Cover
Cover - shares | 3 Months Ended | |
Mar. 31, 2023 | May 11, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Mar. 31, 2023 | |
Document Transition Report | false | |
Entity File Number | 001-39049 | |
Entity Registrant Name | EXAGEN INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 20-0434866 | |
Entity Address, Address Line One | 1261 Liberty Way | |
Entity Address, City or Town | Vista, | |
Entity Address, State or Province | CA | |
Entity Address, Postal Zip Code | 92081 | |
City Area Code | (760) | |
Local Phone Number | 560-1501 | |
Title of 12(b) Security | Common Stock, par value $0.001 per share | |
Trading Symbol | XGN | |
Security Exchange Name | NASDAQ | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Non-accelerated Filer | |
Entity Small Business | true | |
Entity Emerging Growth Company | true | |
Entity Ex Transition Period | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding (in shares) | 16,825,696 | |
Entity Central Index Key | 0001274737 | |
Current Fiscal Year End Date | --12-31 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
Unaudited Condensed Balance She
Unaudited Condensed Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Current assets: | ||
Cash and cash equivalents | $ 52,184 | $ 62,391 |
Accounts receivable, net | 9,303 | 6,077 |
Prepaid expenses and other current assets | 4,229 | 4,143 |
Total current assets | 65,716 | 72,611 |
Property and equipment, net | 8,264 | 8,197 |
Operating lease right-of-use assets | 4,651 | 4,885 |
Other assets | 603 | 528 |
Total assets | 79,234 | 86,221 |
Current liabilities: | ||
Accounts payable | 1,878 | 3,046 |
Accrued and other current liabilities | 6,064 | 5,347 |
Operating lease liabilities | 1,072 | 1,040 |
Borrowings-current portion | 254 | 190 |
Total current liabilities | 9,268 | 9,623 |
Borrowings-non-current portion, net of discounts and debt issuance costs | 29,092 | 28,778 |
Non-current operating lease liabilities | 4,211 | 4,493 |
Other non-current liabilities | 726 | 867 |
Total liabilities | 43,297 | 43,761 |
Commitments and contingencies (Note 5) | ||
Stockholders' equity: | ||
Preferred stock, $0.001 par value; 10,000,000 shares authorized, no shares issued or outstanding as of March 31, 2023 and December 31, 2022 | 0 | 0 |
Common stock, $0.001 par value; 200,000,000 shares authorized as of March 31, 2023 and December 31, 2022; 16,827,014 and 16,549,984 shares issued and outstanding as of March 31, 2023 and December 31, 2022, respectively | 17 | 17 |
Additional paid-in capital | 299,135 | 297,970 |
Accumulated deficit | (263,215) | (255,527) |
Total stockholders' equity | 35,937 | 42,460 |
Total liabilities and stockholders' equity | $ 79,234 | $ 86,221 |
Unaudited Condensed Balance S_2
Unaudited Condensed Balance Sheets (Parenthetical) - $ / shares | Mar. 31, 2023 | Dec. 31, 2022 |
Preferred stock | ||
Par value (in dollars per share) | $ 0.001 | $ 0.001 |
Shares authorized (in shares) | 10,000,000 | 10,000,000 |
Shares outstanding (in shares) | 0 | 0 |
Shares issued (in shares) | 0 | 0 |
Common stock | ||
Par value (in dollars per share) | $ 0.001 | $ 0.001 |
Shares authorized (in shares) | 200,000,000 | 200,000,000 |
Shares issued (in shares) | 16,827,014 | 16,549,984 |
Shares outstanding (in shares) | 16,827,014 | 16,549,984 |
Unaudited Condensed Statements
Unaudited Condensed Statements of Operations - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Income Statement [Abstract] | ||
Revenue | $ 11,230 | $ 10,394 |
Operating expenses: | ||
Costs of revenue | 5,926 | 5,817 |
Selling, general and administrative expenses | 11,884 | 12,152 |
Research and development expenses | 1,126 | 2,104 |
Total operating expenses | 18,936 | 20,073 |
Loss from operations | (7,706) | (9,679) |
Interest expense | (638) | (598) |
Interest income | 656 | 5 |
Net loss | $ (7,688) | $ (10,272) |
Net loss per share, basic (in dollars per share) | $ (0.44) | $ (0.60) |
Net loss per share, diluted (in dollars per share) | $ (0.44) | $ (0.60) |
Weighted-average number of shares used to compute net loss per share, basic (in shares) | 17,526,763 | 16,992,391 |
Weighted-average number of shares used to compute net loss per share, diluted (in shares) | 17,526,763 | 16,992,391 |
Unaudited Condensed Statement_2
Unaudited Condensed Statements of Stockholders' Equity - USD ($) $ in Thousands | Total | Common Stock | Additional Paid-In Capital | Accumulated Deficit |
Beginning balance (in shares) at Dec. 31, 2021 | 16,164,994 | |||
Beginning balance at Dec. 31, 2021 | $ 84,936 | $ 16 | $ 293,060 | $ (208,140) |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||
Issuance of stock from vested restricted stock units and payment of employees' taxes (in shares) | 30,523 | |||
Issuance of stock from vested restricted stock units | (115) | (115) | ||
Issuance of stock under Employee Stock Purchase Plan (in shares) | 35,681 | |||
Issuance of stock under Employee Stock Purchase Plan | 231 | 231 | ||
Stock-based compensation | 1,376 | 1,376 | ||
Net loss | (10,272) | (10,272) | ||
Ending balance (in shares) at Mar. 31, 2022 | 16,231,198 | |||
Ending balance at Mar. 31, 2022 | $ 76,156 | $ 16 | 294,552 | (218,412) |
Beginning balance (in shares) at Dec. 31, 2022 | 16,549,984 | 16,549,984 | ||
Beginning balance at Dec. 31, 2022 | $ 42,460 | $ 17 | 297,970 | (255,527) |
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||
Issuance of stock from vested restricted stock units and payment of employees' taxes (in shares) | 113,378 | |||
Issuance of stock from vested restricted stock units | 0 | 0 | ||
Issuance of stock under Employee Stock Purchase Plan (in shares) | 70,317 | |||
Issuance of stock under Employee Stock Purchase Plan | 152 | 152 | ||
Exercise of stock options (in shares) | 93,335 | |||
Exercise of stock options | 27 | 27 | ||
Stock-based compensation | 986 | 986 | ||
Net loss | $ (7,688) | (7,688) | ||
Ending balance (in shares) at Mar. 31, 2023 | 16,827,014 | 16,827,014 | ||
Ending balance at Mar. 31, 2023 | $ 35,937 | $ 17 | $ 299,135 | $ (263,215) |
Unaudited Condensed Statement_3
Unaudited Condensed Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Cash flows from operating activities: | ||
Net loss | $ (7,688) | $ (10,272) |
Adjustments to reconcile net loss to net cash used in operating activities: | ||
Depreciation and amortization | 553 | 283 |
Amortization of debt discount and debt issuance costs | 42 | 38 |
Non-cash interest expense | 137 | 135 |
Loss on disposal of assets | 55 | 0 |
Non-cash lease expense | 234 | 219 |
Stock-based compensation | 986 | 1,376 |
Changes in assets and liabilities: | ||
Accounts receivable, net | (3,226) | (1,257) |
Prepaid expenses and other current assets | (86) | 664 |
Other assets | (79) | (273) |
Operating lease liabilities | (250) | (155) |
Accounts payable | (1,320) | 579 |
Accrued and other current liabilities | 893 | 89 |
Net cash used in operating activities | (9,749) | (8,574) |
Cash flows from investing activities: | ||
Purchases of property and equipment | (396) | (1,087) |
Net cash used in investing activities | (396) | (1,087) |
Cash flows from financing activities: | ||
Proceeds from exercise of stock options | 27 | 0 |
Payments of taxes withheld on vested restricted stock units | 0 | (115) |
Proceeds from common stock issued under Employee Stock Purchase Plan | 152 | 231 |
Principal payments on finance lease obligations | (189) | (146) |
Principal payment on note payable obligations | (52) | 0 |
Net cash used in financing activities | (62) | (30) |
Net change in cash, cash equivalents and restricted cash | (10,207) | (9,691) |
Cash, cash equivalents and restricted cash, beginning of period | 62,591 | 99,542 |
Cash, cash equivalents and restricted cash, end of period | 52,384 | 89,851 |
Supplemental disclosure of cash flow information: | ||
Cash paid for interest | 449 | 424 |
Supplemental disclosure of non-cash items: | ||
Equipment purchased under notes payable obligations | 250 | 0 |
Costs incurred, but not paid, in connection with capital expenditures | $ 199 | $ 1,672 |
Organization
Organization | 3 Months Ended |
Mar. 31, 2023 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization | Organization Description of Business Exagen Inc. (the Company) is a commercial-stage diagnostics company dedicated to helping patients suffering from debilitating and chronic autoimmune diseases by enabling timely differential diagnosis and optimizing therapeutic intervention. Liquidity The Company has incurred recurring losses and negative cash flows from operating activities since inception. The Company anticipates that it will continue to incur net losses into the foreseeable future. As of March 31, 2023, the Company had cash and cash equivalents of $52.2 million and had an accumulated deficit of $263.2 million. Since inception, the Company has financed its operations primarily through a combination of equity financings, debt financing arrangements, and revenue from sales of the Company's products. Based on the Company's current business plan, management believes that its existing capital resources will be sufficient to fund the Company's obligations for at least twelve months following the issuance of these condensed financial statements. To execute its business plans, the Company may need additional funding to support its continuing operations and pursue its growth strategy. Until such time as the Company can achieve significant cash flows from operations, if ever, it expects to finance its operations through the sale of its stock, debt financings or other strategic transactions. Although the Company has been successful in raising capital in the past, there is no assurance that it will be successful in obtaining such additional financing on terms acceptable to the Company, if at all. The terms of any financing may adversely affect the holdings or the rights of the Company's stockholders. If the Company is unable to obtain funding, the Company could be forced to delay, reduce or eliminate some or all of its programs, product portfolio expansion plans or commercialization efforts, which could have a material adverse effect on the Company's business, operating results and financial condition and the Company's ability to achieve its intended business objectives. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | Summary of Significant Accounting Policies Basis of Presentation and Use of Estimates The accompanying interim condensed balance sheet as of March 31, 2023, condensed statements of operations, stockholders' equity and cash flows for the three months ended March 31, 2023 and the related footnote disclosures are unaudited and have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission (SEC), and with accounting principles generally accepted in the United States (GAAP) applicable to interim financial statements. These unaudited condensed financial statements and related footnote disclosures should be read in conjunction with the Company’s audited financial statements for the year ended December 31, 2022, included in its Annual Report on Form 10-K filed with the SEC on March 20, 2023. In management's opinion, the unaudited interim condensed financial statements have been prepared on the same basis as the audited financial statements and include all normal adjustments, necessary for the fair presentation of the Company's financial position as of March 31, 2023 and its results of operations for the periods presented. The results for the three months ended March 31, 2023 are not necessarily indicative of the results expected for the full fiscal year or any other interim period. The year-end condensed balance sheet data was derived from audited financial statements, but does not include all disclosures required by GAAP. The preparation of the accompanying condensed financial statements requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities as of the date of the condensed financial statements, and the reported amounts of revenue and expenses during the reporting period. Actual results could materially differ from those estimates. Significant estimates and assumptions made in the accompanying condensed financial statements include, but are not limited to revenue recognition, the recoverability of its long-lived assets and net deferred tax assets (and related valuation allowance). The Company evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors and adjusts those estimates and assumptions when facts and circumstances dictate. Actual results could materially differ from those estimates. Concentration of Credit Risk and Other Risk and Uncertainties Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents and accounts receivable. Substantially all the Company's cash and cash equivalents are held at one financial institution that management believes is of high credit quality. Such deposits may, at times, exceed federally insured limits. The Company has not experienced any losses on its cash or cash equivalents. Significant payors and customers are those which represent more than 10% of the Company's total revenue or accounts receivable balance at each respective balance sheet date. For each significant payor and customer, revenue as a percentage of total revenue and accounts receivable as a percentage of total accounts receivable are as follows: Revenue Three Months Ended 2023 2022 Medicare 39 % 20 % Medicare Advantage 16 % 15 % Blue Shield * 13 % * Less than 10%. Accounts Receivable, Net March 31, 2023 December 31, 2022 Medicare 45 % 21 % Medicare Advantage 10 % 13 % For the three months ended March 31, 2023 and 2022, approximately 87% and 84%, respectively, of the Company's revenue was related to the AVISE ® CTD test. The Company is dependent on key suppliers for certain laboratory materials. For the three months ended March 31, 2023 and 2022, approximately 97% and 95%, respectively, of the Company's diagnostic testing supplies were purchased from two suppliers. An interruption in the supply of these materials would impact the Company's ability to perform testing services. Disaggregation of Revenue The following table includes the Company's revenues as disaggregated by payor and customer category (in thousands): Three Months Ended March 31, 2023 2022 Revenue: Commercial $ 4,215 $ 6,423 Government 4,426 2,120 Client(1) 2,407 1,591 Other(2) 182 260 Total revenue $ 11,230 $ 10,394 (1) Includes hospitals, other laboratories, etc. (2) Includes patient self-pay . Fair Value Measurements The carrying value of the Company's cash, cash equivalents and restricted cash, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued and other current liabilities approximate their fair values due to their short-term nature, which are determined to be a Level 1 measurement (see Note 6). The estimated fair value of the Company's long-term borrowings is determined by Level 2 inputs and based primarily on quoted market prices for the same or similar issues. As of March 31, 2023, the 2017 Term Loan (as defined below) had a carrying value of $28.4 million and a fair value of $27.1 million. As of December 31, 2022, the 2017 Term Loan had a carrying value of $28.3 million and a fair value of $26.9 million The estimated fair value of the 2017 Term Loan, was determined based on a discounted cash flow approach using available market information on discount and borrowing rates with similar terms, maturities, and credit ratings. The recorded value of the Company's other long-term borrowing was $0.7 million and approximated its fair value as of March 31, 2023. Cash, Cash Equivalents and Restricted Cash The Company considers all highly-liquid investments purchased with a remaining maturity date of three months or less upon acquisition to be cash equivalents. These investments are stated at cost, which approximates fair value. The Company has an arrangement with a financial institution with which it has an existing banking relationship, whereby in exchange for the issuance of corporate credit cards, the Company agreed to obtain a certificate of deposit with this financial institution as collateral for the balances borrowed on these cards ($0.2 million at March 31, 2023 and December 31, 2022). The Company has classified the value of this certificate of deposit (including all interest earned thereon) within other assets in the accompanying balance sheets. The Company has the right to terminate the credit card program at any time. Upon termination of the credit card program and repayment of all outstanding balances owed, the Company may redeem the certificate of deposit (and all interest earned thereon). Cash, cash equivalents and restricted cash presented in the accompanying statements of cash flows consist of the following (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 52,184 $ 89,751 Restricted cash 200 100 $ 52,384 $ 89,851 Long-lived Assets The Company’s long-lived assets are comprised principally of its property and equipment and operating lease assets. The Company amortizes all finite lived intangible assets over their respective estimated useful lives. Operating lease assets are amortized over the term of the leases. In considering whether long-lived assets are impaired, we combine our intangible assets and other long-lived assets, into groupings, a determination which we principally make on the basis of whether the assets are specific to a particular test we offer or technology we are developing. If the Company identifies a change in the circumstances related to its long-lived assets that indicates the carrying value of any such asset may not be recoverable, the Company will perform an impairment analysis. A long-lived asset is deemed to be impaired when the undiscounted cash flows expected to be generated by the asset (or asset group) are less than the asset’s carrying amount. Management’s estimates of future cash flows are impacted by projected test volume and levels of reimbursement, as well as expectations related to the future cost structure of the entity. Any required impairment loss would be measured as the amount by which the asset’s carrying value exceeds its fair value, and would be recorded as a reduction in the carrying value of the related asset and a charge to operating expense. Revenue Recognition Substantially all of the Company's revenue has been derived from sales of its testing products and is primarily comprised of a high volume of relatively low-dollar transactions. The Company primarily markets its testing products to rheumatologists and their physician assistants in the United States. The healthcare professionals who order the Company's testing products and to whom test results are reported are generally not responsible for payment for these products. The parties that pay for these services (each, a payor) consist of commercial payors (healthcare insurers), government payors (primarily Medicare and Medicaid), client payors (i.e., hospitals, other laboratories, etc.) and patient self-pay. The Company's service is a single performance obligation that is completed upon the delivery of test results to the prescribing physician which triggers revenue recognition. Payors are billed at the Company's list price. Net revenues recognized consist of amounts billed net of allowances for differences between amounts billed and the estimated consideration the Company expects to receive from such payors. The process for estimating revenues and the ultimate collection of accounts receivable involves significant judgment and estimation. The Company follows a standard process, which considers historical denial and collection experience, insurance reimbursement policies and other factors, to estimate allowances and implicit price concessions. Adjustments are recorded in the current period as changes in estimates occur. Further adjustments to the allowances, based on actual receipts, are recorded upon settlement. Included in revenues for the three months ended March 31, 2023 and 2022 was a $0.3 million net revenue increase and a $0.2 million net revenue decrease, respectively, associated with changes in estimated variable consideration related to performance obligations satisfied in previous periods. The transaction price is estimated using an expected value method on a portfolio basis. Variable consideration is included in the transaction price only to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainties with respect to the amount are resolved. The Company's portfolios are grouped per payor (i.e. each individual commercial payor, Medicare, Medicaid, client payors, patient self-pay, etc.) and per test. Consideration may be constrained and excluded from the transaction price in situations where there is no contractually agreed upon reimbursement coverage or in absence of a predictable pattern and history of collectability with a payor. Accordingly, in such situations revenues are recognized on the basis of actual cash collections. Additionally, from time to time, the Company may issue refunds to payors for overpayments or amounts billed in error. Any refunds are accounted for as reductions in revenues in the statement of operations as an element of variable consideration. The estimated expected refunds are accrued as a liability on the Company’s balance sheet. Collection of the Company's net revenues from payors is normally a function of providing complete and correct billing information to the healthcare insurers and generally occurs within 30 to 90 days of billing. Contracts do not contain significant financing components based on the typical period of time between performance of services and collection of consideration. Accounts Receivable and Allowance for Credit Losses We accrue an allowance for credit losses against our accounts receivable based on management’s current estimate of amounts that will not be collected. Management’s estimates are typically based on historical loss information adjusted for current conditions. We generally do not perform evaluations of the financial condition of our customers and generally do not require collateral. The allowance for credit losses was zero as of March 31, 2023. Adjustments for implicit price concessions attributable to variable consideration, as discussed above, are incorporated into the measurement of the accounts receivable balances and are not part of the allowance for credit losses. Research and Development Costs associated with research and development activities are expensed as incurred and include, but are not limited to, personnel-related expenses, including stock-based compensation expense, materials, laboratory supplies, consulting costs, costs associated with setting up and conducting clinical studies and allocated overhead including rent and utilities. Advertising and Marketing Costs Costs associated with advertising and marketing activities are expensed as incurred. Total advertising and marketing costs were approximately $0.3 million for the three months ended March 31, 2023 and 2022, and are included in selling, general and administrative expenses in the accompanying condensed statements of operations. Shipping and Handling Costs Costs incurred for shipping and handling are included in costs of revenue in the accompanying condensed statements of operations and totaled approximately $0.7 million and $0.6 million for the three months ended March 31, 2023 and 2022, respectively. Stock-Based Compensation The Company recognizes compensation expense for all stock-based awards to employees and directors based on the grant-date estimated fair values over the requisite service period of the awards (usually the vesting period) on a straight-line basis. The fair value of stock options and purchases under the Company's 2019 Employee Stock Purchase Plan (ESPP) rights is determined using the Black-Scholes-Merton (BSM) option pricing model, which requires management to make certain assumptions regarding a number of complex and subjective variables. Equity award forfeitures are recorded as they occur. The BSM option pricing model incorporates various inputs, including the fair value of the Company's common stock, expected volatility, expected term and risk-free interest rates. Volatility is based on the Company's historical calculated volatility since being publicly traded. The weighted-average expected term of options was calculated using the simplified method. The risk-free interest rate for periods within the contractual term of the option is based on the U.S. Treasury yield in effect at the time of grant. The dividend yield is zero, as the Company has never declared or paid dividends and has no plans to do so in the foreseeable future. The fair value of each restricted stock unit is determined on the grant date using the closing price of the Company's common stock on that date. The Company's restricted stock units generally vest in equal annual installments over four years from the date of grant or, for grants to new hires, date of hire. Vesting of restricted stock units is subject to the holder's continued service with the Company. The Company issues new shares to satisfy restricted stock units upon vesting. Comprehensive Loss Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions from nonowner sources. There have been no items qualifying as other comprehensive loss and, therefore, for all periods presented, the Company's comprehensive loss was the same as its reported net loss. Net Loss Per Share Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period. Diluted net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common stock equivalents outstanding for the period determined using the treasury-stock and if-converted methods. The weighted-average number of shares used to compute basic and diluted shares includes shares issuable upon the exercise of pre-funded warrants at a nominal price. Potentially dilutive common stock equivalents are comprised of warrants for the purchase of common stock, stock options, restricted stock units outstanding under the Company's 2019 Incentive Award Plan (the 2019 Plan) and shares of the Company's common stock pursuant to the ESPP. For the three months ended March 31, 2023 and 2022, there is no difference in the number of shares used to calculate basic and diluted shares outstanding, as the inclusion of the potentially dilutive securities would be antidilutive. Potentially dilutive securities not included in the calculation of diluted net loss per share, because to do so would be anti-dilutive, are as follows (in common stock equivalent shares): March 31, 2023 2022 Warrants to purchase common stock 409,108 409,108 Common stock options 1,019,076 2,002,039 Restricted stock units 1,494,085 878,575 Employee stock purchase plan 14,736 6,929 Total 2,937,005 3,296,651 Segment Reporting Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision-maker in making decisions regarding resource allocation and assessing performance. The Company views its operations as, and manages its business in, one operating segment. Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (FASB), or other standard setting bodies and adopted by the Company as of the specified effective date. Under the Jumpstart Our Business Startups Act of 2012 (JOBS Act), the Company meets the definition of an emerging growth company. The Company has elected to use the extended transition period for complying with new or revised accounting standards pursuant to Section 107(b) of the JOBS Act. Unless otherwise discussed, the impact of recently issued standards that are not yet effective will not have a material impact on the Company's financial position or results of operations upon adoption. Recently Adopted Accounting Standards In June 2016, the FASB issued Accounting Standards Update (ASU) 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires the measurement of expected credit losses (based on historical experience, current conditions and reasonable forecasts) for financial instruments (such as accounts receivable) held at the reporting date which are carried at amortized cost. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. In November 2018, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financing Instruments-Credit Losses , which included an amendment of the effective date for nonpublic entities. For emerging growth companies, ASU 2016-13 is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. The Company adopted this pronouncement on January 1, 2023. The adoption did not have an impact on its condensed financial statements. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) . ASU 2020-06 eliminates the beneficial conversion and cash conversion accounting models for convertible instruments. It also amends the accounting for certain contracts in an entity’s own equity that are currently accounted for as derivatives because of specific settlement provisions. In addition, ASU 2020-06 modifies how particular convertible instruments and certain contracts that may be settled in cash or shares impact the diluted EPS computation. The amendments in ASU 2020-06 are effective for smaller reporting companies as defined by the SEC for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. The Company adopted ASU 2020-06 as of January 1, 2023. The adoption did not have an impact on its condensed financial statements. |
Other Financial Information
Other Financial Information | 3 Months Ended |
Mar. 31, 2023 | |
Other Financial Information [Abstract] | |
Other Financial Information | Other Financial Information Prepaid Expenses and Other Current Assets Prepaid expenses and other current assets consist of the following (in thousands): March 31, 2023 December 31, 2022 Diagnostic testing supplies $ 1,736 $ 1,795 Prepaid product royalties 39 40 Prepaid maintenance and insurance contracts 2,210 2,072 Other prepaid expenses and other current assets 244 236 Prepaid expenses and other current assets $ 4,229 $ 4,143 Property and Equipment Property and equipment consist of the following (in thousands): March 31, 2023 December 31, 2022 Furniture and fixtures $ 98 $ 98 Laboratory equipment 5,209 5,136 Computer equipment and software 1,548 1,482 Leasehold improvements 5,223 5,223 Construction in progress 1,856 1,382 Total property and equipment 13,934 13,321 Less: accumulated depreciation and amortization (5,670) (5,124) Property and equipment, net $ 8,264 $ 8,197 Depreciation and amortization expense for the three months ended March 31, 2023 and 2022 was approximately $0.6 million and $0.3 million, respectively. Accrued and Other Current Liabilities Accrued and other current liabilities consist of the following (in thousands): March 31, 2023 December 31, 2022 Accrued payroll and related expenses $ 3,662 $ 2,355 Accrued interest 142 142 Accrued purchases of goods and services 665 803 Accrued royalties 114 514 Accrued clinical study activity 160 162 Finance lease obligations, current portion 650 700 Refund liability 445 445 Other accrued liabilities 226 226 Accrued and other current liabilities $ 6,064 $ 5,347 |
Borrowings
Borrowings | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Borrowings | Borrowings 2017 Term Loan In September 2017, the Company executed a term loan agreement (the 2017 Term Loan) with Innovatus Life Sciences Lending Fund I, LP (Innovatus), as amended, pursuant to which the Company borrowed $25.0 million. As of March 31, 2023, no additional amounts remained available to borrow under the 2017 Term Loan. In November 2021, the Company executed the Second Amendment to the Loan and Security Agreement (the 2017 Loan Amendment) and, as further described in Note 9, on April 28, 2023, the Company and Innovatus entered into the Third Loan Amendment to the 2017 Term Loan (Third Loan Amendment). The interest rate on all borrowings under the 2017 Loan Amendment was 8.0%, of which 2.0% was paid in-kind in the form of additional term loans (PIK Loans) until December of 2024, after which interest was scheduled to accrue at an annual rate of 8.0%. The Company estimated the effective interest rate of this loan to be approximately 8.5%. Accrued interest is due and payable monthly, unless the Company elects to pay paid-in-kind interest. The outstanding principal and accrued interest on the 2017 Loan Amendment was to be repaid in twenty-four equal monthly installments commencing in December 2024. Upon repayment of the final installment under the 2017 Loan Amendment, the Company is required to pay an additional fee of $1.0 million. This obligation is being accreted into interest expense over the term of the Loan Amendment using the effective interest method. For each of the three months ended March 31, 2023 and 2022, the Company issued PIK Loans totaling $0.1 million. The 2017 Loan Amendment required a prepayment premium of 2% of the aggregate outstanding principal and decreased by 1% on each of November 1, 2023 and 2024. The 2017 Loan Amendment is collateralized by a first priority security interest in substantially all of the Company's assets, including intellectual property. The affirmative covenants of the 2017 Loan Amendment require that the Company timely file taxes, maintain good standing and government compliance, maintain liability and other insurance, provide prompt notification of significant corporate events, and furnish audited financial statements within 150 days of fiscal year end without qualification as to the scope of the audit or as to going concern and without any other similar qualification. The affirmative covenants require that the Company achieve a specified level of revenue, as measured quarterly on a rolling twelve-month basis. The consequences of failing to achieve the performance covenant were eligible to be cured if, within sixty days of failing to achieve the performance covenant, the Company issues additional equity securities or subordinated debt with net proceeds sufficient to fund any cash flow deficiency generated from operations, as defined. The 2017 Loan Amendment requires that the Company maintain certain levels of minimum liquidity and maintains an unrestricted cash balance of $2.0 million. The negative covenants provide, among other things, that without the prior consent of Innovatus, subject to certain exceptions, the Company may not dispose of certain assets, engage in certain business combinations or acquisitions, incur additional indebtedness or encumber any of the Company's property, pay dividends on the Company's capital stock or make prohibited investments. The Loan Amendment agreement provides that an event of default will occur if, among other triggers, (i) the Company defaults in the payment of any amount payable under the agreement when due, (ii) there occurs any circumstance(s) that could reasonably be expected to result in a material adverse effect on the Company's business, operations or condition, or on the Company's ability to perform its obligations under the agreement, (iii) the Company becomes insolvent, (iv) the Company undergoes a change in control or (v) the Company breaches any negative covenants or certain affirmative covenants in the agreement or, subject to a cure period, otherwise neglects to perform or observe any material item in the agreement. As of March 31, 2023, the Company was in compliance with all covenants of the 2017 Loan Amendment. Upon an event of default in any of the 2017 Loan Amendment covenants, the repayment of the 2017 Loan Amendment may be accelerated, and the applicable interest rate will be increased by 4.0% until the default is cured. Although repayment of the 2017 Loan Amendment can be accelerated under certain circumstances, the Company believes acceleration of this loan is not probable as of the date of these condensed financial statements. Accordingly, the Company has reflected the amounts of the 2017 Loan Amendment due beyond twelve months of the balance sheet date as non-current. 2022 Equipment Notes Payable In May 2022, the Company purchased laboratory equipment using notes payable. At March 31, 2023, the total notes payable balance related to this financed equipment was $1.0 million, with $0.3 million classified within borrowings-current portion and $0.7 million within borrowings-non-current portion, net of discounts and debt issuance costs in the accompanying balance sheets. The financed equipment is subject to a 5.28% effective interest rate and will mature on October 1, 2026. Future Minimum Payments on the Outstanding Borrowings As of March 31, 2023, future minimum aggregate payments, including interest, for outstanding borrowings under the 2017 Loan Amendment are as follows (in thousands): 2023 (remaining) $ 1,498 2024 3,279 2025 16,451 2026 15,037 Total 36,265 Less: Unamortized debt discount and issuance costs (145) Interest (6,774) Total borrowings, net of discounts and debt issuance costs 29,346 Less: Borrowings-current portion (254) Borrowings-non-current portion, net of discounts and debt issuance costs $ 29,092 |
Commitment and Contingencies
Commitment and Contingencies | 3 Months Ended |
Mar. 31, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments and Contingencies Acquisition-related liabilities In connection with the acquisition of the medical diagnostics division of Royalty Pharma Collection Trust (Royalty Pharma) (formerly known as Cypress Bioscience, Inc.) in 2010, the Company has ongoing royalty payment obligations of 2.5% on net sales of products which incorporate certain acquired technologies. Future royalties payable under these arrangements are limited to the lesser of (i) an aggregate of $1.2 million (including an upfront payment of $0.1 million) and (ii) the total royalties earned through January 1, 2024. Licensing Agreements The Company has licensed technology for use in its diagnostic tests. In addition to the milestone payments required by these agreements, individual license agreements generally provide for ongoing royalty payments ranging from 1.5% to 7.0% on net sales of products which incorporate licensed technology, as defined in such agreements. Royalties are accrued when earned and recorded in costs of revenue in the accompanying condensed statements of operations. Collaboration Obligations In May 2021, the Company entered into a master research collaboration agreement with Allegheny Health Network Research Institute (AHN), pursuant to which the Company is required to pay AHN a collaboration fee of $0.4 million for each year during the initial term of the agreement. Collaboration expenses under the master research collaboration agreement were $0.1 million for each of the three months ended March 31, 2023 and 2022. Collaboration expenses under the AHN collaboration are included in research and development expenses. Supply Agreement In December 2021, the Company entered into an amended supply agreement with one supplier for reagents which includes minimum annual purchase commitments of $6.9 million and $8.0 million for the years ending December 31, 2023 and 2024, respectively, with a 15% annual increase thereafter for unconditional minimum purchase commitments through the year ending December 31, 2025. Contingencies In the normal course of business, the Company enters into contracts and agreements that contain a variety of representations and warranties and provide for general indemnifications; including for subpoenas and other civil investigative demands, from governmental agencies, Medicare or Medicaid and managed care organizations reviewing billing practices or requesting comment on allegations of billing irregularities that are brought to their attention through billing audits or third parties. The Company's exposure under these agreements is unknown because it involves claims that may be made against the Company in the future, but have not yet been made or that the Company believes to be immaterial. The Company accrues a liability for such matters when it is probable that future expenditures will be made and such expenditures can be reasonably estimated. Litigation From time to time, the Company may be subject to various legal proceedings that arise in the ordinary course of business activities. The Company does not believe the outcome of any such matters will have a material effect on its financial position or results of operations. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2023 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements Fair value is defined as the exchange price that would be received for an asset or an exit price paid to transfer a liability in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. The three-levels of the valuation hierarchy for disclosure of fair value measurements are defined as follows: Level 1 - Unadjusted quoted prices in active markets for identical assets or liabilities; Level 2 - Inputs other than quoted prices included within Level I that are observable, unadjusted 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 related assets or liabilities; and Level 3 - Unobservable inputs that are supported by little or no market activity for the related assets or liabilities. The categorization of a financial instrument within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement. The following table sets forth the Company's financial instruments that were measured at fair value on a recurring basis within the fair value hierarchy (in thousands): March 31, 2023 Total Level 1 Level 2 Level 3 Assets: Money market funds, included in cash and cash equivalents $ 20,146 $ 20,146 $ — $ — Certificate of deposit, included in cash and cash equivalents 30,000 30,000 — — Total $ 50,146 $ 50,146 $ — $ — December 31, 2022 Total Level 1 Level 2 Level 3 Assets: Money market funds, included in cash and cash equivalents $ 29,438 $ 29,438 $ — $ — Certificate of deposit, included in cash and cash equivalents 30,100 30,100 — — Total $ 59,538 $ 59,538 $ — $ — |
Stockholders' Equity
Stockholders' Equity | 3 Months Ended |
Mar. 31, 2023 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity Common Stock At The Market Sales Agreement On September 15, 2022, the Company entered into a sales agreement (the Sales Agreement) with Cowen and Company, LLC (the Sales Agent), pursuant to which the Company may offer and sell, from time to time, shares of Company common stock having an aggregate offering price of up to $50.0 million. The Company is not obligated to sell any shares of Company common stock in the offering. As of March 31, 2023, the Company has not sold any shares of its common stock pursuant to the Sales Agreement. Outstanding Warrants The following equity classified warrants to purchase common stock were outstanding as of March 31, 2023: Shares Exercise Price Issuance date Expiration date Common stock warrants 237,169 $ 1.84 January 19, 2016 January 19, 2026 Common stock warrants 67,086 $ 1.84 March 31, 2016 March 31, 2026 Common stock warrants 131 $ 1.84 April 1, 2016 April 1, 2026 Common stock warrants 83,778 $ 14.32 September 7, 2017 September 7, 2024 Common stock warrants 20,944 $ 14.32 December 7, 2018 December 7, 2025 Common stock warrants 804,951 $ 0.001 June 22, 2021 None 1,214,059 During the three months ended March 31, 2023, no warrants to purchase common stock were exercised. |
Stock Option Plan
Stock Option Plan | 3 Months Ended |
Mar. 31, 2023 | |
Share-Based Payment Arrangement [Abstract] | |
Stock Option Plan | Stock Option Plan 2019 Incentive Award Plan In September 2019, the Company's Board of Directors adopted, and the Company's stockholders approved, the 2019 Plan. Under the 2019 Plan, which expires in September 2029, the Company may grant stock options, stock appreciation rights, restricted stock, restricted stock units and other awards to individuals who are then employees, officers, non-employee directors or consultants of the Company or its subsidiaries. The options generally expire ten years after the date of grant and are exercisable to the extent vested. Vesting is established by the Board of Directors and is generally four years from the date of grant or, for grants to new hires, date of hire. The 2019 Plan contains an "evergreen provision" that allows annual increases in the number of shares available for issuance on the first day of each calendar year through January 1, 2029 in an amount equal to the lesser of: (i) 4% of the outstanding capital stock on each December 31st, or (ii) such lesser amount determined by the Board of Directors. As of March 31, 2023, 1,851,836 shares of common stock remained available for future awards under the 2019 Plan. 2019 Employee Stock Purchase Plan In September 2019, the Board of Directors adopted, and the Company's stockholders approved, the ESPP. The ESPP became effective on the day the ESPP was adopted by the Company's Board of Directors. The ESPP permits participants to purchase common stock through payroll deductions of up to 20% of their eligible compensation. The number of shares of common stock available for issuance under the ESPP will be annually increased on the first day of each calendar year during the term of the ESPP through January 1, 2029 in an amount equal to the lesser of (i) 1% of the outstanding capital stock on each December 31st, or (ii) such lesser amount determined by the Board of Directors. As of March 31, 2023, 508,608 shares of common stock remained available for issuance under the ESPP. Stock Options Stock option activity under the Company's 2019 Plan is set forth below: Number of Weighted- Weighted- Aggregate Outstanding, December 31, 2022 1,421,235 $ 12.94 7.09 $ 483 Granted — $ — Exercised (93,335) $ 0.26 Forfeited (31,019) $ 14.36 Expired (277,805) $ 17.96 Outstanding, March 31, 2023 1,019,076 $ 12.68 6.97 $ 287 Vested and expected to vest, March 31, 2023 1,019,076 $ 12.68 6.97 $ 287 Options exercisable, March 31, 2023 804,742 $ 12.80 6.64 $ 287 There were no stock options granted in the three months ended March 31, 2023 and 2022. The intrinsic value is calculated as the difference between the fair value of the Company's common stock and the exercise price of the stock options. The aggregate intrinsic value of options exercised during the three months ended March 31, 2023 was $0.2 million. There were no options exercised during the three months ended March 31, 2022. As of March 31, 2023, total unrecognized compensation cost related to option awards was $1.1 million, which is expected to be recognized over a remaining weighted-average vesting period of 0.82 years. Restricted Stock Units Restricted stock unit activity under the Company's 2019 Plan is set forth below: Number of Weighted- Aggregate Outstanding, December 31, 2022 1,036,208 $ 7.28 $ 2,487 Awards granted 638,500 $ 2.30 Awards released (113,720) $ 11.27 Awards canceled (66,903) $ 11.37 Outstanding, March 31, 2023 1,494,085 $ 4.66 $ 3,631 As of March 31, 2023, all of the outstanding restricted stock units were unvested. The fair value of restricted stock units vested in each of the three months ended March 31, 2023 and 2022 was $0.3 million. The weighted average grant date fair value for restricted stock units granted in the three months ended March 31, 2023 and 2022 was $2.30 and $8.72, respectively. As of March 31, 2023, total unrecognized compensation cost related to restricted stock units was $6.2 million, which is expected to be recognized over a remaining weighted-average vesting period of 3.5 years. Stock-Based Compensation Expense Total non-cash stock-based compensation expense recorded related to options granted, restricted stock units granted and stock purchase rights granted under the ESPP in the condensed statements of operations is as follows (in thousands): Three Months Ended March 31, 2023 2022 Costs of revenue $ 53 $ 44 Selling, general and administrative 831 1,118 Research and development 102 214 Total $ 986 $ 1,376 |
Subsequent Events
Subsequent Events | 3 Months Ended |
Mar. 31, 2023 | |
Subsequent Events [Abstract] | |
Subsequent Events | Subsequent Events On April 28, 2023, the Company and Innovatus entered into the Third Loan Amendment. Pursuant to the Third Loan Amendment, the Company prepaid $10.0 million of principal (Prepayment) and amended the 2017 Term Loan by, among other things: • waiving the Prepayment Fee (as defined in the 2017 Term Loan, as amended) with respect to the Prepayment; • revising the interest rate to the sum (the Basic Rate) of (a) the greater of The Wall Street Journal prime rate (the Prime Rate) or 8.0%, plus (b) 2.0%, of which 1.5% will be payable in-kind and capitalized to the principal amount of the outstanding term loan on a monthly basis until April 1, 2026; • extending the interest-only period through March 2026 and the maturity date to December 31, 2026; • decreasing the specified levels of revenue, as measured on the last day of each quarter on a rolling twelve-month basis, that the Company must achieve to satisfy the related financial covenants (the Revenue Covenant) in the 2017 Term Loan; • removing the obligation to comply with the Revenue Covenant during any fiscal quarter if the Company maintains a minimum aggregate cash balance equal to fifty percent of the aggregate principal amount of the loan at all times during such quarter; • providing the Company with a cure period in the event it breaches certain covenants; and • revising the definition of “Permitted Indebtedness” to permit the Company to broaden the limits on the Company’s ability to incur capitalized lease obligations, finance lease obligations, purchase money indebtedness or equipment financings without Innovatus’s prior written consent. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Concentration of Credit Risk and Other Risk and Uncertainties | Concentration of Credit Risk and Other Risk and Uncertainties Financial instruments that potentially subject the Company to credit risk consist principally of cash, cash equivalents and accounts receivable. Substantially all the Company's cash and cash equivalents are held at one financial institution that management believes is of high credit quality. Such deposits may, at times, exceed federally insured limits. The Company has not experienced any losses on its cash or cash equivalents. |
Fair Value Measurements | Fair Value Measurements The carrying value of the Company's cash, cash equivalents and restricted cash, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued and other current liabilities approximate their fair values due to their short-term nature, which are determined to be a Level 1 measurement (see Note 6). The estimated fair value of the Company's long-term borrowings is determined by Level 2 inputs and based primarily on quoted market prices for the same or similar issues. As of March 31, 2023, the 2017 Term Loan (as defined below) had a carrying value of $28.4 million and a fair value of $27.1 million. As of December 31, 2022, the 2017 Term Loan had a carrying value of $28.3 million and a fair value of $26.9 million The estimated fair value of the 2017 Term Loan, was determined based on a discounted cash flow approach using available market information on discount and borrowing rates with similar terms, maturities, and credit ratings. The recorded value of the Company's other long-term borrowing was $0.7 million and approximated its fair value as of March 31, 2023. |
Cash, Cash Equivalents and Restricted Cash | Cash, Cash Equivalents and Restricted Cash The Company considers all highly-liquid investments purchased with a remaining maturity date of three months or less upon acquisition to be cash equivalents. These investments are stated at cost, which approximates fair value. |
Long-lived Assets | Long-lived Assets The Company’s long-lived assets are comprised principally of its property and equipment and operating lease assets. The Company amortizes all finite lived intangible assets over their respective estimated useful lives. Operating lease assets are amortized over the term of the leases. In considering whether long-lived assets are impaired, we combine our intangible assets and other long-lived assets, into groupings, a determination which we principally make on the basis of whether the assets are specific to a particular test we offer or technology we are developing. If the Company identifies a change in the circumstances related to its long-lived assets that indicates the carrying value of any such asset may not be recoverable, the Company will perform an impairment analysis. A |
Revenue Recognition | Revenue Recognition Substantially all of the Company's revenue has been derived from sales of its testing products and is primarily comprised of a high volume of relatively low-dollar transactions. The Company primarily markets its testing products to rheumatologists and their physician assistants in the United States. The healthcare professionals who order the Company's testing products and to whom test results are reported are generally not responsible for payment for these products. The parties that pay for these services (each, a payor) consist of commercial payors (healthcare insurers), government payors (primarily Medicare and Medicaid), client payors (i.e., hospitals, other laboratories, etc.) and patient self-pay. The Company's service is a single performance obligation that is completed upon the delivery of test results to the prescribing physician which triggers revenue recognition. Payors are billed at the Company's list price. Net revenues recognized consist of amounts billed net of allowances for differences between amounts billed and the estimated consideration the Company expects to receive from such payors. The process for estimating revenues and the ultimate collection of accounts receivable involves significant judgment and estimation. The Company follows a standard process, which considers historical denial and collection experience, insurance reimbursement policies and other factors, to estimate allowances and implicit price concessions. Adjustments are recorded in the current period as changes in estimates occur. Further adjustments to the allowances, based on actual receipts, are recorded upon settlement. Included in revenues for the three months ended March 31, 2023 and 2022 was a $0.3 million net revenue increase and a $0.2 million net revenue decrease, respectively, associated with changes in estimated variable consideration related to performance obligations satisfied in previous periods. The transaction price is estimated using an expected value method on a portfolio basis. Variable consideration is included in the transaction price only to the extent it is probable that a significant reversal in the amount of cumulative revenue recognized will not occur when the uncertainties with respect to the amount are resolved. The Company's portfolios are grouped per payor (i.e. each individual commercial payor, Medicare, Medicaid, client payors, patient self-pay, etc.) and per test. Consideration may be constrained and excluded from the transaction price in situations where there is no contractually agreed upon reimbursement coverage or in absence of a predictable pattern and history of collectability with a payor. Accordingly, in such situations revenues are recognized on the basis of actual cash collections. Additionally, from time to time, the Company may issue refunds to payors for overpayments or amounts billed in error. Any refunds are accounted for as reductions in revenues in the statement of operations as an element of variable consideration. The estimated expected refunds are accrued as a liability on the Company’s balance sheet. Collection of the Company's net revenues from payors is normally a function of providing complete and correct billing information to the healthcare insurers and generally occurs within 30 to 90 days of billing. Contracts do not contain significant financing components based on the typical period of time between performance of services and collection of consideration. |
Research and Development | Research and Development Costs associated with research and development activities are expensed as incurred and include, but are not limited to, personnel-related expenses, including stock-based compensation expense, materials, laboratory |
Advertising and Marketing Costs | Advertising and Marketing Costs Costs associated with advertising and marketing activities are expensed as incurred. Total advertising and marketing costs were approximately $0.3 million for the three months ended March 31, 2023 and 2022, and are included in selling, general and administrative expenses in the accompanying condensed statements of operations. |
Shipping and Handling Costs | Shipping and Handling Costs Costs incurred for shipping and handling are included in costs of revenue in the accompanying condensed statements of operations and totaled approximately $0.7 million and $0.6 million for the three months ended March 31, 2023 and 2022, respectively. |
Stock-Based Compensation | Stock-Based Compensation The Company recognizes compensation expense for all stock-based awards to employees and directors based on the grant-date estimated fair values over the requisite service period of the awards (usually the vesting period) on a straight-line basis. The fair value of stock options and purchases under the Company's 2019 Employee Stock Purchase Plan (ESPP) rights is determined using the Black-Scholes-Merton (BSM) option pricing model, which requires management to make certain assumptions regarding a number of complex and subjective variables. Equity award forfeitures are recorded as they occur. The BSM option pricing model incorporates various inputs, including the fair value of the Company's common stock, expected volatility, expected term and risk-free interest rates. Volatility is based on the Company's historical calculated volatility since being publicly traded. The weighted-average expected term of options was calculated using the simplified method. The risk-free interest rate for periods within the contractual term of the option is based on the U.S. Treasury yield in effect at the time of grant. The dividend yield is zero, as the Company has never declared or paid dividends and has no plans to do so in the foreseeable future. The fair value of each restricted stock unit is determined on the grant date using the closing price of the Company's common stock on that date. The Company's restricted stock units generally vest in equal annual installments over four years from the date of grant or, for grants to new hires, date of hire. Vesting of restricted stock units is subject to the holder's continued service with the Company. The Company issues new shares to satisfy restricted stock units upon vesting. |
Comprehensive Loss | Comprehensive Loss Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions from nonowner sources. There have been no items qualifying as other comprehensive loss and, therefore, for all periods presented, the Company's comprehensive loss was the same as its reported net loss. |
Net Loss Per Share | Net Loss Per Share Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period. Diluted net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common stock equivalents outstanding for the period determined using the treasury-stock and if-converted methods. The weighted-average number of shares used to compute basic and diluted shares includes shares issuable upon the exercise of pre-funded warrants at a nominal price. Potentially dilutive common stock equivalents are comprised of warrants for the purchase of common stock, stock options, restricted stock units outstanding under the Company's 2019 Incentive Award Plan (the 2019 Plan) and shares of the Company's common stock pursuant to the ESPP. For the three months ended March 31, 2023 and 2022, there is no difference in the number of shares used to calculate basic and diluted shares outstanding, as the inclusion of the potentially dilutive securities would be antidilutive. |
Segment Reporting | Segment Reporting Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision-maker in making decisions regarding resource allocation and assessing performance. The Company views its operations as, and manages its business in, one operating segment. |
Recent Accounting Pronouncements and Recently Adopted Accounting Standards | Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (FASB), or other standard setting bodies and adopted by the Company as of the specified effective date. Under the Jumpstart Our Business Startups Act of 2012 (JOBS Act), the Company meets the definition of an emerging growth company. The Company has elected to use the extended transition period for complying with new or revised accounting standards pursuant to Section 107(b) of the JOBS Act. Unless otherwise discussed, the impact of recently issued standards that are not yet effective will not have a material impact on the Company's financial position or results of operations upon adoption. Recently Adopted Accounting Standards In June 2016, the FASB issued Accounting Standards Update (ASU) 2016-13, Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments , which requires the measurement of expected credit losses (based on historical experience, current conditions and reasonable forecasts) for financial instruments (such as accounts receivable) held at the reporting date which are carried at amortized cost. The main objective of this ASU is to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments and other commitments to extend credit held by a reporting entity at each reporting date. In November 2018, the FASB issued ASU 2018-19, Codification Improvements to Topic 326, Financing Instruments-Credit Losses , which included an amendment of the effective date for nonpublic entities. For emerging growth companies, ASU 2016-13 is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. The Company adopted this pronouncement on January 1, 2023. The adoption did not have an impact on its condensed financial statements. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) . ASU 2020-06 eliminates the beneficial conversion and cash conversion accounting models for convertible instruments. It also amends the accounting for certain contracts in an entity’s own equity that are currently accounted for as derivatives because of specific settlement provisions. In addition, ASU 2020-06 modifies how particular convertible instruments and certain contracts that may be settled in cash or shares impact the diluted EPS computation. The amendments in ASU 2020-06 are effective for smaller reporting companies as defined by the SEC for fiscal years beginning after December 15, 2023, including interim periods within those fiscal years. The Company adopted ASU 2020-06 as of January 1, 2023. The adoption did not have an impact on its condensed financial statements. |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Schedule of Concentration of Risk, by Risk Factor and Significant Payer | For each significant payor and customer, revenue as a percentage of total revenue and accounts receivable as a percentage of total accounts receivable are as follows: Revenue Three Months Ended 2023 2022 Medicare 39 % 20 % Medicare Advantage 16 % 15 % Blue Shield * 13 % * Less than 10%. Accounts Receivable, Net March 31, 2023 December 31, 2022 Medicare 45 % 21 % Medicare Advantage 10 % 13 % |
Disaggregation of Revenue | The following table includes the Company's revenues as disaggregated by payor and customer category (in thousands): Three Months Ended March 31, 2023 2022 Revenue: Commercial $ 4,215 $ 6,423 Government 4,426 2,120 Client(1) 2,407 1,591 Other(2) 182 260 Total revenue $ 11,230 $ 10,394 (1) Includes hospitals, other laboratories, etc. (2) Includes patient self-pay . |
Schedule of Restricted Cash and Cash Equivalents | Cash, cash equivalents and restricted cash presented in the accompanying statements of cash flows consist of the following (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 52,184 $ 89,751 Restricted cash 200 100 $ 52,384 $ 89,851 |
Schedule of Cash and Cash Equivalents | Cash, cash equivalents and restricted cash presented in the accompanying statements of cash flows consist of the following (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 52,184 $ 89,751 Restricted cash 200 100 $ 52,384 $ 89,851 |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share | Potentially dilutive securities not included in the calculation of diluted net loss per share, because to do so would be anti-dilutive, are as follows (in common stock equivalent shares): March 31, 2023 2022 Warrants to purchase common stock 409,108 409,108 Common stock options 1,019,076 2,002,039 Restricted stock units 1,494,085 878,575 Employee stock purchase plan 14,736 6,929 Total 2,937,005 3,296,651 |
Other Financial Information (Ta
Other Financial Information (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Other Financial Information [Abstract] | |
Prepaid Expenses and Other Current Assets | Prepaid expenses and other current assets consist of the following (in thousands): March 31, 2023 December 31, 2022 Diagnostic testing supplies $ 1,736 $ 1,795 Prepaid product royalties 39 40 Prepaid maintenance and insurance contracts 2,210 2,072 Other prepaid expenses and other current assets 244 236 Prepaid expenses and other current assets $ 4,229 $ 4,143 |
Property and Equipment | Property and equipment consist of the following (in thousands): March 31, 2023 December 31, 2022 Furniture and fixtures $ 98 $ 98 Laboratory equipment 5,209 5,136 Computer equipment and software 1,548 1,482 Leasehold improvements 5,223 5,223 Construction in progress 1,856 1,382 Total property and equipment 13,934 13,321 Less: accumulated depreciation and amortization (5,670) (5,124) Property and equipment, net $ 8,264 $ 8,197 |
Accrued and Other Current Liabilities | Accrued and other current liabilities consist of the following (in thousands): March 31, 2023 December 31, 2022 Accrued payroll and related expenses $ 3,662 $ 2,355 Accrued interest 142 142 Accrued purchases of goods and services 665 803 Accrued royalties 114 514 Accrued clinical study activity 160 162 Finance lease obligations, current portion 650 700 Refund liability 445 445 Other accrued liabilities 226 226 Accrued and other current liabilities $ 6,064 $ 5,347 |
Borrowings (Tables)
Borrowings (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Schedule of Future Minimum Aggregate Payments for Outstanding Borrowings | As of March 31, 2023, future minimum aggregate payments, including interest, for outstanding borrowings under the 2017 Loan Amendment are as follows (in thousands): 2023 (remaining) $ 1,498 2024 3,279 2025 16,451 2026 15,037 Total 36,265 Less: Unamortized debt discount and issuance costs (145) Interest (6,774) Total borrowings, net of discounts and debt issuance costs 29,346 Less: Borrowings-current portion (254) Borrowings-non-current portion, net of discounts and debt issuance costs $ 29,092 |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Fair Value Disclosures [Abstract] | |
Schedule of Fair Value, Financial Instrument Measured on a Recurring Basis | The following table sets forth the Company's financial instruments that were measured at fair value on a recurring basis within the fair value hierarchy (in thousands): March 31, 2023 Total Level 1 Level 2 Level 3 Assets: Money market funds, included in cash and cash equivalents $ 20,146 $ 20,146 $ — $ — Certificate of deposit, included in cash and cash equivalents 30,000 30,000 — — Total $ 50,146 $ 50,146 $ — $ — December 31, 2022 Total Level 1 Level 2 Level 3 Assets: Money market funds, included in cash and cash equivalents $ 29,438 $ 29,438 $ — $ — Certificate of deposit, included in cash and cash equivalents 30,100 30,100 — — Total $ 59,538 $ 59,538 $ — $ — |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Equity [Abstract] | |
Schedule of Outstanding Warrants | The following equity classified warrants to purchase common stock were outstanding as of March 31, 2023: Shares Exercise Price Issuance date Expiration date Common stock warrants 237,169 $ 1.84 January 19, 2016 January 19, 2026 Common stock warrants 67,086 $ 1.84 March 31, 2016 March 31, 2026 Common stock warrants 131 $ 1.84 April 1, 2016 April 1, 2026 Common stock warrants 83,778 $ 14.32 September 7, 2017 September 7, 2024 Common stock warrants 20,944 $ 14.32 December 7, 2018 December 7, 2025 Common stock warrants 804,951 $ 0.001 June 22, 2021 None 1,214,059 |
Stock Option Plan (Tables)
Stock Option Plan (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Share-Based Payment Arrangement [Abstract] | |
Schedule of Stock Option Activity | Stock option activity under the Company's 2019 Plan is set forth below: Number of Weighted- Weighted- Aggregate Outstanding, December 31, 2022 1,421,235 $ 12.94 7.09 $ 483 Granted — $ — Exercised (93,335) $ 0.26 Forfeited (31,019) $ 14.36 Expired (277,805) $ 17.96 Outstanding, March 31, 2023 1,019,076 $ 12.68 6.97 $ 287 Vested and expected to vest, March 31, 2023 1,019,076 $ 12.68 6.97 $ 287 Options exercisable, March 31, 2023 804,742 $ 12.80 6.64 $ 287 |
Schedule of Restricted Stock Unit Activity | Restricted stock unit activity under the Company's 2019 Plan is set forth below: Number of Weighted- Aggregate Outstanding, December 31, 2022 1,036,208 $ 7.28 $ 2,487 Awards granted 638,500 $ 2.30 Awards released (113,720) $ 11.27 Awards canceled (66,903) $ 11.37 Outstanding, March 31, 2023 1,494,085 $ 4.66 $ 3,631 |
Schedule of Non-cash Stock-based Compensation Expense | Total non-cash stock-based compensation expense recorded related to options granted, restricted stock units granted and stock purchase rights granted under the ESPP in the condensed statements of operations is as follows (in thousands): Three Months Ended March 31, 2023 2022 Costs of revenue $ 53 $ 44 Selling, general and administrative 831 1,118 Research and development 102 214 Total $ 986 $ 1,376 |
Organization (Details)
Organization (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 | Mar. 31, 2022 |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |||
Cash and cash equivalents | $ 52,184 | $ 62,391 | $ 89,751 |
Accumulated deficit | $ (263,215) | $ (255,527) |
Summary of Significant Accoun_4
Summary of Significant Accounting Policies - Revenue by Major Payers (Details) - Customer Concentration Risk | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Medicare | Revenue | |||
Disaggregation of Revenue [Line Items] | |||
Percent of total revenue | 39% | 20% | |
Medicare | Accounts Receivable | |||
Disaggregation of Revenue [Line Items] | |||
Percent of total revenue | 45% | 21% | |
Medicare Advantage | Revenue | |||
Disaggregation of Revenue [Line Items] | |||
Percent of total revenue | 16% | 15% | |
Medicare Advantage | Accounts Receivable | |||
Disaggregation of Revenue [Line Items] | |||
Percent of total revenue | 10% | 13% | |
Blue Shield | Revenue | |||
Disaggregation of Revenue [Line Items] | |||
Percent of total revenue | 13% |
Summary of Significant Accoun_5
Summary of Significant Accounting Policies - Narrative (Details) $ in Thousands | 3 Months Ended | ||
Mar. 31, 2023 USD ($) segment | Mar. 31, 2022 USD ($) | Dec. 31, 2022 USD ($) | |
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Long-term debt | $ 29,346 | ||
Restricted cash | 200 | $ 100 | $ 200 |
Revenue recognized in previous periods | 300 | 200 | |
Advertising expense | $ 300 | 300 | |
Number of operating segments | segment | 1 | ||
Other Long Term Debt | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Debt instrument | $ 700 | ||
Restricted stock units | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Stock options, vesting period | 4 years | ||
2017 Term loan | Level 2 | Recurring | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Long-term debt | $ 28,400 | 28,300 | |
Debt instrument | 27,100 | $ 26,900 | |
Shipping and Handling | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Cost of revenue | $ 700 | $ 600 | |
Revenue | Product Concentration Risk | AVISE CTD Test | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Percent of total revenue | 87% | 84% | |
Revenue | Supplier Concentration Risk | Two Major Suppliers | |||
New Accounting Pronouncement, Early Adoption [Line Items] | |||
Percent of total revenue | 97% | 95% |
Summary of Significant Accoun_6
Summary of Significant Accounting Policies - Disaggregation of Revenue (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 11,230 | $ 10,394 |
Commercial | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 4,215 | 6,423 |
Government | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 4,426 | 2,120 |
Client | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | 2,407 | 1,591 |
Other | ||
Disaggregation of Revenue [Line Items] | ||
Revenue | $ 182 | $ 260 |
Summary of Significant Accoun_7
Summary of Significant Accounting Policies - Cash, Cash Equivalents and Restricted Cash (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 | Mar. 31, 2022 | Dec. 31, 2021 |
Accounting Policies [Abstract] | ||||
Cash and cash equivalents | $ 52,184 | $ 62,391 | $ 89,751 | |
Restricted cash | 200 | 200 | 100 | |
Total Cash, Cash Equivalents and Restricted Cash | $ 52,384 | $ 62,591 | $ 89,851 | $ 99,542 |
Summary of Significant Accoun_8
Summary of Significant Accounting Policies - Securities (Details) - shares | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Class of Stock [Line Items] | ||
Anti-dilutive securities excluded from computation (in shares) | 2,937,005 | 3,296,651 |
Warrants to purchase common stock | ||
Class of Stock [Line Items] | ||
Anti-dilutive securities excluded from computation (in shares) | 409,108 | 409,108 |
Common stock options | ||
Class of Stock [Line Items] | ||
Anti-dilutive securities excluded from computation (in shares) | 1,019,076 | 2,002,039 |
Restricted stock units | ||
Class of Stock [Line Items] | ||
Anti-dilutive securities excluded from computation (in shares) | 1,494,085 | 878,575 |
Employee stock purchase plan | ||
Class of Stock [Line Items] | ||
Anti-dilutive securities excluded from computation (in shares) | 14,736 | 6,929 |
Other Financial Information - P
Other Financial Information - Prepaid Expenses (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Other Financial Information [Abstract] | ||
Diagnostic testing supplies | $ 1,736 | $ 1,795 |
Prepaid product royalties | 39 | 40 |
Prepaid maintenance and insurance contracts | 2,210 | 2,072 |
Other prepaid expenses and other current assets | 244 | 236 |
Prepaid expenses and other current assets | $ 4,229 | $ 4,143 |
Other Financial Information -_2
Other Financial Information - Property and Equipment (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | $ 13,934 | $ 13,321 |
Less: accumulated depreciation and amortization | (5,670) | (5,124) |
Property and equipment, net | 8,264 | 8,197 |
Furniture and fixtures | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 98 | 98 |
Laboratory equipment | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 5,209 | 5,136 |
Computer equipment and software | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 1,548 | 1,482 |
Leasehold improvements | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 5,223 | 5,223 |
Construction in progress | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | $ 1,856 | $ 1,382 |
Other Financial Information - N
Other Financial Information - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Other Financial Information [Abstract] | ||
Depreciation and amortization | $ 0.6 | $ 0.3 |
Other Financial Information - A
Other Financial Information - Accrued and Other Current Liabilities (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Other Financial Information [Abstract] | ||
Accrued payroll and related expenses | $ 3,662 | $ 2,355 |
Accrued interest | 142 | 142 |
Accrued purchases of goods and services | 665 | 803 |
Accrued royalties | 114 | 514 |
Accrued clinical study activity | 160 | 162 |
Finance lease obligations, current portion | 650 | 700 |
Refund liability | 445 | 445 |
Other accrued liabilities | 226 | 226 |
Accrued and other current liabilities | $ 6,064 | $ 5,347 |
Borrowings - Narrative (Details
Borrowings - Narrative (Details) | 1 Months Ended | 3 Months Ended | |||
Nov. 30, 2021 USD ($) installment | Sep. 30, 2017 USD ($) | Mar. 31, 2023 USD ($) | Mar. 31, 2022 USD ($) | May 31, 2022 USD ($) | |
2017 Term loan | Loan payable | Innovatus Life Sciences Lending Fund | |||||
Debt Instrument [Line Items] | |||||
Term loan borrowings | $ 25,000,000 | ||||
Remaining borrowing capacity | $ 0 | ||||
Term loan, interest rate | 8% | ||||
Term loan, paid in-kind, interest rate | 2% | ||||
Term loan, effective interest rate | 8.50% | ||||
Number of monthly installments | installment | 24 | ||||
Term loan, fee incurred upon payment of final installment | $ 1,000,000 | ||||
Term loan, prepayment premium percentage | 2% | ||||
Term loan, annual reduction in prepayment penalty percentage | 1% | ||||
Term loan, covenant, revenue performance period | 12 months | ||||
Term loan, covenant, number of days to cure covenant if performance measure is not met | 60 days | ||||
Term loan covenant, minimum unrestricted cash balance | $ 2,000,000 | ||||
Term loan covenant, increase to interest rate | 4% | ||||
2017 Term loan | Paid in-kind note | Innovatus Life Sciences Lending Fund | |||||
Debt Instrument [Line Items] | |||||
Term loan, paid in-kind loans issued | $ 100,000 | $ 100,000 | |||
Equipment Notes Payable | |||||
Debt Instrument [Line Items] | |||||
Term loan, effective interest rate | 5.28% | ||||
Notes payable | $ 1,000,000 | ||||
Notes payable, current | 300,000 | ||||
Notes payable, noncurrent | $ 700,000 |
Borrowings - Future Minimum Pay
Borrowings - Future Minimum Payments (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Debt Disclosure [Abstract] | ||
2023 (remaining) | $ 1,498 | |
2024 | 3,279 | |
2025 | 16,451 | |
2026 | 15,037 | |
Total | 36,265 | |
Unamortized debt discount and issuance costs | (145) | |
Interest | (6,774) | |
Total borrowings, net of discounts and debt issuance costs | 29,346 | |
Less: Borrowings-current portion | (254) | $ (190) |
Borrowings-non-current portion, net of discounts and debt issuance costs | $ 29,092 | $ 28,778 |
Commitment and Contingencies (D
Commitment and Contingencies (Details) - USD ($) $ in Millions | 1 Months Ended | 3 Months Ended | ||
May 31, 2021 | Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2021 | |
Loss Contingencies [Line Items] | ||||
Purchase obligation, due in year one | $ 6.9 | |||
Purchase obligation, due in second year | $ 8 | |||
Annual increase in purchase commitments | 15% | |||
Licensing Agreements | Minimum | ||||
Loss Contingencies [Line Items] | ||||
Royalty obligation, percent of net sales | 1.50% | |||
Licensing Agreements | Maximum | ||||
Loss Contingencies [Line Items] | ||||
Royalty obligation, percent of net sales | 7% | |||
AHN Collaboration | ||||
Loss Contingencies [Line Items] | ||||
Collaboration agreement, collaboration expenses | $ 0.1 | $ 0.1 | ||
Prometheus Laboratories | ||||
Loss Contingencies [Line Items] | ||||
Future minimum royalty commitment | 1.2 | |||
Advance royalties payment | $ 0.1 | |||
Prometheus Laboratories | Minimum | ||||
Loss Contingencies [Line Items] | ||||
Royalty obligation, percent of net sales | 2.50% | |||
Allegheny Health Network Research Institute | ||||
Loss Contingencies [Line Items] | ||||
Collaboration fee | $ 0.4 |
Fair Value Measurements (Detail
Fair Value Measurements (Details) - Recurring - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Assets: | ||
Total | $ 50,146 | $ 59,538 |
Money market funds, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 20,146 | 29,438 |
Certificate of deposit, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 30,000 | 30,100 |
Level 1 | ||
Assets: | ||
Total | 50,146 | 59,538 |
Level 1 | Money market funds, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 20,146 | 29,438 |
Level 1 | Certificate of deposit, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 30,000 | 30,100 |
Level 2 | ||
Assets: | ||
Total | 0 | 0 |
Level 2 | Money market funds, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 0 | 0 |
Level 2 | Certificate of deposit, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 0 | 0 |
Level 3 | ||
Assets: | ||
Total | 0 | 0 |
Level 3 | Money market funds, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | 0 | 0 |
Level 3 | Certificate of deposit, included in cash and cash equivalents | ||
Assets: | ||
Money market funds, included in cash and cash equivalents | $ 0 | $ 0 |
Stockholders' Equity - Narrativ
Stockholders' Equity - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | |
Sep. 15, 2022 | Mar. 31, 2023 | |
Class of Stock [Line Items] | ||
Exercise of common stock warrants (in shares) | 0 | |
Cowen Equity Distribution Agreement | ||
Class of Stock [Line Items] | ||
Proceeds from sale of stock | $ 50 |
Stockholders' Equity - Schedule
Stockholders' Equity - Schedule of Outstanding Warrants (Details) | Mar. 31, 2023 $ / shares shares |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 1,214,059 |
Warrant expiration January 19, 2026 | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 237,169 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 1.84 |
Warrant expiration March 31, 2026 | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 67,086 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 1.84 |
Warrant expiration April 1, 2026 | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 131 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 1.84 |
Warrant expiration September 7, 2024 | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 83,778 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 14.32 |
Warrant expiration December 7, 2025 | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 20,944 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 14.32 |
No expiration | |
Class of Stock [Line Items] | |
Warrants issued to purchase redeemable convertible preferred stock (in shares) | 804,951 |
Class of warrant or right, exercise price of warrants or rights (in dollars per share) | $ / shares | $ 0.001 |
Stock Option Plan - Narrative (
Stock Option Plan - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Intrinsic value | $ 0.2 | |
Stock options | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Granted (in shares) | 0 | 0 |
Stock options, unrecognized compensation cost | $ 1.1 | |
Stock options, cost not yet recognized, remaining weighted average vesting period | 9 months 25 days | |
Employee stock purchase plan | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Shares authorized, percentage | 1% | |
Shares that remain available for future awards (in shares) | 508,608 | |
Maximum employee payroll deduction percentage | 20% | |
Restricted stock units | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock options, vesting period | 4 years | |
Stock options, unrecognized compensation cost | $ 6.2 | |
Aggregate intrinsic value, vested | $ 0.3 | $ 0.3 |
Awards granted, Weighted-Average Grant Date Fair Value (in dollars per share) | $ 2.30 | $ 8.72 |
Stock options, cost not yet recognized, remaining weighted average vesting period | 3 years 6 months | |
2019 Incentive Award Plan | Stock options | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock options, expiration period | 10 years | |
Stock options, vesting period | 4 years | |
Shares authorized, percentage | 4% | |
Shares that remain available for future awards (in shares) | 1,851,836 |
Stock Option Plan - Stock Optio
Stock Option Plan - Stock Option Activity (Details) - Stock options - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward] | |||
Outstanding, December 31, 2022 (in shares) | 1,421,235 | ||
Granted (in shares) | 0 | 0 | |
Exercised (in shares) | (93,335) | ||
Forfeited (in shares) | (31,019) | ||
Expired (in shares) | (277,805) | ||
Outstanding, March 31, 2023 (in shares) | 1,019,076 | 1,421,235 | |
Vested and expected to vest, March 31, 2022 (in shares) | 1,019,076 | ||
Options exercisable, March 31, 2022 (in shares) | 804,742 | ||
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract] | |||
Outstanding, December 31, 2022, Weighted Average Exercise Price (in dollars per share) | $ 12.94 | ||
Granted, Weighted Average Exercise Price (in dollars per share) | 0 | ||
Exercised, Weighted Average Exercise Price (in dollars per share) | 0.26 | ||
Forfeited, Weighted Average Exercise Price (in dollars per share) | 14.36 | ||
Expired, Weighted Average Exercise Price (in dollars per share) | 17.96 | ||
Outstanding, March 31, 2023, Weighted Average Exercise Price (in dollars per share) | 12.68 | $ 12.94 | |
Vested and expected to vest, March 31, 2022 (in shares), Weighted Average Exercise Price (in dollars per share) | 12.68 | ||
Options exercised, March 31, 2022 (in shares), Weighted Average Exercise Price (in dollars per share) | $ 12.80 | ||
Stock Options, Additional Disclosures [Abstract] | |||
Outstanding, Weighted Average Remaining Contractual Term | 6 years 11 months 19 days | 7 years 1 month 2 days | |
Vested and expected to vest, Weighted Average Remaining Contractual Term | 6 years 11 months 19 days | ||
Options exercisable, Weighted Average Remaining Contractual Term | 6 years 7 months 20 days | ||
Outstanding, Aggregate Intrinsic Value | $ 287 | $ 483 | |
Vested and expected to vest, Aggregate Intrinsic Value | 287 | ||
Options exercisable, Aggregate Intrinsic Value | $ 287 |
Stock Option Plan - Restricted
Stock Option Plan - Restricted Stock Units (Details) - Restricted stock units - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward] | |||
Outstanding, December 31, 2022 (in shares) | 1,036,208 | ||
Awards granted (in shares) | 638,500 | ||
Awards released (in shares) | (113,720) | ||
Awards canceled (in shares) | (66,903) | ||
Outstanding, March 31, 2023 (in shares) | 1,494,085 | ||
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract] | |||
Outstanding, December 31, 2022 (in dollars per share) | $ 7.28 | ||
Awards granted, Weighted-Average Grant Date Fair Value (in dollars per share) | 2.30 | $ 8.72 | |
Awards released, Weighted-Average Grant Date Fair Value (in dollars per share) | 11.27 | ||
Awards canceled, Weighted-Average Grant Date Fair Value (in dollars per share) | 11.37 | ||
Outstanding, March 31, 2023 (in dollars per share) | $ 4.66 | ||
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Aggregate Intrinsic Value [Abstract] | |||
Outstanding, Aggregate Intrinsic Value | $ 3,631 | $ 2,487 |
Stock Option Plan - Stock-Based
Stock Option Plan - Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation expense | $ 986 | $ 1,376 |
Costs of revenue | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation expense | 53 | 44 |
Selling, general and administrative | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation expense | 831 | 1,118 |
Research and development | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation expense | $ 102 | $ 214 |
Subsequent Events (Details)
Subsequent Events (Details) - 2017 Term loan - Innovatus Life Sciences Lending Fund - Loan payable - USD ($) $ in Millions | 1 Months Ended | ||
Apr. 28, 2023 | Sep. 30, 2017 | Nov. 30, 2021 | |
Subsequent Event [Line Items] | |||
Term loan borrowings | $ 25 | ||
Term loan, interest rate | 8% | ||
Term loan, paid in-kind, interest rate | 2% | ||
Subsequent Event | |||
Subsequent Event [Line Items] | |||
Term loan, interest rate | 2% | ||
Term loan, paid in-kind, interest rate | 1.50% | ||
Payment for Debt Extinguishment or Debt Prepayment Cost | $ 10 | ||
Subsequent Event | Prime Rate | |||
Subsequent Event [Line Items] | |||
Variable rate | 8% |