants. 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 AlloSure Kidney has been a covered service for Medicare beneficiaries since October 2017. The Medicare reimbursement rate for AlloSure Kidney is currently $2,841 . AlloSure Kidney has also received positive coverage decisions from BCBS South Carolina and BCB S Kansas City, an d is reimbursed by other private payers on a case-by-case basis. AlloMap Heart has been a covered service for Medicare beneficiaries since January 2006. The Medicare reimbursement rate for AlloMap Heart is currently $3,240. Al loMap Heart has also received positive coverage decisions for reimbursement from many of the largest U.S. private payers, including Aetna, Cigna, Health Care Services Corporation, Humana, Kaiser Foundation Health Plan, Inc., and UnitedHealthcare. AlloCell will initially be commercialized through collaborative research agreements with biopharma companies developing cell therapies. 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 1,600 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 The Company’s suite of AlloSeq products are commercial next generation sequencing (“NGS”)-based kitted solutions that the Company has developed as a result of its license agreement with Illumina, Inc. (“Illumina”). These products include: AlloSeq ™ Tx, a high-resolution Human Leukocyte Antigen (“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. The Company's other HLA typing products include: TruSight HLA, a NGS-based high resolution typing solution; Olerup SSP ® , based on the sequence specific primer (“SSP”) technology; and QTYPE ® , which uses real-time polymerase chain reaction (“PCR”) methodology, to perform HLA typing at a low to intermediate resolution for samples that require a fast turnaround time. 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 Pandemic On January 30, 2020, the World Health Organization (the “WHO”) announced a global health emergency because of a new strain of coronavirus ( “COVID-19”) originating in Wuhan, China 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 pandemic, 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. In the final weeks of March and during April 2020, with hospitals increasingly caring for COVID-19 patients, hospital administrators chose 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. As a result, 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 pandemic, 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 150 transplant centers can offer RemoTraC to their patients and over 4,000 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. Following the introduction of RemoTraC and with the easing of stay-at-home restrictions and the opening up of many hospitals to non-COVID-19 patients, the Company’s testing services volumes returned to levels consistent with those experienced immediately prior to the COVID-19 pandemic, and volumes continued to be at or above those levels throughout May 2020 and June 2020. However, the Company’s product business experienced a reduction in forecasted sales volume throughout the second quarter 2020, as it was unable to undertake onsite discussions and demonstrations of its recently launched NGS products, including AlloSeq Tx 17, which was awarded CE mark approval in May 2020. 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 corporate employees have been asked 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. In addition, the Company has created a COVID-19 task force that is responsible for crisis decision making, employee communications, enforcing pre-arrival temperature checking, daily health check-ins and enhanced safety training/protocols in its offices for employees that cannot work from home. Liquidity and Capital Resources The Company has incurred significant losses and negative cash flows from operations since its inception and had an accumulated deficit of $346.2 million at June 30, 2020. As of June 30, 2020, the Company had cash and cash equivalents of $211.4 million. CMS Accelerated and Advance Payment Program for Medicare Providers On March 27, 2020 the U.S. government enacted the Coronavirus Aid, Relief, and Economic Security Act ( “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 pandemic. 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, and recorded the payment as Deferred revenue - CMS advance payment on the Company's condensed consolidated balance sheet. Refer to Note 7, Balance Sheet Components, for further explanation. At-the-Market Equity Offering On August 31, 2018, the Company entered into a sales agreement (the “ Sales Agreement”), with Jefferies, LLC, as sales agent ( “ Jefferies”), pursuant to which the Company may offer and sell, from time to time, through Jefferies, up to $50.0 million in shares of its 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 its 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. CARES Act Provider Relief Fund for Medicare Providers Pursuant to the CARES Act, the U.S. Department of Health & Human Services ( “HHS ”) distributed 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. As a condition to receiving these payments, providers must agree to certain terms and conditions and submit sufficient documentation demonstrating that the funds are being used for healthcare-related expenses or lost revenue attributable to the COVID-19 pandemic. Due to the recent enactment of legislation and absence of definitive guidance, there is a high degree of uncertainty around the CARES Act’s implementation and the Company continues to assess the impact on its business. Furthermore, HHS has indicated that it, along with the Office of Inspector General, will be closely monitoring and auditing providers to ensure that recipients comply with the terms and conditions of relief programs and to prevent fraud and abuse. All providers will be subject to civil and criminal penalties for any deliberate omissions, misrepresentations or falsifications of any information given to HHS. Providers will be distributed a portion of the initial $30.0 billion of funds 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 its portion of the initial tranche of funds, recorded in other income (expense), net on the condensed consolidated statement of operations. Underwritten Public Equity Offering In June 2020, the Company sold 4,492,187 shares of common stock (which includes shares sold pursuant to the underwriters’ full exercise of an overallotment option granted to the underwriters in connection with the offering) through an underwritten public offering at a price of $32.00 per share for aggregate net proceeds of approximately $134.6 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 and debt. 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.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES The 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 and six months ended June 30, 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 June 30, 2020 and 2019 , approximately 56% and 54%, respectively, of total revenue was derived from Medicare. For the six months ended June 30, 2020 and 2019 , approximately 55% and 54%, 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 June 30, 2020 and December 31, 2019, approximately 29% and 36%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable on either June 30, 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 0.50 years to 8.67 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 June 2016, 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	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Numerator: Net loss used to compute basic and diluted net loss per share $ (6,558) $ (7,847) $ (12,381) $ (15,378) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 44,708,037 42,132,396 43,765,732 41,873,337 Net loss per share: Basic and diluted $ (0.15) $ (0.19) $ (0.28) $ (0.37) The following potentially dilutive securities have been excluded from diluted net loss per share as at June 30, 2020 and 2019 because their effect would be antidilutive: Three and Six Months Ended June 30, 2020 2019 Shares of common stock subject to outstanding options 2,939,893 2,705,393 Shares of common stock subject to outstanding common stock warrants 49,006 466,695 Restricted stock units 1,762,420 1,292,440 Total common stock equivalents 4,751,319 4,464,528

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2020
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTSThe 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 June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 202,157 $ — $ — $ 202,157 Liabilities Common stock warrant liability $ — $ — $ 1,681 $ 1,681 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 1,069 Balance as of June 30, 2020 $ 1,681 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 June 30, 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: June 30, 2020 December 31, 2019 Private Placement Common Stock Warrant Liability Stock Price $ 35.43 $ 21.57 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 2.79 3.29 Volatility 75.00% 81.00% Risk-free interest rate 0.18% 1.62%

Business Combinations

Business Combinations	6 Months Ended
	Jun. 30, 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. OttrCare’s digital revenue was $1.7 million and $3.4 million for the three and six months ended June 30, 2020, respectively, and $1.1 million for each of the three and six months ended June 30, 2019, respectively, and was included in the Company’s unaudited condensed consolidated statement of operations. Unaudited supplemental pro forma information is not disclosed because it is considered immaterial. XynManagement On August 26, 2019, the Company acquired 100% of the outstanding common stock of XynManagement for total cash consideration of $2.0 million. As a result of the acquisition, the Company recognized contingent consideration of $1.4 million, including liability and equity components, goodwill of $1.7 million and intangible assets of $2.1 million. Goodwill synergies arise from acquired workforce know-how of transplant centers workflow. The goodwill for this acquisition is not deductible for income tax purposes. The contingent consideration relates to potential future cash payments upon reaching specified revenue and non-financial targets.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 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 and six months ended June 30, 2020. The balance of the Company's goodwill as of June 30, 2020 was $23.9 million. Intangible Assets The following tables present details of the Company’s intangible assets as of June 30, 2020 ($ in thousands): June 30, 2020 Gross Accumulated Foreign Net Carrying Weighted Average Remaining Intangible assets with finite lives: Acquired and developed technology $ 31,209 $ (7,665) $ (1,920) $ 21,624 9.7 Customer relationships 18,168 (4,021) (1,546) 12,601 11.4 Commercialization rights 8,079 (635) — 7,444 9.2 Trademarks and tradenames 2,360 (708) (215) 1,437 10.2 Total intangible assets with finite lives $ 59,816 $ (13,029) $ (3,681) $ 43,106 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 61,066 $ (13,029) $ (3,681) $ 44,356 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 In June 2020, the Company commercially launched AlloSeq HCT, a NGS solution for chimerism testing for stem cell transplant recipients. This technology can provide better sensitivity and data analysis compared to current solutions on the market. AlloSeq HCT, previously included in Acquired in-process technology as of December 31, 2019, is included in Acquired and developed technology as of June 30, 2020. 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 $1.2 million and $0.7 million for the three months ended June 30, 2020 and 2019, respectively. For the three months ended June 30, 2020, expenses of $0.8 million and $0.4 million were amortized to cost of revenue and sales and marketing expense, respectively. For the three months ended June 30, 2019, expenses of $0.4 million and $0.3 million were amortized to cost of product and sales and marketing expense, respectively. Amortization expense was $2.3 million and $1.3 million for the six months ended June 30, 2020 and 2019, respectively. For the six months ended June 30, 2020, expenses of $1.6 million and $0.7 million were amortized to cost of revenue and sales and marketing expense, respectively. For the six months ended June 30, 2019, expenses of $0.7 million and $0.6 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 June 30, 2020 (in thousands): Years Ending December 31, Cost of Sales and Total Remainder of 2020 $ 1,682 $ 727 $ 2,409 2021 3,319 1,265 4,584 2022 3,319 1,247 4,566 2023 3,319 1,247 4,566 2024 3,319 1,247 4,566 Thereafter 14,115 8,300 22,415 Total future amortization expense $ 29,073 $ 14,033 $ 43,106

Balance Sheet Components

Balance Sheet Components	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	BALANCE SHEET COMPONENTS Inventory Inventory consisted of the following (in thousands): June 30, December 31, 2019 Finished goods $ 4,762 $ 1,236 Work in progress 1,949 1,189 Raw materials 2,030 3,589 Total inventory $ 8,741 $ 6,014 Accrued and other liabilities Accrued and other liabilities consisted of the following (in thousands): June 30, December 31, 2019 Deferred revenue $ 3,731 $ 3,686 Clinical studies 4,912 3,068 Deferred payments for intangible assets 1,042 2,098 Short-term lease liability 1,733 3,017 Test sample processing fees 640 835 Accrued royalty 726 547 Contingent consideration 983 810 Professional fees 1,587 766 Other accrued expenses 1,328 2,011 Total accrued and other liabilities $ 16,682 $ 16,838

Commitments

Commitments	6 Months Ended
	Jun. 30, 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. At the inception of the lease modification, the ROU asset increased by $13.0 million. 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 June 30, 2020, the carrying value of the ROU asset was $16.4 million. The related current and non-current liabilities as of June 30, 2020 were $1.7 million and $17.0 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 and six months ended June 30, 2020 and 2019 (in thousands): Three Months Ended Six Months Ended 2020 2019 2020 2019 Operating lease cost $ 1,114 $ 455 $ 2,233 $ 905 Finance lease cost 51 55 104 110 Total lease cost $ 1,165 $ 510 $ 2,337 $ 1,015 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) 7.57 Weighted-average remaining lease term - Finance leases (in years) 0.84 Weighted-average discount rate - Operating leases (%) 10.5% Weighted-average discount rate - Finance leases (%) 6.2% Rent expense under non-cancelable operating leases was $1.2 million and $0.5 million for the three months ended June 30, 2020 and 2019, respectively. Rent expense under non-cancelable operating leases was $2.4 million and $0.9 million for the six months ended June 30, 2020 and 2019, respectively. Future minimum lease commitments under these operating and finance leases as of June 30, 2020 are as follows (in thousands): Year Ending December 31, Finance Operating Remainder of 2020 $ 105 $ 1,699 2021 71 3,522 2022 — 3,964 2023 — 2,811 2024 — 2,909 Thereafter — 13,267 Total future minimum lease payments $ 176 $ 28,172 The current portion of obligations under finance leases are included in accrued and other liabilities, and the long-term portion of finance leases are included in other liabilities within 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 “Illumina Agreement”). The Illumina Agreement requires the Company to pay royalties in the mid-single to low-double digits on sales of products covered by the Illumina 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 Illumina Agreement, the Company 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. The suit seeks injunctive relief and unspecified monetary relief. 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 also 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 also 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 patents 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.

Plan 401(K)

Plan 401(K)	6 Months Ended
	Jun. 30, 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 $0.2 million and $0.1 million for the three months ended June 30, 2020 and 2019, respectively. The Company incurred expenses related to contributions to the plan of $0.5 million and $0.3 million for the six months ended June 30, 2020 and 2019, respectively.

Warrants

Warrants	6 Months Ended
	Jun. 30, 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 June 30, 2020, there were no warrants exercised to purchase shares of common stock for cash proceeds. In the six months ended June 30, 2020, warrants to purchase approximately 272,000 shares of common stock were exercised for cash proceeds of $0.3 million. During the three months ended June 30, 2020, no warrants to purchase shares of common stock were exercised on a cashless basis. During the six months ended June 30, 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 June 30, 2019, warrants to purchase approximately 24,000 shares of common stock were exercised for cash proceeds of less than $0.1 million. During the three months ended June 30, 2019 warrants to purchase approximately 40,000 shares of common stock were exercised on a cashless basis and approximately 15,000 shares were issued pursuant to the exercises. In the six months ended June 30, 2019, warrants to purchase approximately 94,000 shares of common stock were exercised for cash proceeds of $0.1 million. During the six months ended June 30, 2019, approximately 96,000 warrants were exercised on a cashless basis and approximately 40,000 shares were issued pursuant to the exercises. As of June 30, 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	6 Months Ended
	Jun. 30, 2020
Share-based Payment Arrangement [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 (6,083) — — — — RSUs granted (821,204) — — 821,204 23.93 RSUs vested — — — (488,869) 21.38 Options granted (660,739) 660,739 24.89 — — Options exercised — (246,830) 8.49 — — Repurchase of common stock under employee incentive plans 143,603 — — — — RSUs forfeited 86,200 — — (86,200) 26.48 Options forfeited 65,536 (65,536) 25.00 — — Options expired 18,328 (18,328) 14.58 — — Balance—June 30, 2020 1,029,965 2,939,893 $ 18.86 1,762,420 $ 16.37 The total intrinsic value of options exercised was $3.3 million and $4.0 million in the three and six months ended June 30, 2020, respectively. The total intrinsic value of options exercised was $6.0 million and $12.0 million in the three and six months ended June 30, 2019, respectively. As of June 30, 2020, the total intrinsic value of outstanding RSUs was approximately $62.4 million and there were $33.1 million of unrecognized compensation costs related to RSUs, which are expected to be recognized over a weighted-average period of 2.39 years. Options outstanding that have vested and are expected to vest at June 30, 2020 are as follows: Number of Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Vested 1,149 $ 13.05 6.76 $ 25,774 Expected to vest 1,658 22.57 8.89 21,326 Total 2,807 $ 47,100 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 June 30, 2020 for stock options that were in-the-money. The total fair value of options that vested during the three and six month periods ended June 30, 2020 was $3.1 million and $5.5 million, respectively. As of June 30, 2020, there were approximately $22.7 million of unrecognized compensation costs related to stock options, which are expected to be recognized over a weighted-average period of 2.95 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 2020 that ended on June 30, 2020, 38,576 shares were purchased for aggregate proceeds of $0.7 million from the issuance of shares, which occurred on July 1, 2020. 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. 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Employee stock options Expected term (in years) 5.9 6.0 5.9 6.0 Expected volatility 77.00% 71.00% 77.00% 70.72% Risk-free interest rate 0.12% 2.34% 0.12% 2.43% Expected dividend yield —% —% —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 0.5 0.5 Expected volatility 62.56% 76.66% 62.56% 76.66% Risk-free interest rate 1.57% 2.51% 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 and six months ended June 30, 2020 and 2019, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Cost of revenue $ 711 $ 508 $ 1,075 $ 1,280 Research and development 1,456 1,441 2,267 2,273 Sales and marketing 1,580 940 2,550 1,671 General and administrative 2,670 2,103 4,784 5,821 Total $ 6,417 $ 4,992 $ 10,676 $ 11,045 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	6 Months Ended
	Jun. 30, 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 and six months ended June 30, 2020, the Company recorded an income tax benefit of $0.3 million and $0.6 million, respectively, compared to $0.2 million and $0.8 million for the three and six months ended June 30, 2019, respectively. The income tax benefit of $0.3 million and $0.6 million for the three and six months ended June 30, 2020, respectively, 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	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Testing services revenue United States $ 36,208 $ 25,499 $ 67,537 $ 46,885 Rest of World 85 178 198 310 $ 36,293 $ 25,677 $ 67,735 $ 47,195 Product revenue United States $ 1,216 $ 2,168 $ 3,277 $ 4,000 Europe 1,496 1,906 3,498 3,849 Rest of World 579 519 1,211 1,177 $ 3,291 $ 4,593 $ 7,986 $ 9,026 Digital and other revenue United States $ 2,153 $ 1,108 $ 4,336 $ 1,130 Europe 10 50 40 60 Rest of World 54 26 84 25 $ 2,217 $ 1,184 $ 4,460 $ 1,215 Total United States $ 39,577 $ 28,775 $ 75,150 $ 52,015 Total Europe $ 1,506 $ 1,956 $ 3,538 $ 3,909 Total Rest of World $ 718 $ 723 $ 1,493 $ 1,512 Total $ 41,801 $ 31,454 $ 80,181 $ 57,436 The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands): June 30, 2020 December 31, 2019 Long-lived assets: United States $ 6,404 $ 3,346 Europe 379 509 Rest of World 530 575 Total $ 7,313 $ 4,430

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Liquidity and Capital Resources	Liquidity and Capital Resources The Company has incurred significant losses and negative cash flows from operations since its inception and had an accumulated deficit of $346.2 million at June 30, 2020. As of June 30, 2020, the Company had cash and cash equivalents of $211.4 million. CMS Accelerated and Advance Payment Program for Medicare Providers On March 27, 2020 the U.S. government enacted the Coronavirus Aid, Relief, and Economic Security Act ( “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 pandemic. 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, and recorded the payment as Deferred revenue - CMS advance payment on the Company's condensed consolidated balance sheet. Refer to Note 7, Balance Sheet Components, for further explanation. At-the-Market Equity Offering On August 31, 2018, the Company entered into a sales agreement (the “ Sales Agreement”), with Jefferies, LLC, as sales agent ( “ Jefferies”), pursuant to which the Company may offer and sell, from time to time, through Jefferies, up to $50.0 million in shares of its 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 its 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. CARES Act Provider Relief Fund for Medicare Providers Pursuant to the CARES Act, the U.S. Department of Health & Human Services ( “HHS ”) distributed 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. As a condition to receiving these payments, providers must agree to certain terms and conditions and submit sufficient documentation demonstrating that the funds are being used for healthcare-related expenses or lost revenue attributable to the COVID-19 pandemic. Due to the recent enactment of legislation and absence of definitive guidance, there is a high degree of uncertainty around the CARES Act’s implementation and the Company continues to assess the impact on its business. Furthermore, HHS has indicated that it, along with the Office of Inspector General, will be closely monitoring and auditing providers to ensure that recipients comply with the terms and conditions of relief programs and to prevent fraud and abuse. All providers will be subject to civil and criminal penalties for any deliberate omissions, misrepresentations or falsifications of any information given to HHS. Providers will be distributed a portion of the initial $30.0 billion of funds 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 its portion of the initial tranche of funds, recorded in other income (expense), net on the condensed consolidated statement of operations. Underwritten Public Equity Offering In June 2020, the Company sold 4,492,187 shares of common stock (which includes shares sold pursuant to the underwriters’ full exercise of an overallotment option granted to the underwriters in connection with the offering) through an underwritten public offering at a price of $32.00 per share for aggregate net proceeds of approximately $134.6 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 and debt. 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.
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
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 June 30, 2020 and 2019 , approximately 56% and 54%, respectively, of total revenue was derived from Medicare. For the six months ended June 30, 2020 and 2019 , approximately 55% and 54%, 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 June 30, 2020 and December 31, 2019, approximately 29% and 36%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable on either June 30, 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 June 2016, 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)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Numerator: Net loss used to compute basic and diluted net loss per share $ (6,558) $ (7,847) $ (12,381) $ (15,378) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 44,708,037 42,132,396 43,765,732 41,873,337 Net loss per share: Basic and diluted $ (0.15) $ (0.19) $ (0.28) $ (0.37)
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 June 30, 2020 and 2019 because their effect would be antidilutive: Three and Six Months Ended June 30, 2020 2019 Shares of common stock subject to outstanding options 2,939,893 2,705,393 Shares of common stock subject to outstanding common stock warrants 49,006 466,695 Restricted stock units 1,762,420 1,292,440 Total common stock equivalents 4,751,319 4,464,528

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 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 June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Assets Money market funds $ 202,157 $ — $ — $ 202,157 Liabilities Common stock warrant liability $ — $ — $ 1,681 $ 1,681 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 1,069 Balance as of June 30, 2020 $ 1,681
Summary of Common Stock Warrant Liability Valuation Assumptions	Common Stock Warrant Liability Valuation Assumptions: June 30, 2020 December 31, 2019 Private Placement Common Stock Warrant Liability Stock Price $ 35.43 $ 21.57 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 2.79 3.29 Volatility 75.00% 81.00% Risk-free interest rate 0.18% 1.62%

Business Combinations (Tables)

Business Combinations (Tables)	6 Months Ended
	Jun. 30, 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)	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Intangible Assets	The following tables present details of the Company’s intangible assets as of June 30, 2020 ($ in thousands): June 30, 2020 Gross Accumulated Foreign Net Carrying Weighted Average Remaining Intangible assets with finite lives: Acquired and developed technology $ 31,209 $ (7,665) $ (1,920) $ 21,624 9.7 Customer relationships 18,168 (4,021) (1,546) 12,601 11.4 Commercialization rights 8,079 (635) — 7,444 9.2 Trademarks and tradenames 2,360 (708) (215) 1,437 10.2 Total intangible assets with finite lives $ 59,816 $ (13,029) $ (3,681) $ 43,106 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 61,066 $ (13,029) $ (3,681) $ 44,356 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 June 30, 2020 (in thousands): Years Ending December 31, Cost of Sales and Total Remainder of 2020 $ 1,682 $ 727 $ 2,409 2021 3,319 1,265 4,584 2022 3,319 1,247 4,566 2023 3,319 1,247 4,566 2024 3,319 1,247 4,566 Thereafter 14,115 8,300 22,415 Total future amortization expense $ 29,073 $ 14,033 $ 43,106

Balance Sheet Components (Table

Balance Sheet Components (Tables)	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Inventory	Inventory consisted of the following (in thousands): June 30, December 31, 2019 Finished goods $ 4,762 $ 1,236 Work in progress 1,949 1,189 Raw materials 2,030 3,589 Total inventory $ 8,741 $ 6,014
Components of Accrued and Other Liabilities	Accrued and other liabilities consisted of the following (in thousands): June 30, December 31, 2019 Deferred revenue $ 3,731 $ 3,686 Clinical studies 4,912 3,068 Deferred payments for intangible assets 1,042 2,098 Short-term lease liability 1,733 3,017 Test sample processing fees 640 835 Accrued royalty 726 547 Contingent consideration 983 810 Professional fees 1,587 766 Other accrued expenses 1,328 2,011 Total accrued and other liabilities $ 16,682 $ 16,838

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Summary of Lease Cost	The following table summarizes the lease cost for the three and six months ended June 30, 2020 and 2019 (in thousands): Three Months Ended Six Months Ended 2020 2019 2020 2019 Operating lease cost $ 1,114 $ 455 $ 2,233 $ 905 Finance lease cost 51 55 104 110 Total lease cost $ 1,165 $ 510 $ 2,337 $ 1,015 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) 7.57 Weighted-average remaining lease term - Finance leases (in years) 0.84 Weighted-average discount rate - Operating leases (%) 10.5% Weighted-average discount rate - Finance leases (%) 6.2%
Future Minimum Lease Commitments under Operating and Finance Leases	Future minimum lease commitments under these operating and finance leases as of June 30, 2020 are as follows (in thousands): Year Ending December 31, Finance Operating Remainder of 2020 $ 105 $ 1,699 2021 71 3,522 2022 — 3,964 2023 — 2,811 2024 — 2,909 Thereafter — 13,267 Total future minimum lease payments $ 176 $ 28,172

Warrants (Tables)

Warrants (Tables)	6 Months Ended
	Jun. 30, 2020
Warrants and Rights Note Disclosure [Abstract]
Components of Warrants Outstanding	As of June 30, 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)	6 Months Ended
	Jun. 30, 2020
Share-based Payment Arrangement [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 (6,083) — — — — RSUs granted (821,204) — — 821,204 23.93 RSUs vested — — — (488,869) 21.38 Options granted (660,739) 660,739 24.89 — — Options exercised — (246,830) 8.49 — — Repurchase of common stock under employee incentive plans 143,603 — — — — RSUs forfeited 86,200 — — (86,200) 26.48 Options forfeited 65,536 (65,536) 25.00 — — Options expired 18,328 (18,328) 14.58 — — Balance—June 30, 2020 1,029,965 2,939,893 $ 18.86 1,762,420 $ 16.37
Summary of Options Outstanding and Exercisable Vested or Expected to Vest	Options outstanding that have vested and are expected to vest at June 30, 2020 are as follows: Number of Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Vested 1,149 $ 13.05 6.76 $ 25,774 Expected to vest 1,658 22.57 8.89 21,326 Total 2,807 $ 47,100
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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Employee stock options Expected term (in years) 5.9 6.0 5.9 6.0 Expected volatility 77.00% 71.00% 77.00% 70.72% Risk-free interest rate 0.12% 2.34% 0.12% 2.43% Expected dividend yield —% —% —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 0.5 0.5 Expected volatility 62.56% 76.66% 62.56% 76.66% Risk-free interest rate 1.57% 2.51% 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 and six months ended June 30, 2020 and 2019, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Cost of revenue $ 711 $ 508 $ 1,075 $ 1,280 Research and development 1,456 1,441 2,267 2,273 Sales and marketing 1,580 940 2,550 1,671 General and administrative 2,670 2,103 4,784 5,821 Total $ 6,417 $ 4,992 $ 10,676 $ 11,045

Segment Reporting (Tables)

Segment Reporting (Tables)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Testing services revenue United States $ 36,208 $ 25,499 $ 67,537 $ 46,885 Rest of World 85 178 198 310 $ 36,293 $ 25,677 $ 67,735 $ 47,195 Product revenue United States $ 1,216 $ 2,168 $ 3,277 $ 4,000 Europe 1,496 1,906 3,498 3,849 Rest of World 579 519 1,211 1,177 $ 3,291 $ 4,593 $ 7,986 $ 9,026 Digital and other revenue United States $ 2,153 $ 1,108 $ 4,336 $ 1,130 Europe 10 50 40 60 Rest of World 54 26 84 25 $ 2,217 $ 1,184 $ 4,460 $ 1,215 Total United States $ 39,577 $ 28,775 $ 75,150 $ 52,015 Total Europe $ 1,506 $ 1,956 $ 3,538 $ 3,909 Total Rest of World $ 718 $ 723 $ 1,493 $ 1,512 Total $ 41,801 $ 31,454 $ 80,181 $ 57,436
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): June 30, 2020 December 31, 2019 Long-lived assets: United States $ 6,404 $ 3,346 Europe 379 509 Rest of World 530 575 Total $ 7,313 $ 4,430

Organization and Description _2

Organization and Description of Business - Additional Information (Detail)	1 Months Ended		6 Months Ended
	Jun. 30, 2020USD ($)centerphlebotomistpatient$ / sharesshares	Apr. 30, 2020USD ($)$ / sharesshares	Jun. 30, 2020USD ($)patientcenterphlebotomistuniqueSolution$ / shares	Dec. 31, 2019USD ($)	Aug. 31, 2018USD ($)	Jan. 31, 2018patient
Schedule of Capitalization, Equity [Line Items]
Number of renal transplant patients (more than) | patient						1,600
Number of transplant centers offering RemoTraC (more than) | center	150		150
Number of patients enrolled in RemoTraC (more than) | patient	4,000		4,000
Number of mobile phlebotomists (more than) | phlebotomist	10,000		10,000
Accumulated deficit	$ 346,194,000		$ 346,194,000	$ 333,813,000
Cash and cash equivalents	$ 211,409,000		$ 211,409,000	$ 38,223,000
Accelerated and advanced payment		$ 20,500,000
Medicare fee-for-service reimbursements proceeds, initial tranche		$ 4,800,000
Sales Agreement
Schedule of Capitalization, Equity [Line Items]
Sale of stock amount maximum					$ 50,000,000
Shares issued and sold (in shares) | shares		1,000,000
Sale of stock (in usd per share) | $ / shares		$ 24.24
Sale of stock, consideration received on transaction		$ 23,500,000
Public Offering
Schedule of Capitalization, Equity [Line Items]
Shares issued and sold (in shares) | shares	4,492,187
Sale of stock (in usd per share) | $ / shares	$ 32		$ 32
Sale of stock, consideration received on transaction	$ 134,600,000
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		6 Months Ended		12 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Revenues | Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage	56.00%	54.00%	55.00%	54.00%
Accounts Receivable | Credit Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage			29.00%		36.00%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Leases (Detail)	6 Months Ended
	Jun. 30, 2020
Minimum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	6 months
Maximum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	8 years 8 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				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Numerator:
Net loss used to compute basic and diluted net loss per share	$ (6,558)	$ (5,823)	$ (7,847)	$ (7,531)	$ (12,381)	$ (15,378)
Denominator:
Weighted average number of shares outstanding basic and diluted (in shares)	44,708,037		42,132,396		43,765,732	41,873,337
Net loss per share:
Basic and diluted (in dollars per share)	$ (0.15)		$ (0.19)		$ (0.28)	$ (0.37)

Net Loss Per Share - Potentiall

Net Loss Per Share - Potentially Dilutive Securities Excluded from Diluted Net Loss Per Share (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 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)	4,751,319	4,464,528	4,751,319	4,464,528
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)	2,939,893	2,705,393	2,939,893	2,705,393
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	466,695	49,006	466,695
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)	1,762,420	1,292,440	1,762,420	1,292,440

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Recurring - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Assets
Money market funds	$ 202,157	$ 29,177
Liabilities
Common stock warrant liability	1,681	6,607
Fair Value Measured Using - (Level 1)
Assets
Money market funds	202,157	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	$ 1,681	$ 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	6 Months Ended
	Jun. 30, 2020USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Beginning balance	$ 6,607
Exercise of warrants	(5,995)
Change in estimated fair value	1,069
Ending balance	$ 1,681

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of Common Stock Warrant Liability Valuation Assumptions (Detail) - Private Placement Common Stock Warrant Liability	6 Months Ended	12 Months Ended
	Jun. 30, 2020$ / shares	Dec. 31, 2019$ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Stock price (in dollars per share)	$ 35.43	$ 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)	2 years 9 months 14 days	3 years 3 months 14 days
Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input	75	81
Risk Free Interest Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input	0.18	1.62

Business Combinations - Additio

Business Combinations - Additional Information (Detail) - USD ($)	Aug. 26, 2019	May 07, 2019	Jun. 30, 2020	Sep. 30, 2019	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill		$ 10,200,000	$ 23,857,000			$ 23,857,000		$ 23,857,000
Royalty Rate | Developed Technology
Business Acquisition [Line Items]
Rate used in estimating fair value		0.150
Royalty Rate | Trademarks
Business Acquisition [Line Items]
Rate used in estimating fair value		0.010
Discount Rate
Business Acquisition [Line Items]
Rate used in estimating fair value		0.145
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		$ 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		$ 1,100,000	$ 3,400,000	$ 1,100,000
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	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Business Acquisition [Line Items]
Cash		$ 0	$ 16,037
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	Jun. 30, 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 4 months 24 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 Intangible Assets (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2020	Dec. 31, 2019
Intangible assets with finite lives:
Gross Carrying Amount	$ 59,816	$ 57,713
Accumulated Amortization	(13,029)	(10,719)
Foreign Currency Translation	(3,681)	(3,556)
Total	43,106	43,438
Intangible Assets, Net (Excluding Goodwill)
Total intangible assets - gross carrying amount	61,066	59,816
Total intangible assets, net	44,356	45,541
Acquired and developed technology
Intangible assets with finite lives:
Gross Carrying Amount	31,209	29,106
Accumulated Amortization	(7,665)	(6,473)
Foreign Currency Translation	(1,920)	(1,852)
Total	$ 21,624	$ 20,781
Weighted Average Remaining Useful Life (In Years)	9 years 8 months 12 days	8 years 2 months 12 days
Customer relationships
Intangible assets with finite lives:
Gross Carrying Amount	$ 18,168	$ 18,168
Accumulated Amortization	(4,021)	(3,397)
Foreign Currency Translation	(1,546)	(1,498)
Total	$ 12,601	$ 13,273
Weighted Average Remaining Useful Life (In Years)	11 years 4 months 24 days	10 years 1 month 6 days
Commercialization rights
Intangible assets with finite lives:
Gross Carrying Amount	$ 8,079	$ 8,079
Accumulated Amortization	(635)	(231)
Foreign Currency Translation	0	0
Total	$ 7,444	$ 7,848
Weighted Average Remaining Useful Life (In Years)	9 years 2 months 12 days	9 years 8 months 12 days
Trademarks and tradenames
Intangible assets with finite lives:
Gross Carrying Amount	$ 2,360	$ 2,360
Accumulated Amortization	(708)	(618)
Foreign Currency Translation	(215)	(206)
Total	$ 1,437	$ 1,536
Weighted Average Remaining Useful Life (In Years)	10 years 2 months 12 days	9 years 1 month 6 days
Acquired in-process technology
Intangible assets with indefinite lives
Net carrying amount	$ 1,250	$ 2,103

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Additional Information (Detail) $ in Thousands	Apr. 30, 2019	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Dec. 31, 2019USD ($)	Jul. 26, 2019USD ($)	May 07, 2019USD ($)
Goodwill And Intangible Assets [Line Items]
Goodwill		$ 23,857		$ 23,857		$ 23,857		$ 10,200
Amortization expense of intangible assets		1,200	$ 700	2,300	$ 1,300
Cost of Product
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets		800	400	1,600	700
Sales and Marketing Expense
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets		$ 400	$ 300	$ 700	$ 600
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							$ 1,000
Discount Rate
Goodwill And Intangible Assets [Line Items]
Rate used in estimating fair value								0.145
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_4

Goodwill and Intangible Assets - Summary of Estimated Future Amortization Expense of Intangible Assets with Finite Lives (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	$ 2,409
2021	4,584
2022	4,566
2023	4,566
2024	4,566
Thereafter	22,415
Total	43,106	$ 43,438
Cost of Revenue
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	1,682
2021	3,319
2022	3,319
2023	3,319
2024	3,319
Thereafter	14,115
Total	29,073
Sales and Marketing
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2020	727
2021	1,265
2022	1,247
2023	1,247
2024	1,247
Thereafter	8,300
Total	$ 14,033

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Inventory (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Finished goods	$ 4,762	$ 1,236
Work in progress	1,949	1,189
Raw materials	2,030	3,589
Total inventory	$ 8,741	$ 6,014

Balance Sheet Components - Comp

Balance Sheet Components - Components of Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Deferred revenue	$ 3,731	$ 3,686
Clinical studies	4,912	3,068
Deferred payments for intangible assets	1,042	2,098
Short-term lease liability	1,733	3,017
Test sample processing fees	640	835
Accrued royalty	726	547
Contingent consideration	983	810
Professional fees	1,587	766
Other accrued expenses	1,328	2,011
Total accrued and other liabilities	$ 16,682	$ 16,838

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Details) $ in Millions	1 Months Ended
	Apr. 30, 2020USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accelerated and advanced payment	$ 20.5

Commitments and Contingencies -

Commitments and Contingencies - Summary of Lease Cost (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Operating lease cost	$ 1,114	$ 455	$ 2,233	$ 905
Finance lease cost	51	55	104	110
Total lease cost	$ 1,165	$ 510	$ 2,337	$ 1,015

Commitments and Contingencies_2

Commitments and Contingencies - Summary of Other Information Related to Lease (Detail)	Jun. 30, 2020
Other information:
Weighted-average remaining lease term - Operating leases (in years)	7 years 6 months 25 days
Weighted-average remaining lease term - Finance leases (in years)	10 months 2 days
Weighted-average discount rate - Operating leases	10.50%
Weighted-average discount rate - Finance leases	6.20%

Commitments and Contingencies_3

Commitments and Contingencies - Additional Information (Detail) $ in Thousands	1 Months Ended	3 Months Ended		6 Months Ended
	Jun. 30, 2014milestone_payment	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jan. 02, 2020	Jan. 01, 2020USD ($)	Dec. 31, 2019USD ($)
Commitments and Contingencies Disclosure [Abstract]
Operating lease, right-of-use asset increase amount							$ 13,000
Lease extension term period						8 years 2 months
Operating leases right-of-use assets		$ 16,416		$ 16,416				$ 4,730
Current lease liabilities		1,733		1,733				3,017
Operating lease liability, less current portion		17,025		17,025				$ 2,370
Rent expense under non-cancelable operating leases		$ 1,200	$ 500	$ 2,400	$ 900
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	Jun. 30, 2020USD ($)
Finance Leases
Remainder of 2020	$ 105
2021	71
2022	0
2023	0
2024	0
Thereafter	0
Total future minimum lease payments	176
Operating Leases
Remainder of 2020	1,699
2021	3,522
2022	3,964
2023	2,811
2024	2,909
Thereafter	13,267
Total future minimum lease payments	$ 28,172

Plan 401(K) - Additional Inform

Plan 401(K) - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Retirement Benefits [Abstract]
Expense incurred related to plan	$ 0.2	$ 0.1	$ 0.5	$ 0.3

Warrants - Additional Informati

Warrants - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Warrants and Rights Note Disclosure [Abstract]
Purchase of common stock warrants exercised (in shares)	0	24,000	272,000	94,000
Proceeds from exercise of warrants		$ 100	$ 304	$ 105
Number of warrants exercised on cashless basis (in shares)	0	40,000,000	34,000	96,000,000
Shares issued (in shares)		15,000,000	24,000	40,000,000

Warrants - Outstanding Warrants

Warrants - Outstanding Warrants To Purchase Common Stock Warrants (Detail) - Common Stock	6 Months Ended
	Jun. 30, 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)	6 Months Ended
	Jun. 30, 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)	(6,083)
RSUs granted (in shares)	(821,204)
Options granted (in shares)	(660,739)
Repurchase of common stock under employee incentive plans (in shares)	143,603
RSUs forfeited (in shares)	86,200
Options forfeited (in shares)	65,536
Options expired (in shares)	18,328
Shares available for grant ending balance (in shares)	1,029,965
Stock Options Outstanding
Stock options outstanding beginning balance (in shares)	2,609,848
Options granted (in shares)	660,739
Stock option exercised (in shares)	(246,830)
Options forfeited (in shares)	(65,536)
Options expired (in shares)	(18,328)
Stock options outstanding ending balance (in shares)	2,939,893
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	24.89
Weighted average exercise price - options exercised (in dollars per share) | $ / shares	8.49
Weighted average exercise price - options forfeited (in dollars per share) | $ / shares	25
Weighted average exercise price - options expired (in dollars per share) | $ / shares	14.58
Weighted average exercise price ending balance (in dollars per share) | $ / shares	$ 18.86
Number of RSU Shares
RSUs granted (in shares)	821,204
RSUs forfeited (in shares)	(86,200)
Restricted Stock Units
Shares Available for Grant
RSUs granted (in shares)	(821,204)
RSUs forfeited (in shares)	86,200
Number of RSU Shares
Number of RSU shares beginning balance (in shares)	1,516,285
RSUs granted (in shares)	821,204
RSUs vested (in shares)	(488,869)
RSUs forfeited (in shares)	(86,200)
Number of RSU shares ending balance (in shares)	1,762,420
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	23.93
Weighted average grant date fair value - RSUs vested (in dollars per share) | $ / shares	21.38
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	$ 16.37

Stock Incentive Plans - Additio

Stock Incentive Plans - Additional Information (Detail) - USD ($)	Jul. 01, 2020	Jan. 02, 2020	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total intrinsic value of options exercised			$ 3,300,000	$ 6,000,000	$ 4,000,000	$ 12,000,000
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%		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
Aggregate proceeds from the issuance of shares		$ 700,000
2014 Employee Stock Purchase Plan | Subsequent Event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Issuance of common stock under ESPP (in shares)	38,576
Aggregate proceeds from the issuance of shares	$ 700,000
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Intrinsic value of RSUs			$ 62,400,000		$ 62,400,000
Total unrecognized compensation costs related to stock options and RSUs			33,100,000		$ 33,100,000
Stock options and RSUs expected weighted average period					2 years 4 months 20 days
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options and RSUs expected weighted average period					2 years 11 months 12 days
Total fair value of options vested during period			3,100,000		$ 5,500,000
Total unrecognized compensation costs related to stock options			$ 22,700,000		$ 22,700,000

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	6 Months Ended
	Jun. 30, 2020USD ($)$ / sharesshares
Share-based Payment Arrangement [Abstract]
Number of vested shares (in shares) | shares	1,149
Number of shares expected to vest (in shares) | shares	1,658
Number of shares total (in shares) | shares	2,807
Weighted-average exercise price vested (in dollars per share) | $ / shares	$ 13.05
Weighted-average exercise price expected to vest (in dollars per share) | $ / shares	$ 22.57
Weighted-average remaining contractual life vested (in years)	6 years 9 months 3 days
Weighted-average remaining contractual life expected to vest (in years)	8 years 10 months 20 days
Aggregate intrinsic value vested | $	$ 25,774,000
Aggregate intrinsic value expected to vest | $	21,326,000
Aggregate intrinsic value total | $	$ 47,100,000

Stock Incentive Plans - Weighte

Stock Incentive Plans - Weighted-Average Assumptions Used to Estimated Fair Values of Share-Based Awards (Detail)	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 months	6 months	6 months	6 months
Expected volatility	62.56%	76.66%	62.56%	76.66%
Risk-free interest rate	1.57%	2.51%	1.57%	2.51%
Expected dividend yield	0.00%	0.00%	0.00%	0.00%
Shares of common stock subject to outstanding options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 10 months 24 days	6 years	5 years 10 months 24 days	6 years
Expected volatility	77.00%	71.00%	77.00%	70.72%
Risk-free interest rate	0.12%	2.34%	0.12%	2.43%
Expected dividend yield	0.00%	0.00%	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		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	$ 6,417	$ 4,992	$ 10,676	$ 11,045
Cost of Revenue
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	711	508	1,075	1,280
Research and development
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	1,456	1,441	2,267	2,273
Sales and Marketing
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	1,580	940	2,550	1,671
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation total expensed	$ 2,670	$ 2,103	$ 4,784	$ 5,821

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Income tax benefit	$ 330	$ 220	$ 630	$ 826

Segment Reporting - Reportable

Segment Reporting - Reportable Revenues by Geographic Regions (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Segment Reporting Information [Line Items]
Total revenue	$ 41,801	$ 31,454	$ 80,181	$ 57,436
United States
Segment Reporting Information [Line Items]
Total revenue	39,577	28,775	75,150	52,015
Rest of World
Segment Reporting Information [Line Items]
Total revenue	718	723	1,493	1,512
Europe
Segment Reporting Information [Line Items]
Total revenue	1,506	1,956	3,538	3,909
Testing services revenue
Segment Reporting Information [Line Items]
Total revenue	36,293	25,677	67,735	47,195
Testing services revenue | United States
Segment Reporting Information [Line Items]
Total revenue	36,208	25,499	67,537	46,885
Testing services revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	85	178	198	310
Product revenue
Segment Reporting Information [Line Items]
Total revenue	3,291	4,593	7,986	9,026
Product revenue | United States
Segment Reporting Information [Line Items]
Total revenue	1,216	2,168	3,277	4,000
Product revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	579	519	1,211	1,177
Product revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	1,496	1,906	3,498	3,849
Digital and other revenue
Segment Reporting Information [Line Items]
Total revenue	2,217	1,184	4,460	1,215
Digital and other revenue | United States
Segment Reporting Information [Line Items]
Total revenue	2,153	1,108	4,336	1,130
Digital and other revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	54	26	84	25
Digital and other revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	$ 10	$ 50	$ 40	$ 60

Segment Reporting - Long-Lived

Segment Reporting - Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Segment Reporting Information [Line Items]
Long-lived assets	$ 7,313	$ 4,430
United States
Segment Reporting Information [Line Items]
Long-lived assets	6,404	3,346
Europe
Segment Reporting Information [Line Items]
Long-lived assets	379	509
Rest of World
Segment Reporting Information [Line Items]
Long-lived assets	$ 530	$ 575