CareDx (CDNA) 10-Q 4 Aug 22 2022 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2022	Aug. 02, 2022
Entity Addresses [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2022
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	8000 Marina Boulevard
Entity Address, City or Town	Brisbane
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94005
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		53,458,126
Amendment Flag	false
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q2
Entity Central Index Key	0001217234
Current Fiscal Year End Date	--12-31
Former Address
Entity Addresses [Line Items]
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

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 166,832	$ 348,485
Marketable securities	139,388	0
Accounts receivable	70,142	59,761
Inventory	18,861	17,186
Prepaid and other current assets	8,657	7,928
Total current assets	403,880	433,360
Property and equipment, net	32,904	22,044
Operating leases right-of-use assets	15,841	17,993
Intangible assets, net	46,318	50,195
Goodwill	37,084	36,983
Restricted cash	204	211
Other assets	5,057	5,835
Total assets	541,288	566,621
Current liabilities:
Accounts payable	16,892	13,337
Accrued compensation	14,631	26,042
Accrued and other liabilities	46,933	37,922
Total current liabilities	78,456	77,301
Deferred tax liability	25	415
Common stock warrant liability	64	139
Deferred payments for intangible assets	2,877	5,041
Operating lease liability, less current portion	16,065	17,394
Other liabilities	252	455
Total liabilities	97,739	100,745
Commitments and contingencies (Note 9)
Stockholders’ equity:
Preferred stock: $0.001 par value; 10,000,000 shares authorized at June 30, 2022 and December 31, 2021; no shares issued and outstanding at June 30, 2022 and December 31, 2021	0	0
Common stock: $0.001 par value; 100,000,000 shares authorized at June 30, 2022 and December 31, 2021; 53,323,712 shares and 52,923,360 shares issued and outstanding at June 30, 2022 and December 31, 2021, respectively	52	52
Additional paid-in capital	875,213	853,683
Accumulated other comprehensive loss	(7,182)	(4,670)
Accumulated deficit	(424,534)	(383,189)
Total stockholders’ equity	443,549	465,876
Total liabilities and stockholders’ equity	$ 541,288	$ 566,621

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2022	Dec. 31, 2021
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)	53,323,712	52,923,360
Common stock, shares outstanding (in shares)	53,323,712	52,923,360

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Revenue:
Total revenue	$ 80,634	$ 74,188	$ 160,050	$ 141,588
Operating expenses:
Research and development	22,632	19,036	44,512	35,040
Sales and marketing	26,950	19,599	50,098	35,051
General and administrative	25,232	16,322	51,791	31,545
Total operating expenses	102,353	78,930	200,822	147,188
Loss from operations	(21,719)	(4,742)	(40,772)	(5,600)
Other (expense) income:
Interest income, net	478	1	667	127
Change in estimated fair value of common stock warrant liability	48	(65)	75	(38)
Other (expense) income, net	(553)	2,779	(1,376)	2,534
Total other (expense) income	(27)	2,715	(634)	2,623
Loss before income taxes	(21,746)	(2,027)	(41,406)	(2,977)
Income tax benefit	49	100	61	363
Net loss	$ (21,697)	$ (1,927)	$ (41,345)	$ (2,614)
Net loss per share
Basic (in dollars per share)	$ (0.41)	$ (0.04)	$ (0.78)	$ (0.05)
Diluted (in dollars per share)	$ (0.41)	$ (0.04)	$ (0.78)	$ (0.05)
Weighted-average shares used to compute net loss per share:
Basic (in shares)	53,249,545	52,224,300	53,133,149	51,705,587
Diluted (in shares)	53,249,545	52,224,300	53,133,149	51,705,587
Testing services revenue
Revenue:
Total revenue	$ 67,135	$ 64,890	$ 133,579	$ 124,171
Operating expenses:
Cost of testing services, product, digital, and other	18,230	17,235	35,858	33,718
Product revenue
Revenue:
Total revenue	6,714	6,861	13,502	12,639
Operating expenses:
Cost of testing services, product, digital, and other	3,887	5,205	8,286	8,852
Patient and digital solutions revenue
Revenue:
Total revenue	6,785	2,437	12,969	4,778
Operating expenses:
Cost of testing services, product, digital, and other	$ 5,422	$ 1,533	$ 10,277	$ 2,982

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Net loss	$ (21,697)	$ (1,927)	$ (41,345)	$ (2,614)
Other comprehensive loss:
Foreign currency translation adjustments, net of tax	(2,092)	443	(2,512)	(1,060)
Net comprehensive loss	$ (23,789)	$ (1,484)	$ (43,857)	$ (3,674)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Loss	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2020		49,441,166
Beginning balance at Dec. 31, 2020	$ 277,679	$ 49	$ 632,253	$ (2,096)	$ (352,527)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common shares through public equity offering, net of commissions and offering costs (in shares)		2,211,538
Issuance of common shares through public equity offering, net of commissions and offering costs	188,755	$ 2	188,753
Issuance of common stock under employee stock purchase plan (in shares)		24,052
Issuance of common stock under employee stock purchase plan	838		838
RSU settlements, net of shares withheld (in shares)		121,447
RSU settlements, net of shares withheld	(2,313)		(2,313)
Issuance of common stock for services (in shares)		1,339
Issuance of common stock for services	96		96
Issuance of common stock for cash upon exercise of stock options (in shares)		139,579
Issuance of common stock for cash upon exercise of stock options	2,193		2,193
Employee stock-based compensation expense	6,488		6,488
Foreign currency translation adjustment	(1,503)			(1,503)
Net loss	(687)				(687)
Ending balance (in shares) at Mar. 31, 2021		51,939,121
Ending balance at Mar. 31, 2021	471,546	$ 51	828,308	(3,599)	(353,214)
Beginning balance (in shares) at Dec. 31, 2020		49,441,166
Beginning balance at Dec. 31, 2020	277,679	$ 49	632,253	(2,096)	(352,527)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Foreign currency translation adjustment	(1,060)
Net loss	(2,614)
Ending balance (in shares) at Jun. 30, 2021		52,552,761
Ending balance at Jun. 30, 2021	479,843	$ 51	838,089	(3,156)	(355,141)
Beginning balance (in shares) at Dec. 31, 2020		49,441,166
Beginning balance at Dec. 31, 2020	277,679	$ 49	632,253	(2,096)	(352,527)
Ending balance (in shares) at Dec. 31, 2021		52,923,360
Ending balance at Dec. 31, 2021	465,876	$ 52	853,683	(4,670)	(383,189)
Beginning balance (in shares) at Mar. 31, 2021		51,939,121
Beginning balance at Mar. 31, 2021	471,546	$ 51	828,308	(3,599)	(353,214)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
RSU settlements, net of shares withheld (in shares)		160,286
RSU settlements, net of shares withheld	(6,638)		(6,638)
Issuance of common stock for services (in shares)		23,163
Issuance of common stock for services	59		59
Issuance of common stock for cash upon exercise of stock options (in shares)		427,059
Issuance of common stock for cash upon exercise of stock options	6,833		6,833
Issuance of common stock for cash upon exercise of warrants (in shares)		3,132
Issuance of common stock for cash upon exercise of warrants	205		205
Employee stock-based compensation expense	9,322		9,322
Foreign currency translation adjustment	443			443
Net loss	(1,927)				(1,927)
Ending balance (in shares) at Jun. 30, 2021		52,552,761
Ending balance at Jun. 30, 2021	479,843	$ 51	838,089	(3,156)	(355,141)
Beginning balance (in shares) at Dec. 31, 2021		52,923,360
Beginning balance at Dec. 31, 2021	465,876	$ 52	853,683	(4,670)	(383,189)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock under employee stock purchase plan (in shares)		25,852
Issuance of common stock under employee stock purchase plan	999		999
RSU settlements, net of shares withheld (in shares)		64,819
RSU settlements, net of shares withheld	(1,482)		(1,482)
Issuance of common stock for services (in shares)		1,249
Issuance of common stock for services	58		58
Issuance of common stock for cash upon exercise of stock options (in shares)		69,993
Issuance of common stock for cash upon exercise of stock options	1,598		1,598
Employee stock-based compensation expense	10,563		10,563
Foreign currency translation adjustment	(420)			(420)
Net loss	(19,648)				(19,648)
Ending balance (in shares) at Mar. 31, 2022		53,085,273
Ending balance at Mar. 31, 2022	457,544	$ 52	865,419	(5,090)	(402,837)
Beginning balance (in shares) at Dec. 31, 2021		52,923,360
Beginning balance at Dec. 31, 2021	$ 465,876	$ 52	853,683	(4,670)	(383,189)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for cash upon exercise of stock options (in shares)	89,326
Foreign currency translation adjustment	$ (2,512)
Net loss	(41,345)
Ending balance (in shares) at Jun. 30, 2022		53,323,712
Ending balance at Jun. 30, 2022	443,549	$ 52	875,213	(7,182)	(424,534)
Beginning balance (in shares) at Mar. 31, 2022		53,085,273
Beginning balance at Mar. 31, 2022	457,544	$ 52	865,419	(5,090)	(402,837)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
RSU settlements, net of shares withheld (in shares)		216,950
RSU settlements, net of shares withheld	(3,211)		(3,211)
Issuance of common stock for services (in shares)		2,156
Issuance of common stock for services	79		79
Issuance of common stock for cash upon exercise of stock options (in shares)		19,333
Issuance of common stock for cash upon exercise of stock options	413		413
Employee stock-based compensation expense	12,513		12,513
Foreign currency translation adjustment	(2,092)			(2,092)
Net loss	(21,697)				(21,697)
Ending balance (in shares) at Jun. 30, 2022		53,323,712
Ending balance at Jun. 30, 2022	$ 443,549	$ 52	$ 875,213	$ (7,182)	$ (424,534)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) $ in Thousands	3 Months Ended
	Mar. 31, 2021 USD ($)
Public Offering
Common stock, commissions and offering costs	$ 12,495

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Operating activities:
Net loss	$ (41,345)	$ (2,614)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation	23,227	15,945
Revaluation of common stock warrant liability to estimated fair value	(75)	38
Depreciation and amortization	5,363	4,102
Amortization of right-of-use assets	1,822	1,366
Unrealized loss (gain) on long-term marketable equity securities	486	(3,090)
Revaluation of contingent consideration to estimated fair value	564	(191)
Amortization of premium on short-term marketable securities, net	540	637
Changes in operating assets and liabilities:
Accounts receivable	(10,562)	(13,419)
Inventory	(2,506)	(5,331)
Prepaid and other assets	(514)	(4,203)
Operating leases liabilities, net	(1,962)	(951)
Accounts payable	4,486	1,559
Accrued compensation	(12,290)	(1,395)
Accrued and other liabilities	7,579	4,646
Refund liability - CMS advance payment	0	(20,496)
Change in deferred taxes	(158)	(445)
Net cash used in operating activities	(25,345)	(23,842)
Investing activities:
Acquisition of business, net of cash acquired	(102)	(3,500)
Acquisition of intangible assets	(2,100)	(6,700)
Purchases of short-term marketable securities	(182,913)	(5,500)
Maturities of short-term marketable securities	42,984	55,080
Additions of capital expenditures, net	(13,111)	(4,088)
Net cash (used in) provided by investing activities	(155,242)	35,292
Financing activities:
Proceeds from issuance of common shares in public equity offering, net of issuance costs paid	0	188,755
Proceeds from issuance of common stock under employee stock purchase plan	999	838
Taxes paid related to net share settlement of restricted stock units	(3,892)	(8,951)
Proceeds from exercise of warrants	0	4
Proceeds from exercise of stock options	2,011	9,026
Principal payments on finance lease obligations	0	(63)
Payment of contingent consideration	(250)	0
Net cash (used in) provided by financing activities	(1,132)	189,609
Effect of exchange rate changes on cash, cash equivalents and restricted cash	59	(105)
Net (decrease) increase in cash, cash equivalents and restricted cash	(181,660)	200,954
Cash, cash equivalents, and restricted cash at beginning of period	348,696	134,939
Cash, cash equivalents, and restricted cash at end of period	$ 167,036	$ 335,893

Organization and Description of

Organization and Description of Business	6 Months Ended
	Jun. 30, 2022
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 Brisbane, 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, a donor-derived cell-free DNA (“dd-cfDNA”) solution for kidney transplant patients, AlloMap® Heart, a gene expression solution for heart transplant patients, AlloSure® Heart, a dd-cfDNA solution for heart transplant patients, and AlloSure® Lung, a dd-cfDNA solution for lung 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 (“Ottr”) and XynManagement, Inc. (“XynManagement”), as well as the acquisitions of TransChart LLC (“TransChart”), MedActionPlan.com, LLC (“MedActionPlan”) and The Transplant Pharmacy, LLC (“TTP”) in 2021. 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 received positive coverage decisions from several commercial payers, and 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 . AlloMap Heart has also received positive coverage decisions for reimbursement from many of the largest U.S. private payers. In October 2020, AlloSure Heart received a final Palmetto MolDx Medicare coverage decision for AlloSure Heart. In November 2020 , Noridian Healthcare Solutions, the Company's Medicare Administrative Contractor, issued a parallel coverage policy granting coverage when used in conjunction with AlloMap Heart, which became effective in December 2020. The Medicare reimbursement rate for AlloSure Heart is currently $2,753. In May 2021, the Company purchased a minority investment of common stock in the biotechnology company Miromatrix Medical, Inc. (“Miromatrix”), for $5.0 million, and the investment is marked to market. Miromatrix works to eliminate the need for an organ transplant waiting list through the development of implantable engineered biological organs. 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 1,700 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 February 2019, AlloSure® Lung became available for lung transplant patients through a compassionate use program while the test is undergoing further studies. In June 2020, the Company submitted an AlloSure Lung application to the Palmetto MolDx Technical Assessment program seeking coverage and reimbursement for Medicare beneficiaries. 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 iBox for a multimodality surveillance solution. The Company has not yet made any applications to private payers for reimbursement coverage of AlloMap Kidney or KidneyCare. Products The Company’s suite of AlloSeq products are commercial next generation sequencing (“NGS”)-based kitted solutions. 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. In March 2021, the Company acquired certain assets of BFS Molecular S.R.L. (“BFS Molecular”), a software company focused on NGS-based patient testing solutions. BFS Molecular brings extensive software and algorithm development capabilities for NGS transplant surveillance products. Patient and Digital Solutions Following the acquisitions of both Ottr and XynManagement, the Company is a leading provider of transplant patient management 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 XynCare. XynQAPI simplifies transplant quality tracking and Scientific Registry of Transplant Recipients ("SRTR") reporting. XynCare includes a team of transplant assistants who maintain regular contact with patients on the waitlist to help prepare for their transplant and maintain eligibility. In September 2020, the Company launched AlloCare, a mobile app that provides a patient-centric resource for transplant recipients to manage medication adherence, coordinate with Patient Care Managers for AlloSure scheduling and measure health metrics. In January 2021, the Company acquired TransChart. TransChart provides EMR software to hospitals throughout the U.S. to care for patients who have or may need an organ transplant. As part of the Company's acquisition of TransChart in January 2021, the Company acquired TxAccess, a cloud-based service that allows nephrologists and dialysis centers to electronically submit referrals to transplant programs, closely follow and assist patients through the transplant waitlist process, and ultimately, through transplantation. In June 2021, the Company acquired the Transplant Hero patient application. The application helps patients manage their medications through alarms and interactive logging of medication eve nts . In June 2021, the Company entered into a strategic agreement, which was amended in April 2022, with OrganX to develop clinical decision support tools across the transplant patient journey. Together, the Company and OrganX will develop advanced analytics that integrate AlloSure, the first transplant specific dd-cfDNA assay, with large transplant databases to provide clinical data solutions. This partnership delivers the next level of innovation beyond multi-modality by incorporating a variety of clinical inputs to create a universal composite scoring system. The Company has agreed to potential future milestone payments. In November 2021, the Company acquired MedActionPlan, a New Jersey-based provider of medication safety, medication adherence and patient education. MedActionPlan is a leader in patient medication management for transplant patients and beyond. In December 2021, the Company acquired TTP, a transplant focused pharmacy located in Mississippi. TTP provides individualized transplant pharmacy services for patients at multiple transplant centers located throughout the U.S. COVID-19 Pandemic The full impact of the continued COVID-19 pandemic, including the impact associated with preventative and precautionary measures that the Company, other businesses and governments have taken and may take, 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. There continues to be uncertainty around the COVID-19 pandemic as the Omicron variant, including its sub-variants, has caused an increase in COVID-19 cases globally, impacted the availability of medical personnel in transplant centers and the volume of transplant procedures. A sustained reduction in transplant volume can negatively impact the testing volumes, as the Company saw in the early part of the first quarter of 2022. The Company's product business experienced a reduction in forecasted sales volume throughout the second and third quarters of 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 authorization in May 2020. The Company's product business regained normalized sales volumes during the fourth quarter of 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 virtual platforms. Although the executive orders that placed certain restrictions on operations in San Mateo County and the State of California, where the Company's laboratory and headquarters are located, were lifted effective June 15, 2021, new orders or restrictions could be adopted in the future depending upon the COVID-19 transmission rates in the Company's county and state, as well as other factors. In addition, the Company created, and continues to have, a COVID-19 task force that is responsible for crisis decision making, employee communications, and enforcing all safety, monitoring and testing protocols in line with local regulations. 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 $424.5 million at June 30, 2022. As of June 30, 2022, the Company had cash, cash equivalents and marketable securities of $306.2 million and no debt outstanding. 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 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 submitted a request to the appropriate Medicare Administrative Contractor and met 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. During December 2020, the Company reassessed the Deferred revenue - CMS advance payment and repaid the entire amount in January 2021. January 2021 Underwritten Public Offering of Common Stock On January 25, 2021, the Company sold 1,923,077 shares of its common stock through an underwritten public offering at a public offering price of $91.00 per share. The net proceeds to the Company from the offering were approximately $164.0 million, after deducting underwriting discounts and commissions and offering expenses. On February 11, 2021, the Company sold 288,461 shares of its common stock pursuant to the full exercise of the overallotment option granted to the underwriters in connection with the offering. The net proceeds to the Company from the full exercise of the underwriters' overallotment option were approximately $24.7 million.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2022
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, 2021, and the notes thereto, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021, filed with the Securities and Exchange Commission (the "SEC") on February 24, 2022. 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, 2021 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 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, 2021 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, 2022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2022. 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 patient and digital solutions revenue performance obligations; accrued expenses for clinical studies; inventory valuation; 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 or an asset acquisition; 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, 2022 and 2021, approximately 54% and 61%, respectively, of total revenue was derived from Medicare. For the six months ended June 30, 2022 and 2021, approximately 54% and 61%, respectively, of total revenue was derived from Medicare. As of June 30, 2022 and December 31, 2021, approximately 28% and 27%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable at either June 30, 2022 or December 31, 2021. Marketable Securities The Company considers all highly liquid investments in securities with a maturity of greater than three months at the time of purchase to be marketable securities. As of June 30, 2022, the Company’s short-term marketable securities consisted of corporate debt securities with maturities of greater than three months but less than twelve months at the time of purchase, which were classified as current assets on the condensed consolidated balance sheet . The Company classifies its short-term marketable securities as held-to-maturity at the time of purchase and reevaluates such designation at each balance sheet date. The Company has the positive intent and ability to hold these marketable securities to maturity. Short-term marketable securities are carried at amortized cost and are adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income, net on the condensed consolidated statements of operations. Realized gains and losses and declines in value judged to be other-than-temporary, if any, on short-term marketable securities are included in interest income, net. The cost of securities sold will be determined using specific identification. The Company considers investments in securities with remaining maturities of over one year as long-term investments. As of June 30, 2022, the Company's long-term marketable securities consisted of corporate equity securities and corporate debt securities. These long-term marketable securities are classified as other assets on the condensed consolidated balance sheet . The Company classifies its long-term marketable debt securities as available-for-sale and reevaluates such designation at each balance sheet date. Unrealized gains and losses from the reevaluation of the long-term marketable debt securities, if any, are included in other comprehensive gain (loss) in the condensed consolidated statement of comprehensive income (loss). Realized gains and losses and declines in value judged to be other-than-temporary, if any, on long-term marketable securities are included in interest income, net. The Company records its long-term marketable equity securities at fair market value. Unrealized gains and losses from the remeasurement of the long-term marketable equity securities to fair value are included in other income (expense), net, in the condensed consolidated statements of operations. Leases The Company adopted Accounting Standard Codification (“ASC”) Topic 842, Leases, and 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 incremental borrowing rate is determined by using the rate of interest that the Company would pay to borrow on a collateralized basis an amount equal to the lease payments for a similar term and in a similar economic environment. As of June 30, 2022, the Company’s leases had remaining terms of 0.04 years to 6.67 years, some of which include options to extend the lease term. Recent Accounting Pronouncements In November 2021, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance , which contains amendments that require annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting model. The disclosures include (1) the types of assistance, (2) an entity’s accounting for the assistance, and (3) the effect of the assistance on an entity’s financial statements. The amendments set forth in this ASU are effective for all entities for annual periods beginning after December 15, 2021. Early application of the amendments in this ASU is permitted. The amendments in this ASU should be applied either (1) prospectively to all transactions within the scope of the amendments that are reflected in financial statements at the date of initial application and new transactions that are entered into after the date of initial application or (2) retrospectively to those transactions. The Company adopted the standard prospectively on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers , which requires that an entity recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”). At the acquisition date, an acquirer should account for the related revenue contracts in accordance with ASC 606 as if it had originated the contracts. The amendments set forth in this ASU are effective for fiscal years beginning after December 15, 2022. Early adoption of the amendments is permitted. The amendments in this ASU should be applied prospectively to business combinations occurring on or after the effective date of the amendments. The Company early adopted the standard prospectively on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In May 2021, the FASB issued ASU No. 2021-04, Earnings Per Share (Topic 260), Debt-Modifications and Extinguishments (Subtopic 470-50), Compensation-Stock Compensation (Topic 718), and Derivatives and Hedging-Contracts in Entity’s Own Equity (Subtopic 815-40) : Issuer’s Accounting for Certain Modifications or Exchanges of Freestanding Equity-Classified Written Call Options (a consensus of the FASB Emerging Issues Task Force), which contains amendments that clarify and reduce diversity in an issuer's accounting for modifications or exchanges of freestanding equity-classified written call options that remain equity classified after modification or exchange. The amendments set forth in this ASU are effective for all entities for annual periods beginning after December 15, 2021. Early application of the amendments in this ASU is permitted for all entities. The amendments in this ASU should be applied prospectively. The Company prospectively adopted the standard on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In October 2020, the FASB issued ASU No. 2020-10, Codification Improvements , which contains amendments that improve the consistency of the ASC by including all disclosure guidance in the appropriate Disclosure Section (Section 50). The FASB provided transition guidance for all the amendments in this ASU. The amendments in Sections B and C (Section A has been removed) of this ASU are effective for annual periods beginning after December 15, 2020 for public business entities. Early application of the amendments in this ASU is permitted for public business entities for any annual or interim period for which financial statements have not been issued. The amendments in this ASU should be applied retrospectively. The Company adopted the standard on January 1, 2021. The adoption of the new standard did not have an impact on the Company's consolidated financial statements and disclosures.

Net Loss Per Share

Net Loss Per Share	6 Months Ended
	Jun. 30, 2022
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, 2022 2021 2022 2021 Numerator: Net loss used to compute basic and diluted net loss per share $ (21,697) $ (1,927) $ (41,345) $ (2,614) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 53,249,545 52,224,300 53,133,149 51,705,587 Net loss per share: Basic and diluted $ (0.41) $ (0.04) $ (0.78) $ (0.05) The following potentially dilutive securities have been excluded from diluted net loss per share as of June 30, 2022 and 2021 because their effect would be antidilutive: Three and Six Months Ended 2022 2021 Shares of common stock subject to outstanding options 2,497,986 2,117,516 Shares of common stock subject to outstanding common stock warrants 3,132 3,132 Restricted stock units 2,591,882 1,868,980 Total common stock equivalents 5,093,000 3,989,628

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	FAIR VALUE MEASUREMENTS The Company records its financial assets and liabilities at fair value. The carrying amounts of certain financial instruments of the Company, including cash and cash equivalents, prepaid expenses and other current assets, accounts payable and accrued liabilities, approximate fair value due to their relatively short maturities. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The accounting guidance establishes a three-tiered hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value as follows: • Level 1: Inputs that include quoted prices in active markets for identical assets and liabilities. • Level 2: Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3: Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. The following tables set forth the Company’s financial assets and liabilities, measured at fair value on a recurring basis, as of June 30, 2022 and December 31, 2021 (in thousands): June 30, 2022 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Balance Assets Cash equivalents: Money market funds $ 142,355 $ — $ — $ 142,355 Long-term marketable securities: Corporate equity securities 2,771 — — 2,771 Corporate debt securities — 500 — 500 Total $ 145,126 $ 500 $ — $ 145,626 Liabilities Short-term liabilities: Contingent consideration $ — $ — $ 2,778 $ 2,778 Long-term liabilities: Contingent consideration — — 2,877 2,877 Common stock warrant liability — — 64 64 Total $ — $ — $ 5,719 $ 5,719 December 31, 2021 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Balance Assets Cash equivalents: Money market funds $ 335,107 $ — $ — $ 335,107 Long-term marketable securities: Corporate equity securities 3,257 — — 3,257 Corporate debt securities — 500 — 500 Total $ 338,364 $ 500 $ — $ 338,864 Liabilities Short-term liabilities: Contingent consideration $ — $ — $ 2,114 $ 2,114 Long-term liabilities: Contingent consideration — — 3,227 3,227 Common stock warrant liability — — 139 139 Total $ — $ — $ 5,480 $ 5,480 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 and Contingent Consideration Balance as of December 31, 2021 $ 5,480 Change in estimated fair value of common stock warrant liability (75) Change in estimated fair value of contingent consideration 564 Payments related to contingent consideration (250) Balance as of June 30, 2022 $ 5,719 As of June 30, 2022, the Company had one investment in convertible preferred shares carried at cost. In the event the Company had to calculate the fair value of this investment, it would be based on Level 3 inputs. This investment is not considered material to the Company's condensed consolidated financial statements. 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, 2022 and December 31, 2021, money market funds were included as cash and cash equivalents in the condensed consolidated balance sheets. • Short-term marketable securities – Investments in short-term marketable securities are classified within Level 2. The securities are valued using third-party pricing sources. The pricing services utilize industry standard valuation models, including both income and market-based approaches, for which all significant inputs are observable, either directly or indirectly. • Long-term marketable equity and debt securities – Investments in long-term marketable equity securities are classified within Level 1. The securities are recorded at fair value based on readily available quoted market prices in active markets. Investments in long-term marketable debt securities are classified within Level 2. The securities are recorded at fair value based on observable inputs for quoted prices for identical or similar assets in markets that are not active. Long-term marketable securities are located within other assets on the condensed consolidated balance sheets. • Contingent consideration – Contingent consideration is classified within Level 3. Contingent consideration relates to asset acquisitions and business combinations. The Company recorded the estimate of the fair value of the contingent consideration based on its evaluation of the probability of the achievement of the contractual conditions that would result in the payment of the contingent consideration. Contingent consideration was estimated using the fair value of the milestones to be paid if the contingency is met multiplied by management’s estimate of the probability of success at a discounted rate of 12% at June 30, 2022 and December 31, 2021. The significant input in the Level 3 measurement that is not supported by market activity is the Company’s probability assessment of the achievement of the milestones. The value of the liability is subsequently remeasured to fair value at each reporting date, and the change in estimated fair value is recorded as a component of operating expenses until the milestones are paid, expire or are no longer achievable. Increases or decreases in the estimation of the probability percentage result in a directionally similar impact to the fair value measurement of the contingent consideration liability. The carrying amount of the contingent consideration liability represents its fair value. • Common stock warrant liability – Common stock warrant liability is classified within Level 3. The Company utilizes intrinsic value to estimate the fair value of the warrants. The intrinsic value is computed as the difference between the fair value of the Company’s common stock on the valuation date and the exercise price of the warrants. Increases (decreases) in the Company's stock price discussed above result in a directionally similar impact to the fair value of the common stock warrant liability. Prior to fiscal year 2022, the Company utilized a binomial lattice pricing model (the "Monte Carlo Simulation Model") which 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 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. The change in valuation method does not have material financial impact. Common Stock Warrant Liability Valuation Assumptions Utilized at June 30, 2022 and December 31, 2021: June 30, 2022 December 31, 2021 Private Placement Common Stock Warrant Liability Stock Price $ 21.48 $ 45.48 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 0.79 1.28 Volatility N/A 66.00 % Risk-free interest rate N/A 0.49 %

Cash and Marketable Securities

Cash and Marketable Securities	6 Months Ended
	Jun. 30, 2022
Cash and Cash Equivalents [Abstract]
Cash and Marketable Securities	CASH AND MARKETABLE SECURITIES Cash, Cash Equivalents and Restricted Cash A reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets to the amount reported within the condensed consolidated statements of cash flows is shown in the table below (in thousands): June 30, 2022 June 30, 2021 Cash and cash equivalents $ 166,832 $ 335,625 Restricted cash 204 268 Total cash, cash equivalents, and restricted cash at the end of the period $ 167,036 $ 335,893 Marketable Securities All short-term marketable securities were considered held-to-maturity at June 30, 2022. At June 30, 2022, some of the Company’s short-term marketable securities were in an unrealized loss position. The Company determined that it had the positive intent and ability to hold until maturity all short-term marketable securities that have been in a continuous loss position, thus there was no recognition of any other-than-temporary impairment as of June 30, 2022. All short-term marketable securities with unrealized losses as of the balance sheet date have been in a loss position for less than twelve months. Contractual maturities of the short-term marketable securities were within one year or less at June 30, 2022. The long-term marketable equity securities were recorded at fair market value at June 30, 2022 and December 31, 2021. The long-term marketable debt securities were considered available-for-sale at June 30, 2022 and December 31, 2021. The contractual maturity of the long-term marketable debt securities are less than three years. The amortized cost, gross unrealized holding losses, and fair value of the Company’s marketable securities by major security type at each balance sheet date are summarized in the tables below (in thousands): June 30, 2022 Amortized Cost Unrealized Holding Losses Fair Value Short-term marketable securities: Corporate debt securities $ 139,388 $ (835) $ 138,553 Total short-term marketable securities 139,388 (835) 138,553 Long-term marketable securities: Corporate equity securities 5,000 (2,229) 2,771 Corporate debt securities 500 — 500 Total long-term marketable securities 5,500 (2,229) 3,271 Total $ 144,888 $ (3,064) $ 141,824 December 31, 2021 Amortized Cost Unrealized Holding Losses Fair Value Long-term marketable securities: Corporate equity securities $ 5,000 $ (1,743) $ 3,257 Corporate debt securities 500 — 500 Total long-term marketable securities $ 5,500 $ (1,743) $ 3,757 Contractual maturities of the marketable securities at each balance sheet date are as follows (in thousands): June 30, 2022 December 31, 2021 Within one year $ 139,388 $ — After one year through five years 500 500 Total $ 139,888 $ 500

Business Combinations

Business Combinations	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Business Combinations	BUSINESS COMBINATIONS The Transplant Pharmacy In December 2021, the Company acquired TTP, a transplant focused pharmacy located in Mississippi. The Company acquired TTP with a combination of cash consideration paid upfront and contingent consideration with a fair value of $1.3 million. TTP provides individualized transplant pharmacy services for patients at multiple transplant centers located throughout the U.S. The Company accounted for the transaction as a business combination using the acquisition method of accounting. Acquisition-related costs of $0.3 million were expensed as incurred, and classified as part of general and administrative expenses in the condensed consolidated statements of operations. Goodwill of $5.5 million arising from the acquisition primarily consists of additional growth opportunities within the pharmacy sector. The integration of TTP into the Company’s portfolio is expected to continue to increase the transplant ecosystem for patients and make medication more accessible. The Company estimated net deferred tax liabilities of approximately $0.6 million arising from temporary differences related to the assets acquired and liabilities assumed. None of the goodwill is expected to be deductible for income tax purposes. All of the goodwill has been assigned to the Company’s existing operating segment. The following table summarizes the fair value of the intangible asset acquired as of the acquisition date ($ in thousands): Estimated Fair Value Estimated Useful Life (Years) Trademark $ 2,080 10 The trademark acquired consists primarily of the TTP brand and markings. The fair value of the trademark was 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 due to its ownership of the asset. The royalty rate of 2% was used to estimate the fair value of the trademark. A discount rate of 13.5% was utilized in estimating the fair value of the trademark. The pro forma impact of the TTP acquisition is not material, and the results of operations of the acquisition have been included in the Company's condensed consolidated statements of operations from the respective acquisition date. MedActionPlan In November 2021, the Company acquired MedActionPlan, a New Jersey-based provider of medication safety, medication adherence and patient education. The Company acquired MedActionPlan with a combination of cash consideration paid upfront and contingent consideration with a fair value of $3.5 million. MedActionPlan is a leader in patient medication management for transplant patients and beyond. The Company accounted for the transaction as a business combination using the acquisition method of accounting. 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 $4.9 million arising from the acquisition primarily consists of synergies from integrating the MedActionPlan technology with the current testing and digital solutions offered by the Company. The integration of MedActionPlan into centers with the Company's other software platforms will continue to increase the standard of care for transplant patient safety, increase efficiency and facilitate medication compliance. None of the goodwill is expected to be deductible for income tax purposes. All of the goodwill has been assigned to the Company’s existing operating segment. The following table summarizes the fair values of the intangible assets acquired as of the acquisition date ($ in thousands): Estimated Fair Value Estimated Useful Lives (Years) Customer relationships $ 2,590 10 Developed technology 1,090 10 Trademarks 80 5 Total $ 3,760 Customer relationships acquired by the Company represent the fair value of future projected revenue that is expected to be derived from sales of MedActionPlan’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 MedActionPlan’s proprietary software. The trademark acquired consists primarily of the MedActionPlan 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 due to its ownership of the asset. The royalty rates of 15% and 1% were used to estimate the fair value of the developed technology and the trademark, respectively. A discount rate of 40.0% was utilized in estimating the fair value of these three intangible assets. The pro forma impact of the MedActionPlan acquisition is not material, and the results of operations of the acquisition have been included in the Company's condensed consolidated statements of operations from the respective acquisition date. TransChart LLC In January 2021, the Company acquired TransChart for cash. TransChart provides EMR software to hospitals throughout the U.S. to care for patients who have or may need an organ transplant. As a result of the acquisition, the Company recognized goodwill of $2.2 million and intangible assets of $2.0 million. The pro forma impact of the TransChart acquisition is not material, and the results of operations of the acquisition have been included in the Company's condensed consolidated statements of operations from the respective acquisition date. Combined Consideration Paid The following table summarizes the consideration paid for TTP, MedActionPlan and TransChart, 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 $ 17,166 Total consideration $ 17,166 Recognized amounts of identifiable assets acquired and liabilities assumed Current assets $ 3,444 Fixed assets 23 Identifiable intangible assets 7,860 Other assets 2 Current liabilities (3,915) Noncurrent liabilities (2,883) Total identifiable net assets acquired 4,531 Goodwill 12,635 Total consideration $ 17,166 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.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2022
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, 2022. The balance of the Company's goodwill was $37.1 million and $37.0 million as of June 30, 2022 and December 31, 2021, respectively. Intangible Assets The following table presents details of the Company’s intangible assets as of June 30, 2022 ($ in thousands): June 30, 2022 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life Intangible assets with finite lives: Acquired and developed technology $ 35,874 $ (13,705) $ (2,281) $ 19,888 7.8 Customer relationships 21,898 (6,759) (2,009) 13,130 9.4 Commercialization rights 11,579 (2,601) — 8,978 7.1 Trademarks and tradenames 4,540 (1,170) (298) 3,072 9.0 Total intangible assets with finite lives 73,891 (24,235) (4,588) 45,068 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 75,141 $ (24,235) $ (4,588) $ 46,318 The following table presents details of the Company’s intangible assets as of December 31, 2021 ($ in thousands): December 31, 2021 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life Intangible assets with finite lives: Acquired and developed technology $ 35,874 $ (12,088) $ (1,513) $ 22,273 8.1 Customer relationships 21,898 (6,024) (1,210) 14,664 9.9 Commercialization rights 10,579 (2,030) — 8,549 7.6 Trademarks and tradenames 4,540 (988) (155) 3,397 9.5 Other 250 (188) — 62 0.2 Total intangible assets with finite lives 73,141 (21,318) (2,878) 48,945 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 74,391 $ (21,318) $ (2,878) $ 50,195 Acquisition of Intangible Assets In June 2021and June 2022, the Company acquired commercialization rights in an exclusive partnership for comprehensive data analytics in relation to NGS-based metagenomics testing for infectious diseases. This is included within Commercialization rights as of June 30, 2022. In June 2021, the Company acquired the Transplant Hero patient application. The patient application is included in Acquired and developed technology as of June 30, 2022. In the fourth quarter of 2021, acquisition of intangible assets increased $13.4 million primarily from business combinations. These acquisitions included $4.7 million of Acquired and developed technology, $2.5 million of Commercialization rights, $3.7 million of Customer relationships, $2.2 million of Trademarks and tradenames and $0.3 million of Other intangible assets. Amortization of Intangible Assets Intangible assets are carried at cost less accumulated amortization. Amortization expenses are recorded to cost of testing services, cost of product, cost of patient and digital solutions, and sales and marketing expenses in the condensed consolidated statements of operations. The following table summarizes the Company's amortization expense of intangible assets (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Cost of testing services $ 329 $ 350 $ 658 $ 658 Cost of product 437 489 890 954 Cost of patient and digital solutions 236 141 472 249 Sales & marketing 543 449 1,148 842 Total $ 1,545 $ 1,429 $ 3,168 $ 2,703 The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of June 30, 2022 (in thousands): Years Ending December 31, Cost of Testing Services Cost of Product Cost of Patient and Digital Solutions Sales and Marketing Total Remainder of 2022 $ 658 $ 847 $ 472 $ 1,117 $ 3,094 2023 1,316 1,694 945 2,223 6,178 2024 1,316 1,694 709 2,223 5,942 2025 1,316 1,694 540 2,223 5,773 2026 1,316 747 540 2,221 4,824 Thereafter 4,141 4,052 1,720 9,344 19,257 Total future amortization expense $ 10,063 $ 10,728 $ 4,926 $ 19,351 $ 45,068

Balance Sheet Components

Balance Sheet Components	6 Months Ended
	Jun. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	BALANCE SHEET COMPONENTS Inventory Inventory consisted of the following (in thousands): June 30, 2022 December 31, 2021 Finished goods $ 3,602 $ 3,911 Work in progress 3,944 2,828 Raw materials 11,315 10,447 Total inventory $ 18,861 $ 17,186 Accrued and Other Liabilities Accrued and other liabilities consisted of the following (in thousands): June 30, 2022 December 31, 2021 Clinical studies $ 13,325 $ 10,653 Professional fees 8,257 5,780 Deferred revenue 4,295 4,208 Short-term lease liability 2,989 3,958 Deferred payments for intangible assets 2,906 2,000 Contingent consideration 2,778 2,114 Capital expenditures 2,537 2,612 Laboratory processing fees & materials 2,400 1,888 Accrued royalty 1,560 1,664 Accrued shipping expenses 704 670 Other accrued expenses 5,182 2,375 Total accrued and other liabilities $ 46,933 $ 37,922

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2022
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 Brisbane, California; Columbus, Ohio; West Chester, Pennsylvania; Flowood, Mississippi; Gaithersburg, Maryland; Fremantle, Australia; and Stockholm, Sweden. 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, 2022, the carrying value of the ROU asset was $15.8 million. The related current and non-current liabilities as of June 30, 2022 were $3.0 million and $16.1 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, 2022 and 2021 (in thousands): Three Months Ended Six Months Ended 2022 2021 2022 2021 Operating lease cost $ 1,372 $ 1,207 $ 2,785 $ 2,412 Finance lease cost — 23 — 53 Total lease cost $ 1,372 $ 1,230 $ 2,785 $ 2,465 Finance lease cost includes interest from the lease liability and amortization of the ROU asset. June 30, 2022 Other information: Weighted-average remaining lease term - Operating leases (in years) 5.76 Weighted-average discount rate - Operating leases (%) 9.9 % Maturities of operating lease liabilities as of June 30, 2022 are as follows (in thousands): Years Ending December 31, Operating Leases Remainder of 2022 $ 2,305 2023 4,495 2024 4,318 2025 3,955 2026 3,196 Thereafter 7,140 Total lease payments 25,409 Less imputed interest 6,355 Present value of future minimum lease payments 19,054 Less operating lease liability, current portion 2,989 Operating lease liability, long-term portion $ 16,065 In June 2022, the Company signed a termination agreement (the "Termination Agreement") for its headquarters office lease in South San Francisco, California (the "South San Francisco Lease"). Pursuant to the Termination Agreement, the termination date for the South San Francisco Lease was modified from December 31, 2022 to July 15, 2022. As a result of such modification, the Company remeasured its lease liability using the current incremental borrowing rate and made an adjustment by reducing the ROU asset and lease liability by $0.5 million. In July 2022, the Company moved and relocated its headquarters from South San Francisco, California to Brisbane, California. Also, in June 2022, the Company renewed the lease agreement for its offices in Fremantle, Australia, and extended the lease term for two years through May 2024. 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, Inc. (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 that certain license and commercialization agreement that the Company entered into with Cibiltech SAS (“Cibiltech”) effective April 30, 2019, the Company will share an agreed-upon percentage of revenue with Cibiltech, if and when revenues are generated from iBox. Other Commitments Pursuant to the Illumina Agreement, the Company has agreed to minimum purchase commitments of finished products and raw materials from Illumina, Inc. 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 (the “Court”) alleging the Company made false and misleading claims about the performance capabilities of AlloSure. The suit seeks injunctive relief and unspecified monetary relief. On September 30, 2020, Natera requested leave of Court to amend its counterclaims to include additional allegations regarding purportedly false claims the Company made with respect to AlloSure, and the Court granted Natera’s request. The trial commenced on March 7, 2022 and concluded on March 14, 2022, with the jury awarding the Company $44.9 million in damages, comprised of $21.2 million in compensatory damages and $23.7 million in punitive damages. Post-trial motion practice remains pending. The Company will not record the award until cash is received or the matter is otherwise resolved. On July 19, 2022, the Federal Circuit court of appeals affirmed the district court’s judgment dismissing the Company’s patent infringement suit against Natera. 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 Court alleging, among other things, that AlloSure infringes Natera’s U.S. Patent 10,526,658. This case was consolidated with the Company’s patent infringement suit on February 4, 2020. 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. On May 13, 2022, Natera filed two new complaints alleging that AlloSure infringes Natera’s U.S. Patents 10,655,180 and 11,111,544. These two cases were consolidated with the patent infringement case on June 15, 2022. On May 17, 2022, Natera agreed to dismiss the case alleging infringement of Natera’s U.S. Patent 10,526,658. On July 6, 2022, the Company moved to dismiss the rest of Natera’s claims. The motion remains pending. 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. United States Department of Justice and United States Securities and Exchange Commission Investigations As previously disclosed, in 2021, the Company received a civil investigative demand (“CID”) from the United States Department of Justice ("DOJ") requesting that the Company produce certain documents in connection with a False Claims Act investigation being conducted by the DOJ regarding certain business practices related to the Company's kidney testing and phlebotomy services, and a subpoena from the United States Securities and Exchange Commission (“SEC”) in relation to an investigation by the SEC in respect of matters similar to those identified in the CID, as well as certain of the Company's accounting and public reporting practices. The Company also received an information request from a state regulatory agency and may receive additional requests for information from the DOJ, SEC, or other regulatory and governmental agencies regarding similar or related subject matters. The Company does not believe that the CID, the SEC subpoena or the state regulatory agency information request raise any issues regarding the safety or efficacy of any of the Company's products or services and are cooperating fully with the investigations. Although the Company remains committed to compliance with all applicable laws and regulations, it cannot predict the outcome of the DOJ or SEC investigations, the state regulatory agency information request, or any other requests or investigations that may arise in the future regarding these or other subject matters. 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. Olymbios Matter On April 15, 2022, a complaint was filed by Michael Olymbios against the Company in the Superior Court of the State of California for the County of San Mateo (the “San Mateo County Court”). The complaint alleges that the Company failed to pay certain fees and costs required to continue an arbitration proceeding against Dr. Olymbios, and that the Company has defamed Dr. Olymbios. Dr. Olymbios also seeks to void restrictive covenants previously agreed to by him in favor of the Company and to recover damages purportedly incurred by Dr. Olymbios. The Company filed a motion to compel arbitration and dismiss the case. On April 25, 2022, the San Mateo County Court granted the Company’s ex parte application to stay the case and advance the hearing date to June 10, 2022 for the motion to compel arbitration and dismiss. At the June 10, 2022 hearing, the San Mateo County Court found that the decision should be made by the arbitrator, and stayed the case. The arbitration hearing is currently set for October 27, 2022. The Company intends to defend itself vigorously. The Company believes it has good and substantial defenses to the claims alleged in the suit, but there is no guarantee that the Company will prevail if the case continues. The Company has not recorded any liabilities for this suit. Securities Class Action On May 23, 2022, Plumbers & Pipefitters Local Union #295 Pension Fund filed a federal securities class action in the U.S. District Court for the Northern District of California against the Company, Reginald Seeto, its President, Chief Executive Officer and member of the Company’s Board of Directors, Ankur Dhingra, its former Chief Financial Officer, Marcel Konrad, its former interim Chief Financial Officer and former Senior Vice President of Finance & Accounting, and Peter Maag, its

401(K) Plan

401(K) Plan	6 Months Ended
	Jun. 30, 2022
Retirement Benefits [Abstract]
401(K) Plan	401(K) PLANThe Company sponsors a 401(k)

Warrants

Warrants	6 Months Ended
	Jun. 30, 2022
Warrants and Rights Note Disclosure [Abstract]
Warrants	WARRANTS The Company issues 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 and six months ended June 30, 2022, no warrants to purchase shares of common stock were exercised. In the three and six months ended June 30, 2021, warrants to purchase approximately 3,000 shares of common stock were exercised for cash proceeds of $4 thousand. As of June 30, 2022, outstanding warrants to purchase common stock were: Classified as Original Term Exercise Price Number of Shares Underlying Warrants Original issue date: April 2016 Liability 7 years $ 1.12 3,132 3,132

Stock Incentive Plans

Stock Incentive Plans	6 Months Ended
	Jun. 30, 2022
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, 2021 2,066,529 1,863,633 $ 29.33 2,047,657 $ 50.21 Additional shares authorized 2,116,934 — — — — Common stock awards for services (3,082) — — — — RSUs granted (1,223,905) — — 1,223,905 34.20 RSUs vested — — (408,565) 39.00 Options granted (908,835) 908,835 34.68 — — Options exercised — (89,326) 22.51 — — Repurchase of common stock under employee incentive plans 126,796 — — — — RSUs forfeited 271,115 — — (271,115) 50.39 Options forfeited 177,860 (177,860) 39.34 — — Options expired 7,296 (7,296) 30.96 — — Balance—June 30, 2022 2,630,708 2,497,986 $ 30.58 2,591,882 $ 44.52 The total intrinsic value of options exercised was $0.3 million and $1.3 million for the three and six months ended June 30, 2022, respectively. The total intrinsic value of options exercised was $25.9 million and $35.0 million for the three and six months ended June 30, 2021, respectively. As of June 30, 2022, the total intrinsic value of outstanding RSUs was approximately $55.7 million and there were $91.7 million of unrecognized compensation costs related to RSUs, which are expected to be recognized over a weighted-average period of 2.95 years. Options outstanding that have vested and are expected to vest at June 30, 2022 are as follows: Number of Shares Issued Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Intrinsic Value Vested 1,134 $ 23.80 6.35 $ 5,857 Expected to vest 1,260 36.21 9.02 637 Total 2,394 $ 6,494 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, 2022 for stock options that were in-the-money. The total fair value of options that vested during the three and six months ended June 30, 2022 was $2.4 million and $6.3 million, respectively. As of June 30, 2022, there were approximately $28.8 million of unrecognized compensation costs related to stock options, which are expected to be recognized over a weighted-average period of 2.96 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 2022 that ended on June 30, 2022, 67,570 shares were purchased pursuant to the ESPP for aggregate proceeds of $1.2 million from the issuance of such shares, which occurred on July 1, 2022. During the offering period in 2021 that ended on December 31, 2021, 25,852 shares were purchased pursuant to the ESPP for aggregate proceeds of $1.0 million from the issuance of such shares, which occurred on January 6, 2022. 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, 2022 2021 2022 2021 Employee stock options Expected term (in years) 5.9 5.6 5.9 5.9 Expected volatility 76.94% 78.07% 76.94% 77.78% Risk-free interest rate 2.88% 1.03% 2.41% 0.76% Expected dividend yield —% —% —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 0.5 0.5 Expected volatility 67.79% 53.10% 67.79% 53.10% Risk-free interest rate 2.51% 0.09% 2.51% 0.09% 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. 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 non-employee stock-based awards for the three and six months ended June 30, 2022 and 2021, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Cost of testing services $ 566 $ 570 $ 585 $ 965 Cost of product 402 214 530 289 Cost of patient and digital solutions 391 230 583 338 Research and development 2,323 1,940 4,513 3,298 Sales and marketing 3,907 2,632 7,030 4,292 General and administrative 5,004 3,811 9,986 6,763 Total $ 12,593 $ 9,397 $ 23,227 $ 15,945 No tax benefit was recognized related to stock-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, 2022
Income Tax Disclosure [Abstract]
Income Taxes	INCOME TAXES The 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, 2022, the Company recorded an income tax benefit of $49 thousand and $61 thousand, respectively. For the three and six months ended June 30, 2021, the Company recorded an income tax benefit of $0.1 million and $0.4 million, respectively. The income tax benefit of $49 thousand and $61 thousand for the three and six months ended June 30, 2022 is primarily attributable to the recognition of deferred tax assets from foreign losses. 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 Australian net deferred tax assets have been offset by a full valuation allowance.

Segment Reporting

Segment Reporting	6 Months Ended
	Jun. 30, 2022
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, the region of testing for testing services revenue, and the region of services provided for patient and digital solutions revenue. The following table summarizes reportable revenues by geographic regions (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Testing services revenue United States $ 66,905 $ 64,839 $ 133,128 $ 123,860 Rest of World 230 51 451 311 $ 67,135 $ 64,890 $ 133,579 $ 124,171 Product revenue United States $ 3,577 $ 3,465 $ 7,190 $ 5,960 Europe 2,383 2,659 4,625 4,911 Rest of World 754 737 1,687 1,768 $ 6,714 $ 6,861 $ 13,502 $ 12,639 Patient and digital solutions revenue United States $ 6,525 $ 2,407 $ 12,678 $ 4,695 Europe 210 10 220 41 Rest of World 50 20 71 42 $ 6,785 $ 2,437 $ 12,969 $ 4,778 Total United States $ 77,007 $ 70,711 $ 152,996 $ 134,515 Total Europe $ 2,593 $ 2,669 $ 4,845 $ 4,952 Total Rest of World $ 1,034 $ 808 $ 2,209 $ 2,121 Total $ 80,634 $ 74,188 $ 160,050 $ 141,588 The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands): June 30, 2022 December 31, 2021 Long-lived assets: United States $ 32,321 $ 21,444 Europe 441 403 Rest of World 142 197 Total $ 32,904 $ 22,044

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2022
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 $424.5 million at June 30, 2022. As of June 30, 2022, the Company had cash, cash equivalents and marketable securities of $306.2 million and no debt outstanding. 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 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 submitted a request to the appropriate Medicare Administrative Contractor and met the required qualifications. During April 2020, the Company received an advance payment from CMS of approximately
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 SEC for
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 patient and digital solutions revenue performance obligations; accrued expenses for clinical studies; inventory valuation; 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 or an asset acquisition; 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, 2022 and 2021, approximately 54% and 61%, respectively, of total revenue was derived from Medicare. For the six months ended June 30, 2022 and 2021, approximately 54% and 61%, respectively, of total revenue was derived from Medicare. As of June 30, 2022 and December 31, 2021, approximately 28% and 27%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable at either June 30, 2022 or December 31, 2021.
Marketable Securities	Marketable Securities The Company considers all highly liquid investments in securities with a maturity of greater than three months at the time of purchase to be marketable securities. As of June 30, 2022, the Company’s short-term marketable securities consisted of corporate debt securities with maturities of greater than three months but less than twelve months at the time of purchase, which were classified as current assets on the condensed consolidated balance sheet . The Company classifies its short-term marketable securities as held-to-maturity at the time of purchase and reevaluates such designation at each balance sheet date. The Company has the positive intent and ability to hold these marketable securities to maturity. Short-term marketable securities are carried at amortized cost and are adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income, net on the condensed consolidated statements of operations. Realized gains and losses and declines in value judged to be other-than-temporary, if any, on short-term marketable securities are included in interest income, net. The cost of securities sold will be determined using specific identification. The Company considers investments in securities with remaining maturities of over one year as long-term investments. As of June 30, 2022, the Company's long-term marketable securities consisted of corporate equity securities and corporate debt securities. These long-term marketable securities are classified as other assets on the condensed consolidated balance sheet . The Company classifies its long-term marketable debt securities as available-for-sale and reevaluates such designation at each balance sheet date. Unrealized gains and losses from the reevaluation of the long-term marketable debt securities, if any, are included in other comprehensive gain (loss) in the condensed consolidated statement of comprehensive income (loss). Realized gains and losses and declines in value judged to be other-than-temporary, if any, on long-term marketable securities are included in interest income, net.
Leases	Leases The Company adopted Accounting Standard Codification (“ASC”) Topic 842, Leases, and 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 incremental borrowing rate is determined by using the rate of interest that the Company would pay to borrow on a collateralized basis an amount equal to the lease payments for a similar term and in a similar economic environment. As of June 30, 2022, the Company’s leases had remaining terms of 0.04 years to 6.67 years, some of which include options to extend the lease term.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In November 2021, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2021-10, Government Assistance (Topic 832): Disclosures by Business Entities about Government Assistance , which contains amendments that require annual disclosures about transactions with a government that are accounted for by applying a grant or contribution accounting model. The disclosures include (1) the types of assistance, (2) an entity’s accounting for the assistance, and (3) the effect of the assistance on an entity’s financial statements. The amendments set forth in this ASU are effective for all entities for annual periods beginning after December 15, 2021. Early application of the amendments in this ASU is permitted. The amendments in this ASU should be applied either (1) prospectively to all transactions within the scope of the amendments that are reflected in financial statements at the date of initial application and new transactions that are entered into after the date of initial application or (2) retrospectively to those transactions. The Company adopted the standard prospectively on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers , which requires that an entity recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC Topic 606, Revenue from Contracts with Customers (“ASC 606”). At the acquisition date, an acquirer should account for the related revenue contracts in accordance with ASC 606 as if it had originated the contracts. The amendments set forth in this ASU are effective for fiscal years beginning after December 15, 2022. Early adoption of the amendments is permitted. The amendments in this ASU should be applied prospectively to business combinations occurring on or after the effective date of the amendments. The Company early adopted the standard prospectively on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In May 2021, the FASB issued ASU No. 2021-04, Earnings Per Share (Topic 260), Debt-Modifications and Extinguishments (Subtopic 470-50), Compensation-Stock Compensation (Topic 718), and Derivatives and Hedging-Contracts in Entity’s Own Equity (Subtopic 815-40) : Issuer’s Accounting for Certain Modifications or Exchanges of Freestanding Equity-Classified Written Call Options (a consensus of the FASB Emerging Issues Task Force), which contains amendments that clarify and reduce diversity in an issuer's accounting for modifications or exchanges of freestanding equity-classified written call options that remain equity classified after modification or exchange. The amendments set forth in this ASU are effective for all entities for annual periods beginning after December 15, 2021. Early application of the amendments in this ASU is permitted for all entities. The amendments in this ASU should be applied prospectively. The Company prospectively adopted the standard on January 1, 2022. The adoption of this new standard had no impact on the Company's consolidated financial statements and disclosures. In October 2020, the FASB issued ASU No. 2020-10, Codification Improvements , which contains amendments that improve the consistency of the ASC by including all disclosure guidance in the appropriate Disclosure Section (Section 50). The FASB provided transition guidance for all the amendments in this ASU. The amendments in Sections B and C (Section A has been removed) of this ASU are effective for annual periods beginning after December 15, 2020 for public business entities. Early application of the amendments in this ASU is permitted for public business entities for any annual or interim period for which financial statements have not been issued. The amendments in this ASU should be applied retrospectively. The Company adopted the standard on January 1, 2021. The adoption of the new standard did not have an impact on the Company's consolidated financial statements and disclosures.

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2022
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, 2022 2021 2022 2021 Numerator: Net loss used to compute basic and diluted net loss per share $ (21,697) $ (1,927) $ (41,345) $ (2,614) Denominator: Weighted-average shares used to compute basic and diluted net loss per share 53,249,545 52,224,300 53,133,149 51,705,587 Net loss per share: Basic and diluted $ (0.41) $ (0.04) $ (0.78) $ (0.05)
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 of June 30, 2022 and 2021 because their effect would be antidilutive: Three and Six Months Ended 2022 2021 Shares of common stock subject to outstanding options 2,497,986 2,117,516 Shares of common stock subject to outstanding common stock warrants 3,132 3,132 Restricted stock units 2,591,882 1,868,980 Total common stock equivalents 5,093,000 3,989,628

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities Measured on Recurring Basis	The following tables set forth the Company’s financial assets and liabilities, measured at fair value on a recurring basis, as of June 30, 2022 and December 31, 2021 (in thousands): June 30, 2022 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Balance Assets Cash equivalents: Money market funds $ 142,355 $ — $ — $ 142,355 Long-term marketable securities: Corporate equity securities 2,771 — — 2,771 Corporate debt securities — 500 — 500 Total $ 145,126 $ 500 $ — $ 145,626 Liabilities Short-term liabilities: Contingent consideration $ — $ — $ 2,778 $ 2,778 Long-term liabilities: Contingent consideration — — 2,877 2,877 Common stock warrant liability — — 64 64 Total $ — $ — $ 5,719 $ 5,719 December 31, 2021 Fair Value Measured Using (Level 1) (Level 2) (Level 3) Total Balance Assets Cash equivalents: Money market funds $ 335,107 $ — $ — $ 335,107 Long-term marketable securities: Corporate equity securities 3,257 — — 3,257 Corporate debt securities — 500 — 500 Total $ 338,364 $ 500 $ — $ 338,864 Liabilities Short-term liabilities: Contingent consideration $ — $ — $ 2,114 $ 2,114 Long-term liabilities: Contingent consideration — — 3,227 3,227 Common stock warrant liability — — 139 139 Total $ — $ — $ 5,480 $ 5,480
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 and Contingent Consideration Balance as of December 31, 2021 $ 5,480 Change in estimated fair value of common stock warrant liability (75) Change in estimated fair value of contingent consideration 564 Payments related to contingent consideration (250) Balance as of June 30, 2022 $ 5,719
Summary of Common Stock Warrant and Derivative Liability Valuation Assumptions	Common Stock Warrant Liability Valuation Assumptions Utilized at June 30, 2022 and December 31, 2021: June 30, 2022 December 31, 2021 Private Placement Common Stock Warrant Liability Stock Price $ 21.48 $ 45.48 Exercise Price $ 1.12 $ 1.12 Remaining term (in years) 0.79 1.28 Volatility N/A 66.00 % Risk-free interest rate N/A 0.49 %

Cash and Marketable Securities

Cash and Marketable Securities (Tables)	6 Months Ended
	Jun. 30, 2022
Cash and Cash Equivalents [Abstract]
Schedule of Cash and Cash Equivalents	A reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets to the amount reported within the condensed consolidated statements of cash flows is shown in the table below (in thousands): June 30, 2022 June 30, 2021 Cash and cash equivalents $ 166,832 $ 335,625 Restricted cash 204 268 Total cash, cash equivalents, and restricted cash at the end of the period $ 167,036 $ 335,893
Marketable Securities	The amortized cost, gross unrealized holding losses, and fair value of the Company’s marketable securities by major security type at each balance sheet date are summarized in the tables below (in thousands): June 30, 2022 Amortized Cost Unrealized Holding Losses Fair Value Short-term marketable securities: Corporate debt securities $ 139,388 $ (835) $ 138,553 Total short-term marketable securities 139,388 (835) 138,553 Long-term marketable securities: Corporate equity securities 5,000 (2,229) 2,771 Corporate debt securities 500 — 500 Total long-term marketable securities 5,500 (2,229) 3,271 Total $ 144,888 $ (3,064) $ 141,824 December 31, 2021 Amortized Cost Unrealized Holding Losses Fair Value Long-term marketable securities: Corporate equity securities $ 5,000 $ (1,743) $ 3,257 Corporate debt securities 500 — 500 Total long-term marketable securities $ 5,500 $ (1,743) $ 3,757 Contractual maturities of the marketable securities at each balance sheet date are as follows (in thousands): June 30, 2022 December 31, 2021 Within one year $ 139,388 $ — After one year through five years 500 500 Total $ 139,888 $ 500

Business Combinations (Tables)

Business Combinations (Tables)	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Summary of Identified Intangible Assets Acquired at Acquisition Date	The following table summarizes the fair value of the intangible asset acquired as of the acquisition date ($ in thousands): Estimated Fair Value Estimated Useful Life (Years) Trademark $ 2,080 10 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 $ 2,590 10 Developed technology 1,090 10 Trademarks 80 5 Total $ 3,760
Summary of Fair Values of Assets Acquired and Liabilities Assumed as of Acquisition Date	The following table summarizes the consideration paid for TTP, MedActionPlan and TransChart, 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 $ 17,166 Total consideration $ 17,166 Recognized amounts of identifiable assets acquired and liabilities assumed Current assets $ 3,444 Fixed assets 23 Identifiable intangible assets 7,860 Other assets 2 Current liabilities (3,915) Noncurrent liabilities (2,883) Total identifiable net assets acquired 4,531 Goodwill 12,635 Total consideration $ 17,166

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Intangible Assets	The following table presents details of the Company’s intangible assets as of June 30, 2022 ($ in thousands): June 30, 2022 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life Intangible assets with finite lives: Acquired and developed technology $ 35,874 $ (13,705) $ (2,281) $ 19,888 7.8 Customer relationships 21,898 (6,759) (2,009) 13,130 9.4 Commercialization rights 11,579 (2,601) — 8,978 7.1 Trademarks and tradenames 4,540 (1,170) (298) 3,072 9.0 Total intangible assets with finite lives 73,891 (24,235) (4,588) 45,068 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 75,141 $ (24,235) $ (4,588) $ 46,318 The following table presents details of the Company’s intangible assets as of December 31, 2021 ($ in thousands): December 31, 2021 Gross Carrying Amount Accumulated Amortization Foreign Currency Translation Net Carrying Amount Weighted Average Remaining Useful Life Intangible assets with finite lives: Acquired and developed technology $ 35,874 $ (12,088) $ (1,513) $ 22,273 8.1 Customer relationships 21,898 (6,024) (1,210) 14,664 9.9 Commercialization rights 10,579 (2,030) — 8,549 7.6 Trademarks and tradenames 4,540 (988) (155) 3,397 9.5 Other 250 (188) — 62 0.2 Total intangible assets with finite lives 73,141 (21,318) (2,878) 48,945 Acquired in-process technology 1,250 — — 1,250 Total intangible assets $ 74,391 $ (21,318) $ (2,878) $ 50,195
Summary of Estimated Future Amortization Expense of Intangible Assets	The following table summarizes the Company's amortization expense of intangible assets (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Cost of testing services $ 329 $ 350 $ 658 $ 658 Cost of product 437 489 890 954 Cost of patient and digital solutions 236 141 472 249 Sales & marketing 543 449 1,148 842 Total $ 1,545 $ 1,429 $ 3,168 $ 2,703 The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of June 30, 2022 (in thousands): Years Ending December 31, Cost of Testing Services Cost of Product Cost of Patient and Digital Solutions Sales and Marketing Total Remainder of 2022 $ 658 $ 847 $ 472 $ 1,117 $ 3,094 2023 1,316 1,694 945 2,223 6,178 2024 1,316 1,694 709 2,223 5,942 2025 1,316 1,694 540 2,223 5,773 2026 1,316 747 540 2,221 4,824 Thereafter 4,141 4,052 1,720 9,344 19,257 Total future amortization expense $ 10,063 $ 10,728 $ 4,926 $ 19,351 $ 45,068

Balance Sheet Components (Table

Balance Sheet Components (Tables)	6 Months Ended
	Jun. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Inventory	Inventory consisted of the following (in thousands): June 30, 2022 December 31, 2021 Finished goods $ 3,602 $ 3,911 Work in progress 3,944 2,828 Raw materials 11,315 10,447 Total inventory $ 18,861 $ 17,186
Components of Accrued and Other Liabilities	Accrued and other liabilities consisted of the following (in thousands): June 30, 2022 December 31, 2021 Clinical studies $ 13,325 $ 10,653 Professional fees 8,257 5,780 Deferred revenue 4,295 4,208 Short-term lease liability 2,989 3,958 Deferred payments for intangible assets 2,906 2,000 Contingent consideration 2,778 2,114 Capital expenditures 2,537 2,612 Laboratory processing fees & materials 2,400 1,888 Accrued royalty 1,560 1,664 Accrued shipping expenses 704 670 Other accrued expenses 5,182 2,375 Total accrued and other liabilities $ 46,933 $ 37,922

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2022
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, 2022 and 2021 (in thousands): Three Months Ended Six Months Ended 2022 2021 2022 2021 Operating lease cost $ 1,372 $ 1,207 $ 2,785 $ 2,412 Finance lease cost — 23 — 53 Total lease cost $ 1,372 $ 1,230 $ 2,785 $ 2,465 Finance lease cost includes interest from the lease liability and amortization of the ROU asset. June 30, 2022 Other information: Weighted-average remaining lease term - Operating leases (in years) 5.76 Weighted-average discount rate - Operating leases (%) 9.9 %
Future Minimum Lease Commitments under Operating and Finance Leases	Maturities of operating lease liabilities as of June 30, 2022 are as follows (in thousands): Years Ending December 31, Operating Leases Remainder of 2022 $ 2,305 2023 4,495 2024 4,318 2025 3,955 2026 3,196 Thereafter 7,140 Total lease payments 25,409 Less imputed interest 6,355 Present value of future minimum lease payments 19,054 Less operating lease liability, current portion 2,989 Operating lease liability, long-term portion $ 16,065

Warrants (Tables)

Warrants (Tables)	6 Months Ended
	Jun. 30, 2022
Warrants and Rights Note Disclosure [Abstract]
Components of Warrants Outstanding	As of June 30, 2022, outstanding warrants to purchase common stock were: Classified as Original Term Exercise Price Number of Shares Underlying Warrants Original issue date: April 2016 Liability 7 years $ 1.12 3,132 3,132

Stock Incentive Plans (Tables)

Stock Incentive Plans (Tables)	6 Months Ended
	Jun. 30, 2022
Share-Based Payment Arrangement [Abstract]
Summary of Options, RSUs Activity under 2014 Equity Incentive Plan and 2016 Inducement 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, 2021 2,066,529 1,863,633 $ 29.33 2,047,657 $ 50.21 Additional shares authorized 2,116,934 — — — — Common stock awards for services (3,082) — — — — RSUs granted (1,223,905) — — 1,223,905 34.20 RSUs vested — — (408,565) 39.00 Options granted (908,835) 908,835 34.68 — — Options exercised — (89,326) 22.51 — — Repurchase of common stock under employee incentive plans 126,796 — — — — RSUs forfeited 271,115 — — (271,115) 50.39 Options forfeited 177,860 (177,860) 39.34 — — Options expired 7,296 (7,296) 30.96 — — Balance—June 30, 2022 2,630,708 2,497,986 $ 30.58 2,591,882 $ 44.52
Summary of Options Outstanding and Exercisable Vested or Expected to Vest	Options outstanding that have vested and are expected to vest at June 30, 2022 are as follows: Number of Shares Issued Weighted-Average Weighted-Average Remaining Contractual Life (Years) Aggregate Intrinsic Value Vested 1,134 $ 23.80 6.35 $ 5,857 Expected to vest 1,260 36.21 9.02 637 Total 2,394 $ 6,494
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, 2022 2021 2022 2021 Employee stock options Expected term (in years) 5.9 5.6 5.9 5.9 Expected volatility 76.94% 78.07% 76.94% 77.78% Risk-free interest rate 2.88% 1.03% 2.41% 0.76% Expected dividend yield —% —% —% —% Employee stock purchase plan Expected term (in years) 0.5 0.5 0.5 0.5 Expected volatility 67.79% 53.10% 67.79% 53.10% Risk-free interest rate 2.51% 0.09% 2.51% 0.09% 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 non-employee stock-based awards for the three and six months ended June 30, 2022 and 2021, included in the condensed consolidated statements of operations as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Cost of testing services $ 566 $ 570 $ 585 $ 965 Cost of product 402 214 530 289 Cost of patient and digital solutions 391 230 583 338 Research and development 2,323 1,940 4,513 3,298 Sales and marketing 3,907 2,632 7,030 4,292 General and administrative 5,004 3,811 9,986 6,763 Total $ 12,593 $ 9,397 $ 23,227 $ 15,945

Segment Reporting (Tables)

Segment Reporting (Tables)	6 Months Ended
	Jun. 30, 2022
Segment Reporting [Abstract]
Reportable Revenues by Geographic Regions	The following table summarizes reportable revenues by geographic regions (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Testing services revenue United States $ 66,905 $ 64,839 $ 133,128 $ 123,860 Rest of World 230 51 451 311 $ 67,135 $ 64,890 $ 133,579 $ 124,171 Product revenue United States $ 3,577 $ 3,465 $ 7,190 $ 5,960 Europe 2,383 2,659 4,625 4,911 Rest of World 754 737 1,687 1,768 $ 6,714 $ 6,861 $ 13,502 $ 12,639 Patient and digital solutions revenue United States $ 6,525 $ 2,407 $ 12,678 $ 4,695 Europe 210 10 220 41 Rest of World 50 20 71 42 $ 6,785 $ 2,437 $ 12,969 $ 4,778 Total United States $ 77,007 $ 70,711 $ 152,996 $ 134,515 Total Europe $ 2,593 $ 2,669 $ 4,845 $ 4,952 Total Rest of World $ 1,034 $ 808 $ 2,209 $ 2,121 Total $ 80,634 $ 74,188 $ 160,050 $ 141,588
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, 2022 December 31, 2021 Long-lived assets: United States $ 32,321 $ 21,444 Europe 441 403 Rest of World 142 197 Total $ 32,904 $ 22,044

Organization and Description _2

Organization and Description of Business - Additional Information (Details)			1 Months Ended		6 Months Ended
	Feb. 11, 2021 USD ($) shares	Jan. 25, 2021 USD ($) $ / shares shares	May 31, 2021 USD ($)	Apr. 30, 2020 USD ($)	Jun. 30, 2022 USD ($) unique_solution	Dec. 31, 2021 USD ($)	Jan. 31, 2018 patient
Schedule of Capitalization, Equity [Line Items]
Number of renal transplant patients (more than) | patient							1,700
Accumulated deficit					$ 424,534,000	$ 383,189,000
Cash, cash equivalents, and marketable securities					$ 306,200,000
Proceeds from advance payment				$ 20,500,000
Miromatrix, Inc.
Schedule of Capitalization, Equity [Line Items]
Payments to acquire minority interest			$ 5,000,000
Public Offering
Schedule of Capitalization, Equity [Line Items]
Shares issued and sold (in shares) | shares		1,923,077
Sale of stock (in usd per share) | $ / shares		$ 91
Sale of stock, consideration received on transaction		$ 164,000,000
Over-Allotment Option
Schedule of Capitalization, Equity [Line Items]
Shares issued and sold (in shares) | shares	288,461
Sale of stock, consideration received on transaction	$ 24,700,000
XynManagement, Inc.
Schedule of Capitalization, Equity [Line Items]
Number of unique solutions | unique_solution					2
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
Medicare | AlloSure Heart
Schedule of Capitalization, Equity [Line Items]
Reimbursement rate					$ 2,753

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) - Medicare	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Revenue Benchmark | Customer Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage	54%	61%	54%	61%
Accounts Receivable | Credit Concentration Risk
Concentration Risk [Line Items]
Concentration risk percentage			28%		27%

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Leases (Details)	6 Months Ended
	Jun. 30, 2022
Minimum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	14 days
Maximum
Summary Of Significant Accounting Policies [Line Items]
Remaining lease terms	6 years 8 months 1 day

Net Loss Per Share - Computatio

Net Loss Per Share - Computation of Basic and Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Numerator:
Net loss used to compute basic net loss per share	$ (21,697)	$ (1,927)	$ (41,345)	$ (2,614)
Net loss used to compute diluted net loss per share	$ (21,697)	$ (1,927)	$ (41,345)	$ (2,614)
Denominator:
Weighted-average shares used to compute basic net loss per share (in shares)	53,249,545	52,224,300	53,133,149	51,705,587
Weighted-average shares used to compute diluted net loss per share (in shares)	53,249,545	52,224,300	53,133,149	51,705,587
Net loss per share:
Basic (in dollars per share)	$ (0.41)	$ (0.04)	$ (0.78)	$ (0.05)
Diluted (in dollars per share)	$ (0.41)	$ (0.04)	$ (0.78)	$ (0.05)

Net Loss Per Share - Potentiall

Net Loss Per Share - Potentially Dilutive Securities Excluded from Diluted Net Loss Per Share (Details) - shares	3 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
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)	5,093,000	3,989,628
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)	2,497,986	2,117,516
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)	3,132	3,132
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)	2,591,882	1,868,980

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Short-term liabilities:
Contingent consideration	$ 2,778	$ 2,114
Corporate debt securities
Assets
Corporate debt securities	500	500
Recurring
Assets
Total	145,626	338,864
Short-term liabilities:
Contingent consideration	2,778	2,114
Long-term liabilities:
Contingent consideration	2,877	3,227
Common stock warrant liability	64	139
Total	5,719	5,480
Recurring | Money market funds
Assets
Cash equivalents	142,355	335,107
Recurring | Corporate equity securities
Assets
Corporate equity securities	2,771	3,257
Recurring | Corporate debt securities
Assets
Corporate debt securities	500	500
Fair Value Measured Using - (Level 1) | Recurring
Assets
Total	145,126	338,364
Short-term liabilities:
Contingent consideration	0	0
Long-term liabilities:
Contingent consideration	0	0
Common stock warrant liability	0	0
Total	0	0
Fair Value Measured Using - (Level 1) | Recurring | Money market funds
Assets
Cash equivalents	142,355	335,107
Fair Value Measured Using - (Level 1) | Recurring | Corporate equity securities
Assets
Corporate equity securities	2,771	3,257
Fair Value Measured Using - (Level 1) | Recurring | Corporate debt securities
Assets
Corporate debt securities	0	0
Fair Value Measured Using - (Level 2) | Recurring
Assets
Total	500	500
Short-term liabilities:
Contingent consideration	0	0
Long-term liabilities:
Contingent consideration	0	0
Common stock warrant liability	0	0
Total	0	0
Fair Value Measured Using - (Level 2) | Recurring | Money market funds
Assets
Cash equivalents	0	0
Fair Value Measured Using - (Level 2) | Recurring | Corporate equity securities
Assets
Corporate equity securities	0	0
Fair Value Measured Using - (Level 2) | Recurring | Corporate debt securities
Assets
Corporate debt securities	500	500
Fair Value Measured Using - (Level 3) | Recurring
Assets
Total	0	0
Short-term liabilities:
Contingent consideration	2,778	2,114
Long-term liabilities:
Contingent consideration	2,877	3,227
Common stock warrant liability	64	139
Total	5,719	5,480
Fair Value Measured Using - (Level 3) | Recurring | Money market funds
Assets
Cash equivalents	0	0
Fair Value Measured Using - (Level 3) | Recurring | Corporate equity securities
Assets
Corporate equity securities	0	0
Fair Value Measured Using - (Level 3) | Recurring | Corporate debt securities
Assets
Corporate debt securities	$ 0	$ 0

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Issuances, Exercises, Changes in Fair Value and Reclassifications of Level 3 Financial Instruments (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2022 USD ($)
Common Stock Warrant Liability and Contingent Consideration
Beginning balance	$ 5,480
Ending balance	5,719
Common Stock Warrant Liability
Common Stock Warrant Liability and Contingent Consideration
Change in estimated fair value of common stock warrant liability	(75)
Contingent Consideration
Common Stock Warrant Liability and Contingent Consideration
Change in estimated fair value of common stock warrant liability	564
Payments related to contingent consideration	$ (250)

Fair Value Measurements - Narra

Fair Value Measurements - Narratives (Details)	6 Months Ended	12 Months Ended
	Jun. 30, 2022 investment	Dec. 31, 2021
Fair Value Disclosures [Abstract]
Number of investments	1
Contingent consideration, measurement input, discount rate	0.12	0.12

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of Common Stock Warrant Liability Valuation Assumptions (Details) - Private Placement Common Stock Warrant Liability	6 Months Ended	12 Months Ended
	Jun. 30, 2022 $ / shares	Dec. 31, 2021 $ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Stock price (in dollars per share)	$ 21.48	$ 45.48
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)	9 months 14 days	1 year 3 months 10 days
Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input (percent)		0.6600
Risk-free interest rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Derivative liability measurement input (percent)		0.0049

Cash and Marketable Securitie_2

Cash and Marketable Securities - Reconciliation of Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021	Jun. 30, 2021	Dec. 31, 2020
Cash and Cash Equivalents [Abstract]
Cash and cash equivalents	$ 166,832	$ 348,485	$ 335,625
Restricted cash	204	211	268
Total cash, cash equivalents, and restricted cash at the end of the period	$ 167,036	$ 348,696	$ 335,893	$ 134,939

Cash and Marketable Securitie_3

Cash and Marketable Securities - Components of Marketable Securities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Short-term marketable securities
Debt securities, amortized cost	$ 139,888	$ 500
Amortized Cost	139,388
Unrealized Holding Losses	(835)
Fair Value	138,553
Long-term marketable securities
Amortized Cost	5,500	5,500
Unrealized Holding Losses	(2,229)	(1,743)
Fair Value	3,271	3,757
Amortized Cost	144,888
Unrealized Holding Losses	(3,064)
Fair Value	141,824
Corporate debt securities
Short-term marketable securities
Debt securities, amortized cost	139,388
Debt securities, unrealized loss	(835)
Debt securities, fair value	138,553
Long-term marketable securities
Debt securities, amortized cost	500	500
Debt securities, unrealized holding gains (losses)	0	0
Fair value	500	500
Corporate equity securities
Long-term marketable securities
Equity securities, amortized cost	5,000	5,000
Equity securities, unrealized holding gains (losses)	(2,229)	(1,743)
Corporate equity securities	$ 2,771	$ 3,257

Cash and Marketable Securitie_4

Cash and Marketable Securities - Schedule of Maturity (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Cash and Cash Equivalents [Abstract]
Within one year	$ 139,388	$ 0
After one year through five years	500	500
Debt securities, amortized cost	$ 139,888	$ 500

Business Combinations - Additio

Business Combinations - Additional Information (Details)	1 Months Ended
	Dec. 31, 2021 USD ($)	Nov. 30, 2021 USD ($)	Jun. 30, 2022 USD ($)	Jan. 31, 2021 USD ($)
Business Acquisition [Line Items]
Goodwill	$ 36,983,000		$ 37,084,000
Transplant Pharmacy
Business Acquisition [Line Items]
Total consideration	1,300,000
Goodwill	5,500,000
Business combination, deferred tax liabilities	600,000
Goodwill expected to be deductible for income tax purposes	$ 0
Transplant Pharmacy | Trademarks
Business Acquisition [Line Items]
Intangible asset, measurement input, royalty rate	0.02
Intangible asset, measurement input, discount rate	0.135
Transplant Pharmacy | General and Administrative Expense
Business Acquisition [Line Items]
Acquisition related costs	$ 300,000
MedActionPlan
Business Acquisition [Line Items]
Total consideration		$ 3,500,000
Goodwill		4,900,000
Goodwill expected to be deductible for income tax purposes		$ 0
Intangible asset, measurement input, discount rate		0.400
MedActionPlan | Trademarks
Business Acquisition [Line Items]
Intangible asset, measurement input, royalty rate		0.01
MedActionPlan | Developed Technology
Business Acquisition [Line Items]
Intangible asset, measurement input, royalty rate		0.15
MedActionPlan | General and Administrative Expense
Business Acquisition [Line Items]
Acquisition related costs		$ 600,000
TransChart LLC
Business Acquisition [Line Items]
Goodwill				$ 2,200,000
Intangible assets				$ 2,000,000

Business Combinations - Summary

Business Combinations - Summary of Identified Intangible Assets Acquired at Acquisition Date (Details) - USD ($) $ in Thousands	1 Months Ended		6 Months Ended	12 Months Ended
	Dec. 31, 2021	Nov. 30, 2021	Jun. 30, 2022	Dec. 31, 2021
Transplant Pharmacy
Business Acquisition [Line Items]
Estimated Fair Value	$ 2,080			$ 2,080
MedActionPlan
Business Acquisition [Line Items]
Estimated Fair Value		$ 3,760
Customer relationships
Business Acquisition [Line Items]
Estimated Useful Life (Years)			9 years 4 months 24 days	9 years 10 months 24 days
Customer relationships | MedActionPlan
Business Acquisition [Line Items]
Estimated Fair Value		$ 2,590
Estimated Useful Life (Years)		10 years
Developed Technology | MedActionPlan
Business Acquisition [Line Items]
Estimated Fair Value		$ 1,090
Estimated Useful Life (Years)		10 years
Trademarks | Transplant Pharmacy
Business Acquisition [Line Items]
Estimated Useful Life (Years)	10 years
Trademarks | MedActionPlan
Business Acquisition [Line Items]
Estimated Fair Value		$ 80
Estimated Useful Life (Years)		5 years

Business Combinations - Summa_2

Business Combinations - Summary of Consideration Paid and Provisional Amounts of Assets Acquired and Liabilities Assumed Recognized at Their Estimated Fair Value (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Jun. 30, 2022
Business Acquisition [Line Items]
Goodwill	$ 36,983	$ 37,084
TransChart, TTP, and MedActionPlan
Business Acquisition [Line Items]
Cash	17,166
Total consideration	17,166
Current assets	3,444
Fixed assets	23
Identifiable intangible assets	7,860
Other assets	2
Current liabilities	(3,915)
Noncurrent liabilities	(2,883)
Total identifiable net assets acquired	4,531
Goodwill	12,635
Total consideration	$ 17,166

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Dec. 31, 2021	Jun. 30, 2022
Goodwill And Intangible Assets [Line Items]
Goodwill	$ 36,983	$ 37,084
Assets acquired	13,400
Acquired and developed technology
Goodwill And Intangible Assets [Line Items]
Assets acquired	4,700
Commercialization rights
Goodwill And Intangible Assets [Line Items]
Assets acquired	2,500
Customer relationships
Goodwill And Intangible Assets [Line Items]
Assets acquired	3,700
Trademarks and tradenames
Goodwill And Intangible Assets [Line Items]
Assets acquired	2,200
Other
Goodwill And Intangible Assets [Line Items]
Assets acquired	$ 300

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2022	Dec. 31, 2021
Intangible assets with finite lives:
Gross Carrying Amount	$ 73,891	$ 73,141
Accumulated Amortization	(24,235)	(21,318)
Foreign Currency Translation	(4,588)	(2,878)
Total future amortization expense	45,068	48,945
Intangible Assets, Net (Excluding Goodwill)
Total intangible assets - gross carrying amount	75,141	74,391
Total intangible assets, net	46,318	50,195
Acquired in-process technology
Intangible assets with indefinite lives
Net carrying amount	1,250	1,250
Acquired and developed technology
Intangible assets with finite lives:
Gross Carrying Amount	35,874	35,874
Accumulated Amortization	(13,705)	(12,088)
Foreign Currency Translation	(2,281)	(1,513)
Total future amortization expense	$ 19,888	$ 22,273
Intangible Assets, Net (Excluding Goodwill)
Weighted Average Remaining Useful Life (In Years)	7 years 9 months 18 days	8 years 1 month 6 days
Customer relationships
Intangible assets with finite lives:
Gross Carrying Amount	$ 21,898	$ 21,898
Accumulated Amortization	(6,759)	(6,024)
Foreign Currency Translation	(2,009)	(1,210)
Total future amortization expense	$ 13,130	$ 14,664
Intangible Assets, Net (Excluding Goodwill)
Weighted Average Remaining Useful Life (In Years)	9 years 4 months 24 days	9 years 10 months 24 days
Commercialization rights
Intangible assets with finite lives:
Gross Carrying Amount	$ 11,579	$ 10,579
Accumulated Amortization	(2,601)	(2,030)
Foreign Currency Translation	0	0
Total future amortization expense	$ 8,978	$ 8,549
Intangible Assets, Net (Excluding Goodwill)
Weighted Average Remaining Useful Life (In Years)	7 years 1 month 6 days	7 years 7 months 6 days
Trademarks and tradenames
Intangible assets with finite lives:
Gross Carrying Amount	$ 4,540	$ 4,540
Accumulated Amortization	(1,170)	(988)
Foreign Currency Translation	(298)	(155)
Total future amortization expense	$ 3,072	$ 3,397
Intangible Assets, Net (Excluding Goodwill)
Weighted Average Remaining Useful Life (In Years)	9 years	9 years 6 months
Other
Intangible assets with finite lives:
Gross Carrying Amount		$ 250
Accumulated Amortization		(188)
Foreign Currency Translation		0
Total future amortization expense		$ 62
Intangible Assets, Net (Excluding Goodwill)
Weighted Average Remaining Useful Life (In Years)		2 months 12 days

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Amortization Expense of Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets	$ 1,545	$ 1,429	$ 3,168	$ 2,703
Cost of Testing Services
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets	329	350	658	658
Cost of Product
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets	437	489	890	954
Cost of Patient and Digital Solutions
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets	236	141	472	249
Sales and Marketing Expense
Goodwill And Intangible Assets [Line Items]
Amortization expense of intangible assets	$ 543	$ 449	$ 1,148	$ 842

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Summary of Estimated Future Amortization Expense of Intangible Assets with Finite Lives (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2022	$ 3,094
2023	6,178
2024	5,942
2025	5,773
2026	4,824
Thereafter	19,257
Total future amortization expense	45,068	$ 48,945
Cost of Testing Services
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2022	658
2023	1,316
2024	1,316
2025	1,316
2026	1,316
Thereafter	4,141
Total future amortization expense	10,063
Cost of Product
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2022	847
2023	1,694
2024	1,694
2025	1,694
2026	747
Thereafter	4,052
Total future amortization expense	10,728
Cost of Patient and Digital Solutions
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2022	472
2023	945
2024	709
2025	540
2026	540
Thereafter	1,720
Total future amortization expense	4,926
Sales and Marketing
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
Remainder of 2022	1,117
2023	2,223
2024	2,223
2025	2,223
2026	2,221
Thereafter	9,344
Total future amortization expense	$ 19,351

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Finished goods	$ 3,602	$ 3,911
Work in progress	3,944	2,828
Raw materials	11,315	10,447
Total inventory	$ 18,861	$ 17,186

Balance Sheet Components - Comp

Balance Sheet Components - Components of Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Clinical studies	$ 13,325	$ 10,653
Professional fees	8,257	5,780
Deferred revenue	4,295	4,208
Short-term lease liability	2,989	3,958
Deferred payments for intangible assets	2,906	2,000
Contingent consideration	2,778	2,114
Capital expenditures	2,537	2,612
Laboratory processing fees & materials	2,400	1,888
Accrued royalty	1,560	1,664
Accrued shipping expenses	704	670
Other accrued expenses	5,182	2,375
Total accrued and other liabilities	$ 46,933	$ 37,922

Balance Sheet Components - Addi

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

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) $ in Thousands			1 Months Ended
	May 13, 2022 complaint	Mar. 14, 2022 USD ($)	Jun. 30, 2022 USD ($)	Jun. 30, 2014 milestone_payment	Dec. 31, 2021 USD ($)
Loss Contingencies [Line Items]
Operating lease right-of-use asset			$ 15,841		$ 17,993
Short-term lease liability			2,989		3,958
Operating lease liability, less current portion			16,065		$ 17,394
Number of milestone payments | milestone_payment				6
Derecognition of ROU and lease liability			$ 500
Operating lease, extension period			2 years
CAREDX, INC. vs Natera Inc.
Loss Contingencies [Line Items]
Damages awarded		$ 44,900
Number of complaints | complaint	2
CAREDX, INC. vs Natera Inc. | Compensatory Damages
Loss Contingencies [Line Items]
Damages awarded		21,200
CAREDX, INC. vs Natera Inc. | Punitive Damages
Loss Contingencies [Line Items]
Damages awarded		$ 23,700

Commitments and Contingencies_2

Commitments and Contingencies - Summary of Lease Cost (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Operating lease cost	$ 1,372	$ 1,207	$ 2,785	$ 2,412
Finance lease cost	0	23	0	53
Total lease cost	$ 1,372	$ 1,230	$ 2,785	$ 2,465

Commitments and Contingencies_3

Commitments and Contingencies - Summary of Other Information Related to Lease (Details)	Jun. 30, 2022
Other information:
Weighted-average remaining lease term - Operating leases (in years)	5 years 9 months 3 days
Weighted-average discount rate - Operating leases (%)	9.90%

Commitments and Contingencies_4

Commitments and Contingencies - Future Minimum Lease Commitments under Operating and Finance Leases (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Operating Leases
Remainder of 2022	$ 2,305
2023	4,495
2024	4,318
2025	3,955
2026	3,196
Thereafter	7,140
Total lease payments	25,409
Less imputed interest	6,355
Present value of future minimum lease payments	19,054
Less operating lease liability, current portion	2,989	$ 3,958
Operating lease liability, long-term portion	$ 16,065	$ 17,394

401(K) Plan - Additional Inform

401(K) Plan - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Retirement Benefits [Abstract]
Defined Benefit Plan, Type			Postemployment Retirement Benefits [Member]
Expense incurred related to plan	$ 0.5	$ 0.3	$ 1.2	$ 0.8

Warrants - Additional Informati

Warrants - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Warrants and Rights Note Disclosure [Abstract]
Number of warrants exercised (in shares)	0	3,000	0	3,000
Proceeds from exercise of warrants		$ 4	$ 0	$ 4

Warrants - Outstanding Warrants

Warrants - Outstanding Warrants To Purchase Common Stock Warrants (Detail) - Common Stock	6 Months Ended
	Jun. 30, 2022 $ / shares shares
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share) | $ / shares	$ 1.12
Number of shares underlying warrants (in shares) | shares	3,132
Original Term
Class of Warrant or Right [Line Items]
Original Term (in years)	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, 2022 $ / shares shares
Shares Available for Grant
Shares available for grant beginning balance (in shares)	2,066,529
Additional options authorized (in shares)	2,116,934
Common stock awards for services (in shares)	(3,082)
RSUs granted (in shares)	(1,223,905)
Options granted (in shares)	(908,835)
Repurchase of common stock under employee incentive plans (in shares)	126,796
RSUs forfeited (in shares)	271,115
Options forfeited (in shares)	177,860
Options expired (in shares)	7,296
Shares available for grant ending balance (in shares)	2,630,708
Stock Options Outstanding
Stock options outstanding beginning balance (in shares)	1,863,633
Stock options granted (in shares)	908,835
Stock options exercised (in shares)	(89,326)
Stock options forfeited (in shares)	(177,860)
Stock options expired (in shares)	(7,296)
Stock options outstanding ending balance (in shares)	2,497,986
Weighted- Average Exercise Price
Weighted average exercise price beginning balance (in dollars per share) | $ / shares	$ 29.33
Weighted average exercise price - options granted (in dollars per share) | $ / shares	34.68
Weighted average exercise price - options exercised (in dollars per share) | $ / shares	22.51
Weighted average exercise price - options forfeited (in dollars per share) | $ / shares	39.34
Weighted average exercise price - options expired (in dollars per share) | $ / shares	30.96
Weighted average exercise price ending balance (in dollars per share) | $ / shares	$ 30.58
Number of RSU Shares
RSUs granted (in shares)	1,223,905
RSUs forfeited (in shares)	(271,115)
Restricted Stock Units
Shares Available for Grant
RSUs granted (in shares)	(1,223,905)
RSUs forfeited (in shares)	271,115
Number of RSU Shares
Number of RSU shares beginning balance (in shares)	2,047,657
RSUs granted (in shares)	1,223,905
RSUs vested (in shares)	(408,565)
RSUs forfeited (in shares)	(271,115)
Number of RSU shares ending balance (in shares)	2,591,882
Weighted- Average Grant Date Fair Value
Weighted average grant date fair value beginning balance (in dollars per share) | $ / shares	$ 50.21
Weighted average grant date fair value - RSUs granted (in dollars per share) | $ / shares	34.20
Weighted average grant date fair value - RSUs vested (in dollars per share) | $ / shares	39
Weighted average grant date fair value - RSUs forfeited (in dollars per share) | $ / shares	50.39
Weighted average grant date fair value ending balance (in dollars per share) | $ / shares	$ 44.52

Stock Incentive Plans - Additio

Stock Incentive Plans - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total intrinsic value of options exercised	$ 300,000	$ 25,900,000	$ 1,300,000	$ 35,000,000
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 earning an employee may contribute to the ESPP Plan	15%		15%
Maximum value of shares which an employee can purchase 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%
Shares issued under ESPP (in shares)			67,570		25,852
Aggregate proceeds from the issuance of shares			$ 1,200,000		$ 1,000,000
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Intrinsic value of RSUs	$ 55,700,000		55,700,000
Total unrecognized compensation costs related to stock options and RSUs	91,700,000		$ 91,700,000
Stock options and RSUs expected weighted average period			2 years 11 months 12 days
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation costs related to stock options and RSUs	28,800,000		$ 28,800,000
Stock options and RSUs expected weighted average period			2 years 11 months 15 days
Total fair value of options vested during period	$ 2,400,000		$ 6,300,000

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, 2022 USD ($) $ / shares shares
Share-Based Payment Arrangement [Abstract]
Vested (in shares) | shares	1,134
Expected to vest (in shares) | shares	1,260
Total (in shares) | shares	2,394
Vested (in dollars per share) | $ / shares	$ 23.80
Expected to vest (in dollars per share) | $ / shares	$ 36.21
Vested, weighted average remaining life	6 years 4 months 6 days
Expected to vest, weighted average remaining contractual life	9 years 7 days
Vested, aggregate intrinsic value | $	$ 5,857
Expected to vest, aggregate intrinsic value | $	637
Aggregate Intrinsic Value, Total | $	$ 6,494

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, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
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	67.79%	53.10%	67.79%	53.10%
Risk-free interest rate	2.51%	0.09%	2.51%	0.09%
Expected dividend yield	0%	0%	0%	0%
Employee stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 10 months 24 days	5 years 7 months 6 days	5 years 10 months 24 days	5 years 10 months 24 days
Expected volatility	76.94%	78.07%	76.94%	77.78%
Risk-free interest rate	2.88%	1.03%	2.41%	0.76%
Expected dividend yield	0%	0%	0%	0%

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, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	$ 12,593	$ 9,397	$ 23,227	$ 15,945
Cost of testing services
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	566	570	585	965
Cost of product
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	402	214	530	289
Cost of patient and digital solutions
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	391	230	583	338
Research and development
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	2,323	1,940	4,513	3,298
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	3,907	2,632	7,030	4,292
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share based compensation expense	$ 5,004	$ 3,811	$ 9,986	$ 6,763

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Income Tax Disclosure [Abstract]
Income tax benefit	$ 49	$ 100	$ 61	$ 363

Segment Reporting - Reportable

Segment Reporting - Reportable Revenues by Geographic Regions (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Segment Reporting Information [Line Items]
Total revenue	$ 80,634	$ 74,188	$ 160,050	$ 141,588
United States
Segment Reporting Information [Line Items]
Total revenue	77,007	70,711	152,996	134,515
Europe
Segment Reporting Information [Line Items]
Total revenue	2,593	2,669	4,845	4,952
Rest of World
Segment Reporting Information [Line Items]
Total revenue	1,034	808	2,209	2,121
Testing services revenue
Segment Reporting Information [Line Items]
Total revenue	67,135	64,890	133,579	124,171
Testing services revenue | United States
Segment Reporting Information [Line Items]
Total revenue	66,905	64,839	133,128	123,860
Testing services revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	230	51	451	311
Product revenue
Segment Reporting Information [Line Items]
Total revenue	6,714	6,861	13,502	12,639
Product revenue | United States
Segment Reporting Information [Line Items]
Total revenue	3,577	3,465	7,190	5,960
Product revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	2,383	2,659	4,625	4,911
Product revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	754	737	1,687	1,768
Patient and digital solutions revenue
Segment Reporting Information [Line Items]
Total revenue	6,785	2,437	12,969	4,778
Patient and digital solutions revenue | United States
Segment Reporting Information [Line Items]
Total revenue	6,525	2,407	12,678	4,695
Patient and digital solutions revenue | Europe
Segment Reporting Information [Line Items]
Total revenue	210	10	220	41
Patient and digital solutions revenue | Rest of World
Segment Reporting Information [Line Items]
Total revenue	$ 50	$ 20	$ 71	$ 42

Segment Reporting - Long-Lived

Segment Reporting - Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions (Detail) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Long-lived assets	$ 32,904	$ 22,044
United States
Segment Reporting Information [Line Items]
Long-lived assets	32,321	21,444
Europe
Segment Reporting Information [Line Items]
Long-lived assets	441	403
Rest of World
Segment Reporting Information [Line Items]
Long-lived assets	$ 142	$ 197