Invitae (NVTAQ) 10-Q 9 May 23 2023 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2023	May 05, 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	001-36847
Entity Registrant Name	Invitae Corporation
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-1701898
Entity Address, Address Line One	1400 16th Street
Entity Address, City or Town	San Francisco
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94103
City Area Code	415
Local Phone Number	374-7782
Title of 12(b) Security	Common Stock, $0.0001 par value per share
Trading Symbol	NVTA
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		260,674,728
Entity Central Index Key	0001501134
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 161,197	$ 257,489
Marketable securities	217,501	289,611
Accounts receivable	85,592	96,148
Inventory	19,070	30,386
Prepaid expenses and other current assets	20,908	19,496
Total current assets	504,268	693,130
Property and equipment, net	95,445	108,723
Operating lease assets	78,051	106,563
Restricted cash	10,034	10,030
Intangible assets, net	981,888	1,012,549
Other assets	21,977	23,121
Total assets	1,691,663	1,954,116
Current liabilities:
Accounts payable	11,903	13,984
Accrued liabilities	85,131	74,388
Operating lease obligations	16,374	14,600
Finance lease obligations	4,870	5,121
Convertible senior secured notes, current portion (at fair value)	71,902	0
Total current liabilities	190,180	108,093
Operating lease obligations, net of current portion	143,744	134,386
Finance lease obligations, net of current portion	2,529	3,780
Debt	0	122,333
Convertible senior notes, net	1,169,374	1,470,783
Convertible senior secured notes, net of current portion (at fair value)	211,036	0
Deferred tax liability	7,130	8,130
Other long-term liabilities	4,326	4,775
Total liabilities	1,728,319	1,852,280
Commitments and contingencies
Stockholders’ (deficit) equity:
Common stock	26	25
Accumulated other comprehensive loss	(108)	(80)
Additional paid-in capital	4,984,750	4,931,032
Accumulated deficit	(5,021,324)	(4,829,141)
Total stockholders’ (deficit) equity	(36,656)	101,836
Total liabilities and stockholders’ (deficit) equity	$ 1,691,663	$ 1,954,116

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenue:
Total revenue	$ 117,356	$ 123,691
Operating expenses:
Cost of revenue	88,442	97,116
Research and development	61,978	128,236
Selling and marketing	44,510	60,144
General and administrative	45,241	51,428
Restructuring and other costs	52,556	0
Total operating expenses	292,727	336,924
Loss from operations	(175,371)	(213,233)
Other (expense) income, net:
Loss on extinguishment of debt, net	(10,822)	0
Debt issuance costs	(19,859)	0
Change in fair value of convertible senior secured notes	18,304	0
Change in fair value of acquisition-related liabilities	218	10,003
Other income, net	5,883	436
Total other (expense) income, net	(6,276)	10,439
Interest expense	(11,496)	(13,985)
Net loss before taxes	(193,143)	(216,779)
Income tax benefit	960	34,920
Net loss	$ (192,183)	$ (181,859)
Net (loss) income per share, basic (in dollars per share)	$ (0.77)	$ (0.80)
Net (loss) income per share, diluted (in dollars per share)	$ (0.77)	$ (0.80)
Shares used in computing net loss per share, basic	249,907	228,470
Shares used in computing net loss per share, diluted	249,907	228,470
Test revenue
Revenue:
Total revenue	$ 112,623	$ 119,497
Other revenue
Revenue:
Total revenue	$ 4,733	$ 4,194

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net loss	$ (192,183)	$ (181,859)
Other comprehensive income (loss):
Unrealized income (loss) on available-for-sale marketable securities, net of tax	143	(778)
Changes in fair value attributable to instrument-specific credit risk of convertible senior secured notes measured at fair value, net of tax	(171)	0
Comprehensive loss	$ (192,211)	$ (182,637)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' (Deficit) Equity - USD ($) $ in Thousands	Total	Common stock:	Accumulated other comprehensive loss:	Additional paid-in capital:	Accumulated deficit:
Balance, beginning of period at Dec. 31, 2021		$ 23	$ (7)	$ 4,701,230	$ (1,722,848)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued		0
Unrealized income (loss) on available-for-sale marketable securities, net of tax	$ (778)		(778)
Changes in fair value attributable to instrument-specific credit risk of convertible senior secured notes measured at fair value, net of tax	0		0
Common stock issued in connection with the exchange of convertible senior notes due 2024				0
Common stock issued on exercise of stock options, net				425
Common stock and equity awards issued pursuant to acquisitions				1,660
Stock-based compensation expense				46,087
Net loss	(181,859)				(181,859)
Balance, end of period at Mar. 31, 2022	2,843,933	23	(785)	4,749,402	(1,904,707)
Balance, beginning of period at Dec. 31, 2022	101,836	25	(80)	4,931,032	(4,829,141)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued		1
Unrealized income (loss) on available-for-sale marketable securities, net of tax	143		143
Changes in fair value attributable to instrument-specific credit risk of convertible senior secured notes measured at fair value, net of tax	(171)		(171)
Common stock issued in connection with the exchange of convertible senior notes due 2024				23,461
Common stock issued on exercise of stock options, net				1
Common stock and equity awards issued pursuant to acquisitions				1,063
Stock-based compensation expense				29,193
Net loss	(192,183)				(192,183)
Balance, end of period at Mar. 31, 2023	$ (36,656)	$ 26	$ (108)	$ 4,984,750	$ (5,021,324)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net loss	$ (192,183)	$ (181,859)
Adjustments to reconcile net loss to net cash used in operating activities:
Impairments and losses on disposals of long-lived assets, net	50,354	0
Depreciation and amortization	34,963	27,100
Stock-based compensation	29,193	46,822
Amortization of debt discount and issuance costs	3,022	3,883
Loss on extinguishment of debt, net	10,822	0
Debt issuance costs	19,859	0
Change in fair value of convertible senior secured notes	(18,304)	0
Remeasurements of liabilities associated with business combinations	(218)	(10,003)
Benefit from income taxes	(960)	(34,920)
Post-combination expense for acceleration of unvested equity and deferred stock compensation	830	1,660
Amortization of premiums and discounts on investment securities	(2,949)	570
Non-cash lease expense	3,111	1,286
Other	824	674
Changes in operating assets and liabilities, net of businesses acquired:
Accounts receivable	10,556	(14,172)
Inventory	11,316	(9,941)
Prepaid expenses and other current assets	(1,412)	1,654
Other assets	163	(1,984)
Accounts payable	(1,942)	22,863
Accrued expenses and other long-term liabilities	8,557	(1,176)
Net cash used in operating activities	(34,398)	(147,543)
Cash flows from investing activities:
Purchases of marketable securities	(126,053)	(550,541)
Proceeds from maturities of marketable securities	201,255	121,933
Purchases of property and equipment	(1,324)	(20,848)
Net cash provided by (used in) investing activities	73,878	(449,456)
Cash flows from financing activities:
Proceeds from issuance of common stock, net	1	425
Proceeds from issuance of Series B convertible senior secured notes due 2028	30,000	0
Payments for debt issuance costs and prepayment fees	(28,014)	0
Repayment of debt	(135,000)	0
Finance lease principal payments	(1,289)	(1,330)
Settlement of acquisition obligations	(1,466)	(15)
Net cash used in financing activities	(135,768)	(920)
Net decrease in cash, cash equivalents and restricted cash	(96,288)	(597,919)
Cash, cash equivalents and restricted cash at beginning of period	267,519	933,525
Cash, cash equivalents and restricted cash at end of period	171,231	335,606
Supplemental cash flow information of non-cash investing and financing activities:
Equipment acquired through finance leases	0	4,472
Purchases of property and equipment in accounts payable and accrued liabilities	579	11,675
Common stock issued for acquisition of businesses	233	0
Exchange of convertible senior notes due 2024	(302,941)	0
Exchange for convertible senior secured notes due 2028	$ 301,071	$ 0

Organization and description of

Organization and description of business	3 Months Ended
	Mar. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and description of business	Organization and description of business Invitae Corporation ("Invitae," “the Company," "we," "us," and "our") was incorporated in the State of Delaware on January 13, 2010, as Locus Development, Inc. and we changed our name to Invitae Corporation in 2012. We offer high-quality, comprehensive, affordable genetic testing across multiple clinical areas, including hereditary cancer, precision oncology, women's health, rare diseases and pharmacogenomics. To augment our portfolio and realize our mission, we have previously acquired multiple assets and businesses that further expanded our test menu and suite of digital health and offerings and accelerated our entry into key genomics markets. We are building a platform to harness genetics to diagnose more patients correctly and earlier, while enabling our strategic partners to bring therapies to market faster. Invitae operates in one segment. Strategic realignment On July 18, 2022, the Company initiated a strategic realignment of our operations and began implementing cost reduction programs to prioritize its core genetic testing and digital health and data platforms, which was approved by the board of directors of the Company on July 16, 2022. See Note 10, "Restructuring and other costs" for additional information regarding our strategic realignment. Basis of presentation

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 Principles of consolidation Our unaudited condensed consolidated financial statements include our accounts and the accounts of our wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation. Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make judgments, estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent liabilities as of the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. We base these estimates on current facts, historical and anticipated results, trends and various other assumptions that we believe are reasonable under the circumstances, including assumptions as to future events. Actual results could differ materially from those judgments, estimates and assumptions. We evaluate our estimates on an ongoing basis. Concentrations of credit risk and other risks and uncertainties Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, restricted cash, marketable securities and accounts receivable. Our cash and cash equivalents are primarily held by financial institutions in the United States. Such deposits may exceed federally insured limits. Cash, cash equivalents and restricted cash Cash, cash equivalents and restricted cash reported within the condensed consolidated balance sheets are reconciled to the amounts reported in the condensed consolidated statements of cash flows as follows (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 161,197 $ 325,331 Restricted cash 10,034 10,275 Total cash, cash equivalents and restricted cash $ 171,231 $ 335,606 Fair value of financial instruments Our financial instruments consist principally of cash and cash equivalents, marketable securities, accounts receivable, accounts payable, accrued liabilities, operating and finance leases obligations, liabilities associated with business combinations, and convertible senior notes. The carrying amounts of certain of these financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued and other current liabilities approximate their current fair value due to the relatively short-term nature of these accounts. Based on borrowing rates available to us, the carrying value of our operating and finance leases approximates their fair values. Liabilities associated with business combinations and the convertible senior secured notes due 2028 are recorded at their estimated fair value. Fair value option election The fair value option provides an election that allows an entity to irrevocably elect to record certain financial assets and liabilities at fair value on an instrument-by-instrument basis at initial recognition. We have elected to apply the fair value option to our 4.50% Series A and B convertible senior secured notes due 2028 (collectively, the "Senior Secured 2028 Notes") and stock payable liabilities resulting from business combinations. The convertible senior secured notes accounted for under the fair value option election pursuant to Accounting Standards Codification ("ASC") 825, Financial Instruments, are each a debt host financial instrument containing embedded features which would otherwise be required to be bifurcated from the debt-host and recognized as separate derivative liabilities subject to initial and recurring estimated fair value measurements under ASC 815, Derivatives and Hedging . Notwithstanding, ASC 825 provides for the fair value option election, to the extent not otherwise prohibited by ASC 825, to be afforded to financial instruments. When the fair value option election is applied to financial liabilities, bifurcation of an embedded derivative is not required, and the financial liability is initially measured at its issue-date estimated fair value and then subsequently remeasured at estimated fair value on a recurring basis as of each reporting period date. The estimated fair value adjustment related to the portion of the change in fair value attributed to a change in the instrument-specific credit risk is recognized as a component of other comprehensive loss, with the remaining amount of the fair value adjustment recognized in other (expense) income, net in our condensed consolidated statements of operations. We have elected to present the component related to accrued interest in the change in fair value of the Senior Secured 2028 Notes. In circumstances where an acquisition involves certain indemnification hold-backs that are settled in shares of our common stock, we recognize a stock payable liability based upon the number of shares that are issuable to the sellers and the quoted closing price of our common stock as of the reporting date. The number of shares that will ultimately be issued is subject to adjustment for indemnified claims that existed as of the closing date for each acquisition. We remeasure this liability each reporting period and record changes in the fair value related to stock payable liabilities in other income (expense), net in our condensed consolidated statements of operations. Restructuring and other costs Restructuring and other costs are comprised of employee severance and benefits, asset impairments and losses on asset disposals, and other costs primarily related to implementing our strategic realignment. Employee severance and benefit costs are comprised of severance, other termination benefit costs, and stock-based compensation expense for the acceleration of stock awards related to workforce reductions. We recognize costs and liabilities associated with exit and disposal activities in accordance with ASC 420, Exit and Disposal Cost Obligations, and other costs and liabilities associated with nonretirement postemployment benefits in accordance with ASC 712, Nonretirement Postemployment Benefits . Liabilities are based on the estimate of fair value in the period the liabilities are incurred, with subsequent changes to the liability recognized as adjustments in the period of change. We recognize losses on asset disposals in accordance with ASC 360, Impairment or Disposal of Long- Lived Assets . Restructuring and other costs are recognized as an operating expense within the condensed consolidated statements of operations and related liabilities are recorded within accrued liabilities in the condensed consolidated balance sheets. Recent accounting pronouncements We evaluate all Accounting Standards Updates (“ASUs”) issued by the Financial Accounting Standards Board (the "FASB") for consideration of their applicability. ASUs not included in the disclosures in this report were assessed and determined to be either not applicable or are not expected to have a material impact on our condensed consolidated financial statements. Recently adopted accounting pronouncements In October 2021, the FASB issued ASU 2021-08, Business Combinations ("Topic 805"): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments of this ASU require entities to recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC 606, Revenue from Contracts with Customers . The Company adopted the amendments in this update on January 1, 2023 with no impact to our consolidated financial statements at the date of adoption. The amendments will be applied prospectively to future business combinations.

Revenue, accounts receivable an

Revenue, accounts receivable and deferred revenue	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Revenue, accounts receivable and deferred revenue	Revenue, accounts receivable and deferred revenueTest revenue is generated from sales of diagnostic tests and precision oncology products to two groups of customers: patients, consideration for which may be paid directly by the patients or the patients' insurance carriers, and institutions (e.g., hospitals, clinics, medical centers and biopharmaceutical partners). Amounts billed and collected, and the timing of collections, vary based on the type of customer and the corresponding payer, including the patients' insurance carriers that are paying on behalf of the customer. Data and service revenue consists principally of revenue recognized for the performance of activities outlined in biopharmaceutical development contracts and other collaboration and genome network agreements. The following tables present disaggregated revenue by customer and product offering by category (in thousands): Patient Institution Three Months Ended March 31, 2023 Insurance Direct Product: Oncology $ 50,615 $ 1,705 $ 7,986 $ 60,306 Women's health 20,210 3,412 1,259 24,881 Rare diseases 11,427 2,389 6,316 20,132 Data/services — — 12,037 12,037 Total revenue $ 82,252 $ 7,506 $ 27,598 $ 117,356 Patient Institution Three Months Ended March 31, 2022 Insurance Direct Product: Oncology $ 48,538 $ 3,436 $ 20,201 $ 72,175 Women's health 16,765 6,004 2,022 24,791 Rare diseases 6,601 2,717 6,265 15,583 Data/services — — 11,142 11,142 Total revenue $ 71,904 $ 12,157 $ 39,630 $ 123,691 We recognize revenue related to billings based on estimates of the amount that will ultimately be realized. Cash collections for certain tests delivered may differ from rates originally estimated. In subsequent periods, we update our estimate of the amounts recognized for previously delivered tests resulting in the following (decreases) increases to revenue and (decreases) increases to our net (loss) income from operations and basic and diluted net (loss) income per share (in millions, except per share data): Three Months Ended March 31, 2023 2022 Revenue $ (3.0) $ 1.1 (Loss) income from operations $ (3.0) $ 1.1 Net (loss) income per share, basic and diluted $ (0.01) $ 0.00 Accounts receivable The majority of our accounts receivable represents amounts billed to customers for test and data and service activities, and estimated amounts to be collected from patients' insurance carriers for test services. We record a contract asset for services delivered under certain biopharmaceutical contracts, which are unbilled as of the end of the period. The contract receivable was $1.1 million and $1.3 million as of March 31, 2023 and December 31, 2022, respectively, and was included in prepaid expenses and other current assets in the condensed consolidated balance sheets. Deferred revenue We record a contract liability when cash payments are received or due in advance of our performance related to one or more performance obligations. The deferred revenue balance primarily consists of advanced billings for biopharmaceutical development services, including billings at the initiation of performance-based milestones, and recognized as revenue in the applicable future period when the revenue is earned. Also included are prepayments related to our consumer direct channel. We recognized revenue of $2.1 million from deferred revenue during the three months ended March 31, 2023. The current contract liability was $5.7 million and $4.8 million as of March 31, 2023 and December 31, 2022, respectively, which was included in accrued liabilities in the condensed consolidated balance sheets. The long-term contract liability was $36 thousand and $0.1 million at March 31, 2023 and December 31, 2022, respectively, and was included in other long-term liabilities in the condensed consolidated balance sheets. Refund liability As part of our strategic realignment, we terminated early or changed the scope of several companion diagnostic development contracts with milestones in progress. Upon termination, we recorded a refund liability related to the remaining outstanding performance-based milestones. During the three months ended March 31, 2023, we recorded settlement activity associated with the early termination of a companion diagnostic contract. The refund liability was $2.5 million and $4.7 million as of March 31, 2023 and December 31, 2022, respectively, which was included in accrued liabilities in the condensed consolidated balance sheets. Performance obligations

Intangible Assets

Intangible Assets	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible assets The following table presents details of our acquired intangible assets as of March 31, 2023 (in thousands): March 31, 2023 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 40,928 $ (18,577) $ — $ 22,351 10.8 Developed technology 1,138,702 (193,796) (2,051) 942,855 10.8 Trade name 21,072 (4,390) — 16,682 12.0 $ 1,200,702 $ (216,763) $ (2,051) $ 981,888 10.8 The following table presents details of our acquired intangible assets as of December 31, 2022 (in thousands): December 31, 2022 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 41,515 $ (17,675) $ (359) $ 23,481 10.8 Developed technology 1,174,506 (183,133) (19,426) 971,947 10.8 Non-compete agreement 286 (286) — — — Trade name 21,085 (3,964) — 17,121 12.0 Patent assets and licenses 495 (156) (339) — — Right to develop new technology 19,359 (2,474) (16,885) — — $ 1,257,246 $ (207,688) $ (37,009) $ 1,012,549 10.8 Acquisition-related intangibles included in the above tables are generally finite-lived and are carried at cost less accumulated amortization. Customer relationships are being amortized on an accelerated basis in proportion to estimated cash flows. All other finite-lived acquisition-related intangibles are being amortized on a straight-line basis over their estimated lives, which approximates the pattern in which the economic benefits of the intangible assets are expected to be realized. Amortization expense was $28.6 million and $20.2 million for the three months ended March 31, 2023 and 2022, respectively. Amortization expense is recorded in cost of revenue, research and development, and selling and marketing expense in our condensed consolidated statements of operations. In March 2023, we decided to cease development of acquired technology focused on informing clinical decisions as management continued to evaluate its investments in development. During the three months ended March 31, 2023, we wrote-off the remaining carrying value of the related developed technology intangible asset of $2.1 million and recognized $1.0 million for related contractual obligations, which are included in restructuring and other costs in the condensed consolidated statements of operations. See Note 10, "Restructuring and other costs" for additional information. The following table summarizes our estimated future amortization expense of intangible assets with finite lives as of March 31, 2023 (in thousands): 2023 (remainder of year) $ 85,559 2024 113,800 2025 112,046 2026 112,012 2027 111,346 Thereafter 447,125 Total estimated future amortization expense $ 981,888

Balance sheet components

Balance sheet components	3 Months Ended
	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Balance sheet components	Balance sheet components Inventory Inventory consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 18,913 $ 29,992 Work in progress 157 382 Finished goods — 12 Total inventory $ 19,070 $ 30,386 Property and equipment, net Property and equipment consisted of the following (in thousands): March 31, 2023 December 31, 2022 Leasehold improvements $ 72,184 $ 73,095 Laboratory equipment 62,267 67,261 Computer equipment 13,368 13,511 Furniture and fixtures 1,364 1,427 Construction-in-progress 14,186 21,006 Other 5,955 2,996 Total property and equipment, gross 169,324 179,296 Accumulated depreciation (73,879) (70,573) Total property and equipment, net $ 95,445 $ 108,723 Depreciation expense was $5.4 million and $5.6 million for the three months ended March 31, 2023 and 2022, respectively. During the first quarter of 2023, we decided to exit certain leased premises and we recognized a loss on disposal of property and equipment, net of $8.5 million during the three months ended March 31, 2023 for related lab equipment and leasehold improvements, which is included in restructuring and other costs in our condensed consolidated statement of operations. See Note 7, "Commitments and contingencies" and Note 10, "Restructuring and other costs" for additional information. Accrued liabilities Accrued liabilities consisted of the following (in thousands): March 31, 2023 December 31, 2022 Accrued compensation and related expenses $ 33,424 $ 25,315 Accrued expenses 32,394 23,628 Compensation and other liabilities associated with business combinations 3,881 5,335 Deferred revenue 5,721 4,814 Accrued interest 62 6,646 Accrued royalties 2,421 3,177 Other accrued liabilities 7,228 5,473 Total accrued liabilities $ 85,131 $ 74,388

Fair value measurements

Fair value measurements	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Fair value measurements	Fair value measurementsFinancial assets and liabilities are recorded at fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The authoritative guidance establishes a three-level valuation hierarchy that prioritizes the inputs to valuation techniques used to measure fair value based upon whether such inputs are observable or unobservable. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect market assumptions made by the reporting entity. The three-level hierarchy for the inputs to valuation techniques is summarized as follows: Level 1—Observable inputs such as quoted prices (unadjusted) for identical instruments in active markets. Level 2—Observable inputs such as quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, or model-derived valuations whose significant inputs are observable. Level 3—Unobservable inputs that reflect the reporting entity’s own assumptions. The following tables set forth the fair value of our financial instruments that were measured at fair value on a recurring basis (in thousands): March 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value Level 1 Level 2 Level 3 Financial assets: Money market funds $ 169,399 $ — $ — $ 169,399 $ 169,399 $ — $ — U.S. Treasury notes 33,042 11 — 33,053 33,053 — — U.S. government agency securities 184,395 53 — 184,448 — 184,448 — Total financial assets $ 386,836 $ 64 $ — $ 386,900 $ 202,452 $ 184,448 $ — Financial liabilities: Stock payable liability $ 300 $ — $ — $ 300 Contingent consideration 25 — — 25 Convertible senior secured notes 282,938 — — 282,938 Total financial liabilities $ 283,263 $ — $ — $ 283,263 March 31, 2023 Reported as: Cash equivalents $ 159,365 Restricted cash 10,034 Marketable securities 217,501 Total cash equivalents, restricted cash, and marketable securities $ 386,900 Convertible senior secured notes, current portion $ 71,902 Convertible senior secured notes, net of current portion 211,036 Other long-term liabilities 325 Total liabilities $ 283,263 December 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value Level 1 Level 2 Level 3 Financial assets: Money market funds $ 158,931 $ — $ — $ 158,931 $ 158,931 $ — $ — U.S. Treasury notes 193,685 1 (123) 193,563 193,563 — — U.S. government agency securities 96,006 55 (13) 96,048 — 96,048 — Total financial assets $ 448,622 $ 56 $ (136) $ 448,542 $ 352,494 $ 96,048 $ — Financial liabilities: Stock payable liability $ 744 $ — $ — $ 744 Contingent consideration 25 — — 25 Total financial liabilities $ 769 $ — $ — $ 769 December 31, 2022 Reported as: Cash equivalents $ 148,901 Restricted cash 10,030 Marketable securities 289,611 Total cash equivalents, restricted cash, and marketable securities $ 448,542 Other long-term liabilities $ 769 There were no transfers between Level 1, Level 2 and Level 3 during the periods presented. Our debt securities of U.S. government agencies are classified as Level 2 as they are valued based upon quoted market prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active and model-based valuation techniques for which all significant inputs are observable in the market or can be corroborated by observable market data for substantially the full term of the assets. Where applicable, these models project future cash flows and discount the future amounts to a present value using market-based observable inputs obtained from various third-party data providers, including but not limited to benchmark yields, interest rate curves, reported trades, broker/dealer quotes and reference data. At March 31, 2023, the remaining contractual maturities of available-for-sale securities ranged from zero The total fair value of investments with unrealized losses at March 31, 2023 was zero. None of the available-for-sale securities held as of March 31, 2023 have been in an unrealized loss position for more than one year. The Company evaluates investments that are in an unrealized loss position for impairment as a result of credit loss. It was determined that no credit losses exist as of March 31, 2023, because the change in market value of those securities has resulted from fluctuations in market interest rates since the time of purchase, rather than a deterioration of the credit worthiness of the issuers. For marketable securities in an unrealized loss position, we assess our intent to sell, or whether it is more likely than not that we will be required to sell the security before recovery of its amortized cost basis. We intend to hold our marketable securities to maturity and it is unlikely that they would be sold before their cost bases are recovered. The cost of securities sold is based on the specific identification method. The following tables include a rollforward of the stock payable liability, contingent consideration, and Senior Secured 2028 Notes classified within Level 3 of the fair value hierarchy (in thousands): Stock Payable Liability Contingent Consideration Convertible Senior Secured Notes Fair value at December 31, 2022 $ 744 $ 25 $ — Issuance of convertible senior secured notes at fair value — — 301,071 Changes in fair value (218) — (18,304) Changes in fair value related to instrument-specific credit risk — — 171 Settlements (226) — — Fair value at March 31, 2023 $ 300 $ 25 $ 282,938 Stock Payable Liability Contingent Consideration Fair value at December 31, 2021 $ 20,925 $ 1,875 Change in fair value (10,003) 154 Fair value at March 31, 2022 $ 10,922 $ 2,029 Stock payable liabilities relate to certain indemnification hold-backs resulting from business combinations that are settled in shares of our common stock. We elected to account for these liabilities using the fair value option due to the inherent nature of the liabilities and the changes in value of the underlying shares that will ultimately be issued to settle the liabilities. The estimated fair value of these liabilities is classified as Level 3 and determined based upon the number of shares that are issuable to the sellers and the quoted closing price of our common stock as of the reporting date. The number of shares that will ultimately be issued is subject to adjustment for indemnified claims that existed as of the closing date for each acquisition. Changes in the number of shares issued and share price can significantly affect the estimated fair value of the liabilities. The change in fair value related to stock payable liabilities was income of $0.2 million and $10.0 million during the three months ended March 31, 2023 and 2022, respectively, which is recorded in change in fair value of acquisition-related liabilities in the condensed consolidated statements of operations. Contingent consideration relates to the obligation we may be required to pay in the form of additional shares of our common stock resulting from the acquisition of Genelex in April 2020. The amount of the contingent obligation is dependent upon the achievement of a certain product milestone, at which time we would issue shares of our common stock with a value equal to a portion of the gross revenues actually received by us for a pharmacogenetic product reimbursed through certain payers during an earn-out period of up to four years. The estimated fair value of the contingent consideration is based upon significant inputs not observable in the market and, therefore, represents a Level 3 measurement. The material factors that may impact the fair value of the contingent consideration, and therefore, this liability, are the probabilities and timing of achieving the related milestone, the estimated revenues achieved for a pharmacogenetic product and the discount rate used to estimate the fair value. Significant changes in any of the probabilities of success would result in a significant change in the estimated fair value of the liability. The change in fair value related to contingent consideration recorded to other (expense) income, net was zero and expense of $0.2 million during the three months ended March 31, 2023 and 2022, respectively. In March 2023, the Company issued 4.50% Series A convertible senior secured notes due 2028 (“Series A Notes”) with an aggregate principal amount of $275.3 million, and Series B convertible senior secured notes due 2028 (the "Series B Notes") with an aggregate principal amount of $30.0 million. The Company elected the fair value option to account for the Senior Secured 2028 Notes. We utilize the binomial lattice model, specifically a lattice model to estimate the fair value of the convertible senior secured notes at issuance and subsequent reporting dates. The estimated fair value of the Senior Secured 2028 Notes is determined using Level 3 inputs and assumptions unobservable in the market. This model incorporates the terms and conditions of the Senior Secured 2028 Notes and assumptions related to stock price, expected stock price volatility, risk-free interest rate, market credit spread, and cost of debt. The stock price is based on the publicly traded price of our common stock as of the measurement date. We estimate the volatility of our stock price based on the historical and implied volatilities of our publicly traded common stock. The risk-free interest rate is based on interpolated U.S. Treasury rates, commensurate with a similar term to the Senior Secured 2028 Notes. The most significant assumptions in the binomial lattice model impacting the fair value of the Senior Secured 2028 Notes are (i) the estimated stock price, (ii) the estimated cost of debt, and (iii) the volatility of our common stock. Significant changes in any of these inputs may result in a significant change in the fair value of the Senior Secured 2028 Notes. Under the fair value election as prescribed by ASC 825, we will record changes in fair value, inclusive of related accrued interest, through the condensed consolidated statement of operations as a fair value adjustment of the convertible senior secured debt each reporting period, with the portion of the change that results from a change in the instrument-specific credit risk recorded separately in other comprehensive loss, if applicable. The portion of total changes in fair value of debt attributable to changes in instrument-specific credit risk are determined through specific measurement of periodic changes in the risk-free interest rate, credit spread, and cost of debt assumptions. The initial carrying amount of the Senior Secured 2028 Notes, measured at the estimated fair value on the date of issuance, was $301.1 million. As of March 31, 2023, the estimated fair value was $282.9 million. During the three months ended March 31, 2023, the corresponding change in fair value of the Senior Secured 2028 Notes was a gain of $18.3 million, which is included in other (expense) income, net in the condensed consolidated statements of operations. The change in fair value related to instrument-specific credit risk was $0.2 million, which is included in the condensed consolidated statements of comprehensive loss. See Note 7, "Commitments and contingencies" under the heading "Convertible senior notes—Convertible senior secured notes due 2028" for a description of the Senior Secured 2028 Notes. Significant inputs into the binomial lattice model as of March 31, 2023 and March 7, 2023 were as follows: March 31, 2023 March 7, 2023 Stock price $1.35 $1.65 Conversion price $2.58 $2.58 Volatility 110.0 % 107.5 % Risk-free interest rate 3.64 % 4.35 % Credit spread 13.74 % 13.76 % Cost of debt 17.4 % 18.1 % Term (years) 4.96 5.02

Commitments and contingencies

Commitments and contingencies	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and contingencies	Commitments and contingencies Leases The Company has entered into various non-cancellable operating lease agreements for office and laboratory space domestically and internationally. The Company's current leases have remaining terms ranging from approximately 1 to 12 years, some of which include options to extend the leases. The renewal options were not included in the calculation of the operating lease assets and the operating lease liabilities as they are not reasonably certain of being exercised. The security deposits for our operating leases are included in restricted cash in our condensed consolidated balance sheets. In 2015, we entered into a non-cancelable operating lease agreement for our headquarters and main production facility in San Francisco, California, which commenced in 2016 with an initial lease term extending through 2026. In 2020, we entered into a non-cancelable operating lease agreement for additional office and laboratory space in San Francisco, California, which commenced in 2021 and has an initial lease term extending through 2031. In 2021, we entered into a non-cancelable operating lease agreement for a new laboratory and production facilities in Morrisville, North Carolina, which commenced in the same year with an initial lease term extending through 2035. See the discussion below regarding management's decision to exit the operating leases for additional office and laboratory space in San Francisco, California and a portion of the new laboratory and production facilities in Morrisville, North Carolina and the related impairment in the first quarter of 2023. We have entered into various finance lease agreements to obtain laboratory equipment. The terms of our finance leases are generally three years and are typically secured by the underlying equipment. The portion of the future payments designated as principal repayment and related interest was classified as a finance lease obligation in our condensed consolidated balance sheets. Finance lease assets are recorded within other assets in our condensed consolidated balance sheets. During the first quarter of 2023, we decided to exit certain leased premises and actively began looking to sublease certain facilities, including the related leasehold improvements. We determined that the changes in the intended use of these locations represented an indicator of impairment and performed a test of recoverability on March 31, 2023. For operating leases where the carrying values of the asset group were lower than the undiscounted cash flows expected through sublease, we impaired the asset group to their fair value. The fair value was determined by utilizing the discounted cash flow method under the income approach. The key inputs to this valuation were expected sublease rental income ranging from $7.6 million to $35.7 million and a discount rate ranging from 7.0% to 8.0%. This fair value measurement is based on significant inputs not observable in the market and, therefore, represents a Level 3 measurement. During the three months ended March 31, 2023, we recognized an impairment charge of $37.8 million related to the right-of-use assets and $2.0 million for the related leasehold improvements, which are included in restructuring and other costs in our condensed consolidated statement of operations. During the first quarter of 2023, we reassessed certain leases previously impaired as part of the strategic realignment for additional impairment due to the continued decline in market conditions and changes in the ability to sublease the properties. We determined that the changes in market conditions represented an indicator of impairment and performed a test of recoverability on March 31, 2023. For operating leases where the carrying values of the asset group were lower than the undiscounted cash flows expected through sublease, we further impaired the asset group to their fair value. The fair value was determined by utilizing the discounted cash flow method under the income approach. The key inputs to this valuation were expected sublease rental income ranging from $0.3 million to $1.9 million and discount rates ranging from 7.50% to 7.75%. This fair value measurement is based on significant inputs not observable in the market and, therefore, represents a Level 3 measurement. During the three months ended March 31, 2023, we recognized an impairment charge of $2.3 million related to the right-of-use assets, which is included in restructuring and other costs in our consolidated statements of operations. Sublease income was $0.4 million during the three months ended March 31, 2023. There was no sublease income for the three months ended March 31, 2022. Debt financing In October 2020, we entered into a credit agreement with a financial institution under which we borrowed $135.0 million (the "2020 Term Loan") concurrent with the closing of the ArcherDX, Inc. ("ArcherDX") acquisition. The 2020 Term Loan is secured by a first priority lien on all of our and our subsidiaries' assets, and is guaranteed by us and our subsidiaries. The 2020 Term Loan bears interest at an annual rate equal to three-month LIBOR, subject to a 2.00% LIBOR floor, plus a margin of 8.75%. If three-month LIBOR can no longer be determined or if the applicable governmental authority ceases to supervise or sanction such rates, then we will endeavor to agree with the administrative agent, an alternate rate of interest that gives due consideration to the then prevailing market convention for determining interest for comparable loans in the United States, provided that until such alternative rate of interest is agreed, the 2020 Term Loan shall bear interest at the Wall Street Journal Prime Rate. The three-month LIBOR is expected to be available and representative through June 30, 2023. The 2020 Term Loan will mature on (i) June 1, 2024, if at such time our 2024 Notes (defined below) are outstanding and are due to mature on September 1, 2024 (provided that if, prior to such date, the maturity date of at least 80% of the 2024 Notes is extended to a date that is prior to September 1, 2025, the maturity date for the 2020 Term Loan will be automatically extended to a date that is 90 days prior to such 2024 Notes maturity date as extended), or (ii) otherwise, on June 1, 2025. The full amount of the 2020 Term Loan is due upon maturity. If the 2020 Term Loan is prepaid (whether such prepayment is optional or mandatory), we must pay a prepayment fee of 6% if the prepayment occurs prior to the third anniversary of the closing date or 4% if the prepayment occurs after the third anniversary of the closing date and we must also pay a make-whole fee if the prepayment occurs prior to the second anniversary of the closing date. The credit agreement contains customary events of default and covenants, including among others, covenants limiting our ability to incur debt, incur liens, undergo a change in control, merge with or acquire other entities, make investments, pay dividends or other distributions to holders of our equity securities, repurchase stock, and dispose of assets, in each case subject to certain customary exceptions. In addition, the credit agreement contains financial covenants that require us to maintain a minimum cash balance and minimum quarterly revenue levels. Debt discounts, including debt issuance costs, related to the 2020 Term Loan of $32.8 million were recorded as a direct deduction from the debt liability and are being amortized to interest expense over the term of the 2020 Term Loan. Interest expense related to our debt financings, excluding the impact of our convertible senior notes (defined below), was $4.1 million and $5.9 million for the three months ended March 31, 2023 and 2022, respectively. In February 2023, we repaid, prior to the maturity date, the principal balance outstanding of $135.0 million plus accrued interest of $2.6 million. During the three months ended March 31, 2023, we incurred debt extinguishment costs of $19.3 million related to the prepayment, which included the write-off of unamortized debt issuance costs of $11.2 million and prepayment fees of $8.1 million, which are included in loss on extinguishment of debt, net in the condensed consolidated statements of operations. Convertible senior notes Convertible senior notes due 2024 In September 2019, we issued, at par value, $350.0 million aggregate principal amount of 2.00% convertible senior notes due 2024 (the "2024 Notes") in a private offering. The 2024 Notes are our senior unsecured obligations and will mature on September 1, 2024, unless earlier converted, redeemed or repurchased. The 2024 Notes bear cash interest at a rate of 2.0% per year, payable semi-annually in arrears on March 1 and September 1 of each year, beginning on March 1, 2020. Upon conversion, the 2024 Notes will be convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election. The initial conversion rate for the 2024 Notes is 33.6293 shares of our common stock per $1,000 principal amount of the 2024 Notes (equivalent to an initial conversion price of approximately $29.74 per share of common stock). If we undergo a fundamental change (as defined in the indenture governing the 2024 Notes), the holders of the 2024 Notes may require us to repurchase all or any portion of their 2024 Notes for cash at a repurchase price equal to 100% of the principal amount of the 2024 Notes to be repurchased plus accrued and unpaid interest to, but excluding, the redemption date. The 2024 Notes will be convertible at the option of the holders at any time prior to the close of business on the business day immediately preceding March 1, 2024, only under the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ending on December 31, 2019 (and only during such calendar quarter), if the last reported sale price of our common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price for the 2024 Notes on each applicable trading day; (2) during the five business day period after any five consecutive trading day period (the “measurement period”) in which the trading price per $1,000 principal amount of 2024 Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of our common stock and the conversion rate on each such trading day; (3) if we call any or all of the 2024 Notes for redemption, at any time prior to the close of business on the scheduled trading day immediately preceding the redemption date; or (4) upon the occurrence of specified corporate events. On or after March 1, 2024 until the close of business on the business day immediately preceding the maturity date, holders may convert their 2024 Notes at any time, regardless of the foregoing circumstances. Since issuance, these notes were convertible at the option of the holders during the quarters beginning on January 1, 2021 and April 1, 2021 due to the sale price of our common stock during the quarters ended December 31, 2020 and March 31, 2021, respectively. The notes were not convertible during the three months ended March 31, 2023 and there have been no significant conversions in the periods in which they were convertible. We may redeem for cash all or any portion of the 2024 Notes, at our option, on or after September 6, 2022 and on or before the 30th scheduled trading day immediately before the maturity date if the last reported sale price of the common stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending on, and including, the trading day immediately preceding the date on which we provide notice of redemption at a redemption price equal to 100% of the principal amount of the notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. See the discussion below regarding the purchase and exchange agreements with certain holders of the outstanding 2024 Notes. As of March 31, 2023, the outstanding principal balance of the 2024 Note was $44.3 million. Convertible senior notes due 2028 In April 2021, we issued, at 99% of par value, $1,150.0 million aggregate principal amount of 1.5% convertible senior notes due 2028 (the "2028 Notes") in a private offering. The 2028 Notes are our senior unsecured obligations and will mature on April 1, 2028, unless earlier converted, redeemed or repurchased. The 2028 Notes bear cash interest at a rate of 1.5% per year, payable semi-annually in arrears on April 1 and October 1 of each year, beginning on October 1, 2021. Upon conversion, the 2028 Notes will be convertible into cash, shares of our common stock or a combination of cash and shares of our common stock, at our election. The 2028 Notes will be convertible at the option of the holder at any time until the second scheduled trading day prior to the maturity date, including in connection with a redemption by us. The 2028 Notes will be convertible into shares of our common stock based on an initial conversion rate of 23.1589 shares of common stock per $1,000 principal amount of the 2028 Notes (which is equal to an initial conversion price of $43.18 per share), in each case subject to customary anti-dilution and other adjustments as a result of certain extraordinary transactions. None of the 2028 Notes have been converted to date. We may not redeem the 2028 Notes prior to April 6, 2025. On or after April 6, 2025, the 2028 Notes will be redeemable by us in the event that the closing sale price of our common stock has been at least 150% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending on, and including, the trading day immediately preceding the date on which we provide the redemption notice at a redemption price of 100% of the principal amount of such 2028 Notes, plus accrued and unpaid interest to, but excluding, the redemption date. With certain exceptions, upon a change of control of the Company or the failure of our common stock to be listed on certain stock exchanges, the holders of the 2028 Notes may require that we repurchase all or part of the principal amount of the Notes at a repurchase price of 100% of the principal amount of the 2028 Notes to be repurchased, plus unpaid interest to, but excluding, the maturity date. Summary of convertible senior notes Our 2024 Notes and 2028 Notes (collectively, our "Convertible Senior Notes") consisted of the following (in thousands): March 31, 2023 December 31, 2022 Outstanding principal $ 1,194,269 $ 1,499,996 Unamortized debt discount and issuance costs (24,895) (29,213) Net carrying amount $ 1,169,374 $ 1,470,783 As of March 31, 2023, the fair value of the 2024 Notes and 2028 Notes w as $38.9 million and $492.4 million, respectively. The estimated fair value of the 2024 Notes and 2028 Notes, which use Level 2 fair value inputs, was determined based on the estimated or actual bid prices in an over-the-counter market and/or market conditions including the price and volatility of our common stock and comparable company information. We recognized $7.2 million and $7.7 million of interest expense related to our Convertible Senior Notes during the three months ended March 31, 2023 and 2022, respectively. Of the interest expense recognized, $1.5 million and $1.6 million during the three months ended March 31, 2023 and 2022, respectively, was related to amortization of issuance costs and the remainder was related to contractual interest incurred. Convertible senior secured notes due 2028 In February 2023, we entered into purchase and exchange agreements with certain holders of the outstanding 2024 Notes. Under the terms of the agreements, we (a) exchanged $305.7 million aggregate principal amount of 2024 Notes for $275.3 million aggregate principal amount of Series A Notes and 14,219,859 shares of the Company’s common stock and (b) issued and sold $30.0 million aggregate principal amount of Series B Notes for cash. The Senior Secured 2028 Notes are our senior secured obligations and will mature on March 15, 2028, unless earlier converted, redeemed or repurchased. The Senior Secured 2028 Notes bear cash interest at a rate of 4.50% per year, payable quarterly in arrears on March 15, June 15, September 15 and December 15 of each year, beginning on June 15, 2023. Based on the initial conversion price of $2.58, the Senior Secured 2028 Notes will be initially convertible into an aggregate of 118,316,667 shares of common stock, and after taking into account the maximum number of additional shares issuable in certain circumstances as described in the indenture, an aggregate of 141,979,975 shares of common stock. At any time prior to the 60th day prior to the maturity date of the Senior Secured 2028 Notes, we have the option to redeem all or any portion of the principal amount of the Senior Secured 2028 Notes for cash equal to the principal amount of the Senior Secured 2028 Notes to be redeemed. Upon redemption of any Senior Secured 2028 Notes, we will (i) issue warrants to purchase shares of common stock, unless the aggregate principal amount of Senior Secured 2028 Notes outstanding represents less than 10% of the aggregate principal amount of Senior Secured 2028 Notes initially issued and certain other conditions are satisfied, and (ii) make a make-whole payment as determined pursuant to the indenture governing the Senior Secured 2028 Notes, together with accrued and unpaid interest through the redemption date. In addition, in certain circumstances, we may be required to issue additional shares of common stock for any Senior Secured 2028 Notes converted in connection with a notice of optional redemption. The indenture governing the Senior Secured 2028 Notes also provides for the issuance of warrants to purchase shares of common stock in connection with the prepayment of the Senior Secured 2028 Notes upon acceleration of the Senior Secured 2028 Notes following the occurrence of an event of default under the indenture as a result of the failure by the Company to settle any conversion. Any warrants issued will cover the same number of shares of the common stock underlying and at an exercise price equal to the conversion price of the redeemed or prepaid Senior Secured 2028 Notes. The number of shares issuable upon conversion or exercise is subject to customary anti-dilution and other adjustments (as defined in the indenture governing the Senior Secured 2028 Notes). The Senior Secured 2028 Notes will be convertible at any time prior to the maturity date at the option of the holders, subject to a beneficial ownership cap. In addition, prior to such time that the Company obtains stockholder approval for the issuance of shares of common stock in excess of the limitations imposed by the NYSE rules (the “NYSE Cap”), holders of the Series A Notes are prohibited from converting their notes or exercising any warrants issued in respect of the Series A Notes into shares of common stock in excess of such NYSE Cap and we would instead be required to settle any conversion in cash if we are not able to obtain the stockholder approval prior to September 30, 2023 (the grace period specified in the indenture). The cash settlement amount upon conversion of a Series A Note by a holder prior to stockholder approval is equal to the product of the shares of common stock in excess of the NYSE Cap multiplied by the arithmetic average of the volume weighted average price of our common stock on each of the five consecutive trading days immediately preceding the conversion date. After obtaining stockholder approval, the full amount of the outstanding balance of the Senior Secured 2028 Notes will be convertible into shares of common stock, with no conversion limitations. There can be no assurance that we will be successful in obtaining stockholder approval for the proposal to approve the issuance of shares of common stock pursuant to the conversion of the Senior Secured 2028 Notes or the exercise of any warrants issued in respect to the Senior Secured 2028 Notes in excess of the limitations imposed by the NYSE Cap prior to September 30, 2023. If we fail to obtain stockholder approval, we may not have enough available cash or be able to obtain financing at the time we are required to settle any conversion. If we undergo a major transaction (as defined in the indenture), holders may require us to repurchase for cash all or part of their Senior Secured 2028 Notes at a purchase price equal to 100% of the principal amount of the Senior Secured 2028 Notes to be repurchased, plus (i) accrued and unpaid interest to, but excluding, the repurchase date and (ii) the make-whole amount as determined pursuant to the indenture governing the Senior Secured 2028 Notes. In addition, at the election of the holders of the Senior Secured 2028 Notes, we may be required to issue additional shares of common stock for any Senior Secured 2028 Notes converted in connection with a major transaction. The Senior Secured 2028 Notes are guaranteed by our material subsidiaries and secured by (i) a security interest in substantially all of the assets of the Company and its domestic material subsidiaries and (ii) a pledge of the equity interests of the Company's direct and indirect subsidiaries, subject to certain customary exceptions. The indenture contains certain specified events of default, the occurrence of which would entitle the holders of the Senior Secured 2028 Notes to demand repayment of all outstanding principal and accrued interest on the Notes, together with a make-whole payment as determined pursuant to the indenture. The indenture also includes specific affirmative and restrictive covenants agreed to by the Company. In addition, the indenture also contains financial covenants that will require us to maintain revenue in the prior four quarters of not less than $250.0 million and, starting with the quarter ending March 31, 2025, a minimum liquidity of at least 15% of the amount of our secured indebtedness then outstanding. As of March 31, 2023, we are in compliance with all restrictive and financial covenants. We elected the fair value option to account for the Senior Secured 2028 Notes, which requires the notes to be accounted for as a single liability initially measured at its issue-date estimated fair value and then subsequently remeasured at estimated fair value on a recurring basis as of each reporting date. We have elected not to present the interest expenses separate from the fair value changes of the Senior Secured 2028 Notes. Considering the terms of settlement noted above, we elected the fair value option for the Senior Secured 2028 Notes as we believe it best reflects the underlying economics and also for simplification and cost-benefit considerations of accounting such Senior Secured 2028 Notes at fair value versus bifurcation of the embedded derivatives. The initial carrying amount of the Senior Secured 2028 Notes, measured at the estimated fair value on the date of issuance, was $301.1 million. As of March 31, 2023, the estimated fair value of the Senior Secured 2028 Notes was $282.9 million. The portion of the estimated fair value of Series A Notes for which conversion is subject to stockholder approval and for which the Company has a cash settlement obligation is classified as a current liability with the remainder classified as a long-term liability in the condensed consolidated balance sheets. The current liability was determined based on the product of the shares of common stock in excess of the NYSE Cap multiplied by the arithmetic average of the volume weighted average price of our common stock on each of the five consecutive trading dates immediately preceding March 31, 2023. The long-term liability represents the portion of the Senior Secured 2028 Notes for which we have the intent and the ability to settle the obligations by issuing shares. During the three months ended March 31, 2023, the corresponding change in fair value of the Senior Secured 2028 Notes was a gain of $18.3 million, which is included in other (expense) income, net in the condensed consolidated statements of operations. During the three months ended March 31, 2023, the change in fair value related to instrument-specific credit risk was $0.2 million, which is included in the condensed consolidated statements of comprehensive loss. In connection with the issuance of the Senior Secured 2028 Notes, we incurred approximately $19.9 million of debt issuance costs primarily related to legal and consulting fees paid to third parties, which were expensed as incurred during the three months ended March 31, 2023 and included in other (expense) income, net in the condensed consolidated statements of operations. The exchange of the 2024 Notes for the Senior Secured 2028 Notes was treated as an extinguishment of debt, and we recognized a gain on extinguishment of $8.5 million representing the difference between the fair value of the Series A Notes immediately prior to the exchange plus the fair value of common shares issued and the carrying amount of the 2024 Notes, which is included in loss on extinguishment of debt, net in the condensed consolidated statements of operations. Other commitments In the normal course of business, we enter into various purchase commitments primarily related to service agreements and laboratory supplies. At March 31, 2023, our total future payments under noncancelable unconditional purchase commitments having a remaining term of over one year wer e $35.6 million. Guarantees and indemnification As permitted under Delaware law and in accordance with our bylaws, we indemnify our directors and officers for certain events or occurrences while the officer or director is or was serving in such capacity. The maximum amount of potential future indemnification is unlimited; however, we maintain director and officer liability insurance. This insurance allows the transfer of the risk associated with our exposure and may enable us to recover a portion of any future amounts paid. We believe the fair value of these indemnification agreements is minimal. Accordingly, we did not record any liabilities associated with these indemnification agreements at March 31, 2023 or December 31, 2022. Contingencies We are and may from time to time be involved in various legal proceedings and claims arising in the ordinary course of business. Legal proceedings, including litigation, government investigations and enforcement actions could result in material costs, occupy significant management resources and entail civil and criminal penalties, even if we ultimately prevail. If an investigation results in a proceeding against us, an adverse outcome could include us being required to pay treble damages, and incur attorneys’ fees, civil or criminal penalties and other adverse actions that could materially and adversely affect our business, financial condition and results of operations. While we believe any such claims are unsubstantiated, and we believe we are in compliance with applicable laws and regulations applicable to our business, the resolution of any such claims could be material. We were not a party to any material legal proceedings at March 31, 2023, or at the date of this report except for matters listed below. We cannot currently predict the outcome of these actions. Natera, Inc. On January 27, 2020, Natera filed a lawsuit against ArcherDX (a subsidiary of Invitae effective October 2, 2020) in the United States District Court for the District of Delaware, alleging that ArcherDX’s products using Anchored Multiplex PCR ("AMP") chemistry, and the manufacture, use, sale, and offer for sale of such products, infringe U.S. Patent No. 10,538,814. On March 25, 2020, ArcherDX filed an answer denying Natera’s allegations and asserting certain affirmative defenses and counterclaims, including that U.S. Patent No. 10,538,814 is invalid and not infringed. On April 15, 2020, Natera filed an answer denying ArcherDX’s counterclaims and filed an amended complaint alleging that ArcherDX’s products using AMP chemistry, including STRATAFIDE, PCM, LiquidPlex, ArcherMET, FusionPlex, and VariantPlex, and the manufacture, use, sale, and offer for sale of such products, infringe U.S. Patent No. 10,538,814, U.S. Patent No. 10,557,172, U.S. Patent No. 10,590,482, and U.S. Patent No. 10,597,708, each of which are held by Natera. Natera seeks, among other things, damages and other monetary relief, costs and attorneys’ fees, and an order enjoining ArcherDX from further infringement of such patents. On May 13, 2020, ArcherDX filed an answer to Natera’s amended complaint denying Natera’s allegations and asserting certain affirmative defenses and counterclaims, including that the asserted patents are invalid and not infringed. On June 3, 2020, Natera filed an answer denying ArcherDX’s counterclaims. On June 4, 2020, ArcherDX filed a motion seeking dismissal of Natera’s infringement claims against STRATAFIDE, PCM, and ArcherMET, and for a judgment that U.S. Patent No. 10,538,814, U.S. Patent No. 10,557,172, and U.S. Patent No. 10,590,482 are invalid. On August 6, 2020, Natera filed another complaint against ArcherDX in the United States District Court for the District of Delaware alleging that ArcherDX’s products using AMP chemistry, including STRATAFIDE, PCM, LiquidPlex, ArcherMET, and VariantPlex, and the manufacture, use, sale, and offer for sale of such products, infringe U.S. Patent No. 10,731,220. Natera seeks, among other things, damages and other monetary relief, costs and attorneys’ fees, and an order enjoining ArcherDX from further infringement of the patent. On October 13, 2020, the court issued an order denying ArcherDX's motion for dismissal of Natera’s infringement claims against STRATAFIDE, PCM, and ArcherMET, and declined to enter judgment that U.S. Patent No. 10,538,814, U.S. Patent No. 10,557,172, and U.S. Patent No. 10,590,482 are invalid. On January 12, 2021, the court issued an order granting Natera leave to amend its complaint to add Invitae as a co-defendant and plead allegations that ArcherDX and Invitae induce end-users to infringe the patents-in-suit. Natera filed its second amended complaint (“Second Amended Complaint”) on the same day, with service completed on January 15, 2021. ArcherDX and Invitae filed answers to the Second Amended Complaint on January 26, 2021 and February 5, 2021, respectively, denying Natera's allegations and restating certain affirmative defenses and counterclaims of non-infringement and invalidity. The litigations have now been consolidated for all purposes. A claim construction order was issued on June 28, 2021. On October 27, 2021, Natera filed its third amended complaint (“Third Amended Complaint”) to add a Certificate of Correction to U.S. Patent No. 10,590,482. On November 3, 2021, ArcherDX filed its answer and counterclaims to Natera's Third Amended Complaint, adding an inequitable conduct defense and declaratory judgment counterclaims. Discovery concluded in December 2021. On January 21, 2022, Natera, ArcherDX and Invitae moved for summary judgment, wherein Natera seeks a determination on certain legal and equitable defenses and ArcherDX and Invitae seek a determination of non-infringement and invalidity of the asserted patents. Those motions were denied by order dated February 6, 2023, and trial began on May 8, 2023. In addition, on October 6, 2020, Natera filed a complaint against Genosity in the United States District Court for the District of Delaware, alleging that Genosity's use of its AsTra products, and the manufacture, use, sale, and offer for sale of such products, infringes U.S. Patent No. 10,731,220. Natera's complaint further alleges that Genosity's accused products use ArcherDX's ctDNA and region-specific primers. Genosity filed an answer to the complaint on February 15, 2021, denying Natera's allegations and setting forth affirmative defenses and counterclaims of non-infringement, invalidity and unenforceability due to inequitable conduct. On March 8, 2021, Natera filed a motion to dismiss and strike certain affirmative defenses and counterclaims brought by Genosity relating to inequitable conduct. The court denied that moti

Stockholders' equity

Stockholders' equity	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Stockholders' equity	Stockholders’ equity Shares outstanding Shares of common stock were as follows (in thousands): Three Months Ended March 31, 2023 2022 Common stock: Shares outstanding, beginning of period 245,562 228,116 Common stock issued in connection with the convertible senior notes exchange 14,220 — Common stock issued on exercise of stock options, net 1 87 Common stock issued pursuant to vesting of RSUs 715 621 Common stock issued pursuant to acquisitions 177 — Shares outstanding, end of period 260,675 228,824 Common Stock As of March 31, 2023 and December 31 2022, we had 600 million shares of common stock authorized with a par value of $0.0001. Convertible preferred stock In August 2017, in a private placement to certain accredited investors, we issued shares of our Series A convertible preferred stock which are convertible into common stock on a one-for-one basis, subject to adjustment for events such as stock splits, combinations and the like. The Series A convertible preferred stock is a non-voting common stock equivalent with a par value of $0.0001 and has the right to receive dividends first or simultaneously with payment of dividends on common stock. In the event of any liquidation or dissolution of the Company, the Series A preferred stock is entitled to receive $0.001 per share prior to the payment of any amount to any holders of capital stock ranking junior to the Series A preferred stock and thereafter shall participate pari passu with the holders of our common stock (on an as-if-converted-to-common-stock basis). As of March 31, 2023 and December 31, 2022, we had 20 million shares of preferred stock authorized, of which 3,458,823 shares were designated as Series A convertible preferred stock. As of March 31, 2023 and December 31, 2022, there were no shares of preferred stock or Series A convertible preferred stock outstanding. Sales Agreement In May 2021, we entered into a sales agreement (the "2021 Sales Agreement") with Cowen and Company, LLC (“Cowen”) under which we may offer and sell from time to time at our sole discretion shares of our common stock through Cowen as our sales agent, in an aggregate amount not to exceed $400.0 million. Per the terms of the agreement, Cowen will receive a commission of up to 3% of the gross proceeds of the sales price of all shares sold through it as sales agent under the 2021 Sales Agreement. During the three months ended March 31, 2023 and 2022, we did not sell any common stock under the 2021 Sales Agreement. Senior Secured 2028 Notes In connection with the issuance of the Senior Secured 2028 Notes on March 7, 2023, we and Deerfield Partners, L.P. (the "selling stockholder"), also entered into a registration rights agreement ("Registration Rights Agreement"). Pursuant to the Registration Rights Agreement, on March 17, 2023, we filed a registration statement to register 111,627,888 shares of common stock issuable upon conversion of the Series B Notes or exercise of the warrants ("Registrable Securities") issuable in connection with certain prepayments of the Series B Notes or Series A Notes, which registration statement was declared effective on April 21, 2023. The selling stockholder may from time to time offer and sell any or all of such issued shares of common stock. We will not receive any proceeds from the sale of shares of our common stock by the selling stockholder. We will receive the proceeds from any exercise of the warrants on a cash basis. Additionally, under the terms of the purchase and exchange agreements, we exchanged $305.7 million aggregate principal amount of 2024 Notes for $275.3 million aggregate principal amount of Series A Notes and 14,219,859 shares of the Company’s common stock, and we issued and sold $30.0 million aggregate principal amount of Series B Notes for cash. See Note 7, "Commitments and contingencies" under the heading "Convertible senior notes—Convertible senior secured notes due 2028" for additional information.

Stock incentive plans

Stock incentive plans	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Stock incentive plans	Stock incentive plans Stock incentive plans In 2010, we adopted the 2010 Incentive Plan (the “2010 Plan”). The 2010 Plan provides for the granting of stock-based awards to employees, directors and consultants under terms and provisions established by our board of directors. Under the terms of the 2010 Plan, options may be granted at an exercise price not less than the fair market value of our common stock. For employees holding more than 10% of the voting rights of all classes of stock, the exercise prices for incentive and nonstatutory stock options must be at least 110% of fair market value of our common stock on the grant date, as determined by our board of directors. The terms of options granted under the 2010 Plan may not exceed ten years. In January 2015, we adopted the 2015 Stock Incentive Plan (the “2015 Plan”), which became effective upon the closing of our initial public offering. Shares outstanding under the 2010 Plan were transferred to the 2015 Plan upon effectiveness of the 2015 Plan. The 2015 Plan provides for automatic annual increases in shares available for grant, beginning on January 1, 2016 through January 1, 2025. In addition, shares subject to awards under the 2010 Plan that are forfeited or terminated will be added to the 2015 Plan. The 2015 Plan provides for the grant of incentive stock options, nonstatutory stock options, restricted stock awards, stock units, stock appreciation rights and other forms of equity compensation, all of which may be granted to employees, including officers, non-employee directors and consultants. Additionally, the 2015 Plan provides for the grant of cash-based awards. Options granted generally vest over a period of four years. Typically, the vesting schedule for options granted to newly hired employees provides that 1/4 of the award vests upon the first anniversary of the employee’s date of hire, with the remainder of the award vesting monthly thereafter at a rate of 1/48 of the total shares subject to the option. All other options typically vest in equal monthly installments over the four-year vesting schedule. Upon the acquisition of ArcherDX in October 2020, any option that was outstanding was converted into a fully vested option to purchase a share of our common stock, which resulted in the issuance of options to purchase 3.7 million shares of our common stock. Restricted stock units ("RSUs") generally vest ratably in annual installments over a period of three years, commencing on the first anniversary of the grant date, with certain awards that include a portion that vests immediately upon grant. The vesting schedule for the 2022 grants approved in April 2022 provides that the awards vest ratably in quarterly installments over a period of two years, with certain awards that include a portion that vests immediately upon grant. Grants to the executive team in 2022 vest ratably in annual installments over a period of three years. We have also granted certain awards in connection with our management incentive plan that vest over a period of two years. In April 2021, we granted RSUs in connection with the acquisition of Genosity Inc. ("Genosity") having a value of up to $5.0 million to certain continuing employees. During both the three months ended March 31, 2023 and 2022, we recognized $0.4 million in stock-based compensation expense primarily reported in research and development expense in our condensed consolidated statements of operations. In September 2021, we granted RSUs in connection with the acquisition of the Ciitizen Corporation having a value of up to $246.9 million to certain continuing employees. During the three months ended March 31, 2023 and 2022, we recognized stock-based compensation expense of $14.7 million and $24.9 million, respectively, primarily reported in research and development expense in our condensed consolidated statements of operations. Activity under the 2010 Plan and the 2015 Plan is set forth below (in thousands, except per share data and years): Shares Available For Grant Stock Options Outstanding Weighted-Average Exercise Price Per Share Weighted-Average Remaining Contractual Life (Years) Aggregate Intrinsic Value Balances at December 31, 2022 12,625 2,541 $ 8.49 6.6 $ 16 Additional shares reserved 9,822 — Options granted (29) 29 2.46 Options cancelled 257 (257) 8.20 Options exercised — (1) 0.86 RSUs and PRSUs granted (197) — RSUs and PRSUs cancelled 425 — Balances at March 31, 2023 22,903 2,312 $ 8.45 6.7 $ 4 Options exercisable at March 31, 2023 1,163 $ 11.94 4.2 $ 4 Options vested and expected to vest at March 31, 2023 2,118 $ 8.94 6.4 $ 4 The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of our common stock for stock options that were in-the-money. The following table summarizes RSU, including PRSU, activity (in thousands, except per share data): Number of Shares Weighted- Average Grant Date Fair Value Per Share Balance at December 31, 2022 11,895 $ 11.70 RSUs granted 197 $ 2.27 RSUs vested (715) $ 10.47 RSUs cancelled (425) $ 13.54 Balance at March 31, 2023 10,952 $ 11.54 Stock-based compensation The following table summarizes stock-based compensation expense included in the condensed consolidated statements of operations (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 948 $ 1,865 Research and development 18,846 31,994 Selling and marketing 2,599 2,909 General and administrative 6,589 10,054 Restructuring and other costs 211 — Total stock-based compensation expense $ 29,193 $ 46,822 Stock-based compensation expense included in restructuring expense was related to the accelerated vesting of RSUs held by certain employees whose employment was terminated as part of the strategic realignment.

Restructuring and other costs

Restructuring and other costs	3 Months Ended
	Mar. 31, 2023
Restructuring and Related Activities [Abstract]
Restructuring and other costs	Restructuring and other costsIn July 2022, we initiated a strategic realignment of our operations to reduce operating costs and drive future growth aligned with our core genetic testing and data platform and patient network. The strategic realignment includes a reduction in workforce, lab and office space consolidation, portfolio optimization, decrease in other operating expenses, as well as a reduced international footprint. Under this strategic realignment, we reduced our workforce by approximately 1,000 employees with a majority of these employees separating from the Company by September 30, 2022 and the remaining affected employees transitioning over varying periods of time up to 12 months. Employees who were impacted by the restructuring were eligible to receive severance benefits contingent upon an impacted employee’s execution (and non-revocation, where applicable) of a separation agreement, which included a general release of claims against us. The following table summarizes the expenses related to our strategic realignment recognized in restructuring and other costs in our condensed consolidated statement of operations (in thousands): Three Months Ended March 31, 2023 Employee severance and benefits $ 1,283 Impairments and losses on disposals of long-lived assets, net 50,354 Other restructuring costs 919 Total restructuring and other costs $ 52,556 Employee severance and benefits are comprised of severance, other termination benefit costs, and stock-based compensation expense for the acceleration of RSUs related to workforce reductions. See Note 9, "Stock incentive plans" for additional information about the accelerated vesting of RSUs. Asset impairments and losses on asset disposals, net include operating lease impairments, losses on disposals of leasehold improvements associated with the exit of certain lab and office space and the related equipment. See Note 7, "Commitments and contingencies" under the heading "Leases" for additional information about operating lease impairments. See Note 5, "Balance sheet components" for additional information about net losses on disposal of property and equipment. Other restructuring costs include professional fees in relation to restructuring activities and contract exit costs including our decision to cease development of acquired technology. See Note 4, "Intangible assets" for additional information. There were no restructuring and other costs for the three months ended March 31, 2022. We expect to incur additional employee severance and benefits expenses up to $0.6 million, and additional other restructuring costs primarily related to third-party costs up to $5.5 million. This reflects the best estimate of the Company as of the date hereof, which may be revised in subsequent periods as the strategic realignment plan progresses. The following table summarizes the changes in liabilities associated with our strategic realignment initiatives, including restructuring and other costs incurred and cash payments as of March 31, 2023 (in thousands): Employee severance and benefits Other restructuring costs Total Beginning balance $ — $ — $ — Accruals 35,237 7,405 42,642 Payments (32,974) (5,464) (38,438) Balance at December 31, 2022 2,263 1,941 4,204 Accruals 1,072 994 2,066 Payments (2,486) (1,223) (3,709) Balance at March 31, 2023 $ 849 $ 1,712 $ 2,561 The restructuring liabilities are included in accrued liabilities in the condensed consolidated balance sheets. We expect that substantially all of the remaining accrued restructuring liabilities will be paid in cash in 2023. The charges recognized in the roll forward of our accrued restructuring liabilities do not include items charged directly to expense for asset impairments and losses on disposals of long-lived assets, accelerated vesting of RSUs, and other periodic exit costs, as those items are not reflected in our restructuring liabilities in our condensed consolidated balance sheets.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income taxesDuring the three months ended March 31, 2023 and 2022, we recorded an income tax benefit of $1.0 million and $34.9 million, respectively. The income tax benefit for the three months ended March 31, 2023 is primarily related to a $0.9 million release of federal valuation allowances as a result of impact on our deferred taxes related to Internal Revenue Code Section 174 research and experimental expense capitalization and right-of-use and fixed assets impairment, which enabled the associated deferred tax liability to serve as a source of income to support the realization of existing deferred tax assets for which a valuation allowance had previously been established. As of March 31, 2023, we maintained $59.3 million of unrecognized tax benefits, of which $0.2 million, if recognized, would affect the Company’s effective tax rate. The remainder has been recorded as a reduction to the Company’s deferred tax assets and, if recognized, would not have an impact on the effective tax rate due to existing valuation allowance against such deferred tax assets. It is possible that the Company’s unrecognized tax benefits could change within the next twelve months due to activities of tax authorities, including possible settlement of audits, should any arise, or through normal expiration of statutes of limitations. The Company’s policy is to include penalties and interest expense related to income taxes as a component of tax expense. As of March 31, 2023, there were no accrued interest and penalties related to the unrecognized tax benefits. Effective for tax years beginning on or after January 1, 2022, pursuant to the Tax Cuts and Jobs Act of 2017, companies are required to capitalize and amortize Internal Revenue Code Section 174 research and experimental expenses paid or incurred over five years for research and development performed in the United States and 15 years for research and development performed outside of the United States. As a result of the Internal Revenue Code Section 174 research and experimental expense capitalization, the Company recognized a deferred tax asset for the future tax benefit of the amortization deductions with offsetting increase in the valuation allowance on deferred tax assets. The Inflation Reduction Act of 2022 ("IRA") was signed into law on August 16, 2022. The bill was meant to address the high inflation rate in the U.S. through various climate, energy, healthcare and other incentives. These incentives are meant to be paid for by the tax provisions included in the IRA, such as a new 15 percent corporate minimum tax, a 1 percent new excise tax on stock buybacks, additional IRS funding to improve taxpayer compliance and others. At this time, none of the IRA tax provisions are expected to have a material impact to the Company's tax provision. The Company will continue to monitor for updates to the Company's business along with guidance issued with respect to the IRA to determine whether any adjustments are needed to the Company's tax provision in future periods.

Net loss per share

Net loss per share	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Net loss per share	Net loss per share The following table presents the calculation of basic and diluted net loss per share (in thousands, except per share data): Three Months Ended March 31, 2023 2022 Net loss $ (192,183) $ (181,859) Shares used in computing net loss per share, basic and diluted 249,907 228,470 Net loss per share, basic and diluted $ (0.77) $ (0.80) Common stock issuable in connection with our Convertible Senior Notes and the Senior Secured 2028 Notes participate in any dividends that may be declared by the Company and are therefore considered to be participating securities. The net losses were attributable entirely to common stockholders since the participating securities did not have a contractual obligation to share in the Company’s losses. The following common stock equivalents have been excluded from diluted net loss per share because their inclusion would be anti-dilutive (in thousands): Three Months Ended March 31, 2023 2022 Shares of common stock subject to outstanding options 2,366 2,972 Shares of common stock subject to outstanding RSUs and PRSUs 11,399 15,935 Shares of common stock pursuant to ESPP 3,528 1,428 Shares of common stock subject to convertible senior notes conversion 28,122 38,403 Shares of common stock subject to convertible senior secured notes conversion 32,866 — Total shares of common stock equivalents 78,281 58,738

Geographic information

Geographic information	3 Months Ended
	Mar. 31, 2023
Segments, Geographical Areas [Abstract]
Geographic information	Geographic information Revenue by country is determined based on the billing address of the customer and is summarized as follows (in thousands): Three Months Ended March 31, 2023 2022 United States $ 110,464 $ 108,295 Canada 2,101 2,297 United Kingdom 1,186 2,147 Rest of world 3,605 10,952 Total revenue $ 117,356 $ 123,691

Summary of significant accoun_2

Summary of significant accounting policies (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Basis of presentation	Basis of presentationThe accompanying unaudited condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information and in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for complete financial statements. The unaudited interim condensed consolidated financial statements have been prepared on the same basis as the annual financial statements. In the opinion of management, the accompanying unaudited condensed consolidated financial statements reflect all adjustments (consisting only of normal recurring adjustments) considered necessary for a fair presentation. The information included in this Quarterly Report on Form 10-Q should be read in conjunction with the audited financial statements and notes thereto included in our Annual Report on Form 10-K for the year ended December 31, 2022. 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 periods.
Principles of consolidation	Principles of consolidation Our unaudited condensed consolidated financial statements include our accounts and the accounts of our wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated in consolidation.
Use of estimates	Use of estimates The preparation of financial statements in conformity with U.S. GAAP requires management to make judgments, estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent liabilities as of the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. We base these estimates on current facts, historical and anticipated results, trends and various other assumptions that we believe are reasonable under the circumstances, including assumptions as to future events. Actual results could differ materially from those judgments, estimates and assumptions. We evaluate our estimates on an ongoing basis.
Concentrations of credit risk and other risks and uncertainties	Concentrations of credit risk and other risks and uncertainties Financial instruments that potentially subject us to a concentration of credit risk consist of cash, cash equivalents, restricted cash, marketable securities and accounts receivable. Our cash and cash equivalents are primarily held by financial institutions in the United States. Such deposits may exceed federally insured limits.
Fair value of financial instruments	Fair value of financial instruments Our financial instruments consist principally of cash and cash equivalents, marketable securities, accounts receivable, accounts payable, accrued liabilities, operating and finance leases obligations, liabilities associated with business combinations, and convertible senior notes. The carrying amounts of certain of these financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued and other current liabilities approximate their current fair value due to the relatively short-term nature of these accounts. Based on borrowing rates available to us, the carrying value of our operating and finance leases approximates their fair values. Liabilities associated with business combinations and the convertible senior secured notes due 2028 are recorded at their estimated fair value. Fair value option election The fair value option provides an election that allows an entity to irrevocably elect to record certain financial assets and liabilities at fair value on an instrument-by-instrument basis at initial recognition. We have elected to apply the fair value option to our 4.50% Series A and B convertible senior secured notes due 2028 (collectively, the "Senior Secured 2028 Notes") and stock payable liabilities resulting from business combinations. The convertible senior secured notes accounted for under the fair value option election pursuant to Accounting Standards Codification ("ASC") 825, Financial Instruments, are each a debt host financial instrument containing embedded features which would otherwise be required to be bifurcated from the debt-host and recognized as separate derivative liabilities subject to initial and recurring estimated fair value measurements under ASC 815, Derivatives and Hedging . Notwithstanding, ASC 825 provides for the fair value option election, to the extent not otherwise prohibited by ASC 825, to be afforded to financial instruments. When the fair value option election is applied to financial liabilities, bifurcation of an embedded derivative is not required, and the financial liability is initially measured at its issue-date estimated fair value and then subsequently remeasured at estimated fair value on a recurring basis as of each reporting period date. The estimated fair value adjustment related to the portion of the change in fair value attributed to a change in the instrument-specific credit risk is recognized as a component of other comprehensive loss, with the remaining amount of the fair value adjustment recognized in other (expense) income, net in our condensed consolidated statements of operations. We have elected to present the component related to accrued interest in the change in fair value of the Senior Secured 2028 Notes. In circumstances where an acquisition involves certain indemnification hold-backs that are settled in shares of our common stock, we recognize a stock payable liability based upon the number of shares that are issuable to the sellers and the quoted closing price of our common stock as of the reporting date. The number of shares that will ultimately be issued is subject to adjustment for indemnified claims that existed as of the closing date for each acquisition. We remeasure this liability each reporting period and record changes in the fair value related to stock payable liabilities in other income (expense), net in our condensed consolidated statements of operations.
Restructuring and other costs	Restructuring and other costs Restructuring and other costs are comprised of employee severance and benefits, asset impairments and losses on asset disposals, and other costs primarily related to implementing our strategic realignment. Employee severance and benefit costs are comprised of severance, other termination benefit costs, and stock-based compensation expense for the acceleration of stock awards related to workforce reductions. We recognize costs and liabilities associated with exit and disposal activities in accordance with ASC 420, Exit and Disposal Cost Obligations, and other costs and liabilities associated with nonretirement postemployment benefits in accordance with ASC 712, Nonretirement Postemployment Benefits . Liabilities are based on the estimate of fair value in the period the liabilities are incurred, with subsequent changes to the liability recognized as adjustments in the period of change. We recognize losses on asset disposals in accordance with ASC 360, Impairment or Disposal of Long- Lived Assets . Restructuring and other costs are recognized as an operating expense within the condensed consolidated statements of operations and related liabilities are recorded within accrued liabilities in the condensed consolidated balance sheets.
Recent accounting pronouncements	Recent accounting pronouncements We evaluate all Accounting Standards Updates (“ASUs”) issued by the Financial Accounting Standards Board (the "FASB") for consideration of their applicability. ASUs not included in the disclosures in this report were assessed and determined to be either not applicable or are not expected to have a material impact on our condensed consolidated financial statements. Recently adopted accounting pronouncements In October 2021, the FASB issued ASU 2021-08, Business Combinations ("Topic 805"): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments of this ASU require entities to recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC 606, Revenue from Contracts with Customers . The Company adopted the amendments in this update on January 1, 2023 with no impact to our consolidated financial statements at the date of adoption. The amendments will be applied prospectively to future business combinations.

Summary of significant accoun_3

Summary of significant accounting policies (Tables)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Summary of restrictions on cash and cash equivalents	Cash, cash equivalents and restricted cash reported within the condensed consolidated balance sheets are reconciled to the amounts reported in the condensed consolidated statements of cash flows as follows (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 161,197 $ 325,331 Restricted cash 10,034 10,275 Total cash, cash equivalents and restricted cash $ 171,231 $ 335,606
Schedule of cash and cash equivalents	Cash, cash equivalents and restricted cash reported within the condensed consolidated balance sheets are reconciled to the amounts reported in the condensed consolidated statements of cash flows as follows (in thousands): March 31, 2023 March 31, 2022 Cash and cash equivalents $ 161,197 $ 325,331 Restricted cash 10,034 10,275 Total cash, cash equivalents and restricted cash $ 171,231 $ 335,606

Revenue, accounts receivable _2

Revenue, accounts receivable and deferred revenue (Tables)	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Schedule of disaggregated revenue	The following tables present disaggregated revenue by customer and product offering by category (in thousands): Patient Institution Three Months Ended March 31, 2023 Insurance Direct Product: Oncology $ 50,615 $ 1,705 $ 7,986 $ 60,306 Women's health 20,210 3,412 1,259 24,881 Rare diseases 11,427 2,389 6,316 20,132 Data/services — — 12,037 12,037 Total revenue $ 82,252 $ 7,506 $ 27,598 $ 117,356 Patient Institution Three Months Ended March 31, 2022 Insurance Direct Product: Oncology $ 48,538 $ 3,436 $ 20,201 $ 72,175 Women's health 16,765 6,004 2,022 24,791 Rare diseases 6,601 2,717 6,265 15,583 Data/services — — 11,142 11,142 Total revenue $ 71,904 $ 12,157 $ 39,630 $ 123,691
Schedule of change in estimate	In subsequent periods, we update our estimate of the amounts recognized for previously delivered tests resulting in the following (decreases) increases to revenue and (decreases) increases to our net (loss) income from operations and basic and diluted net (loss) income per share (in millions, except per share data): Three Months Ended March 31, 2023 2022 Revenue $ (3.0) $ 1.1 (Loss) income from operations $ (3.0) $ 1.1 Net (loss) income per share, basic and diluted $ (0.01) $ 0.00

Intangible Assets (Tables)

Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of intangible assets, indefinite-lived	The following table presents details of our acquired intangible assets as of March 31, 2023 (in thousands): March 31, 2023 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 40,928 $ (18,577) $ — $ 22,351 10.8 Developed technology 1,138,702 (193,796) (2,051) 942,855 10.8 Trade name 21,072 (4,390) — 16,682 12.0 $ 1,200,702 $ (216,763) $ (2,051) $ 981,888 10.8 The following table presents details of our acquired intangible assets as of December 31, 2022 (in thousands): December 31, 2022 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 41,515 $ (17,675) $ (359) $ 23,481 10.8 Developed technology 1,174,506 (183,133) (19,426) 971,947 10.8 Non-compete agreement 286 (286) — — — Trade name 21,085 (3,964) — 17,121 12.0 Patent assets and licenses 495 (156) (339) — — Right to develop new technology 19,359 (2,474) (16,885) — — $ 1,257,246 $ (207,688) $ (37,009) $ 1,012,549 10.8
Schedule of intangible assets, finite-lived	The following table presents details of our acquired intangible assets as of March 31, 2023 (in thousands): March 31, 2023 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 40,928 $ (18,577) $ — $ 22,351 10.8 Developed technology 1,138,702 (193,796) (2,051) 942,855 10.8 Trade name 21,072 (4,390) — 16,682 12.0 $ 1,200,702 $ (216,763) $ (2,051) $ 981,888 10.8 The following table presents details of our acquired intangible assets as of December 31, 2022 (in thousands): December 31, 2022 Cost Accumulated Asset Disposals Net Weighted-Average Customer relationships $ 41,515 $ (17,675) $ (359) $ 23,481 10.8 Developed technology 1,174,506 (183,133) (19,426) 971,947 10.8 Non-compete agreement 286 (286) — — — Trade name 21,085 (3,964) — 17,121 12.0 Patent assets and licenses 495 (156) (339) — — Right to develop new technology 19,359 (2,474) (16,885) — — $ 1,257,246 $ (207,688) $ (37,009) $ 1,012,549 10.8
Summary of estimated future amortization expense of intangible assets with finite lives	The following table summarizes our estimated future amortization expense of intangible assets with finite lives as of March 31, 2023 (in thousands): 2023 (remainder of year) $ 85,559 2024 113,800 2025 112,046 2026 112,012 2027 111,346 Thereafter 447,125 Total estimated future amortization expense $ 981,888

Balance sheet components (Table

Balance sheet components (Tables)	3 Months Ended
	Mar. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Schedule of inventory	Inventory consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 18,913 $ 29,992 Work in progress 157 382 Finished goods — 12 Total inventory $ 19,070 $ 30,386
Schedule of property and equipment	Property and equipment consisted of the following (in thousands): March 31, 2023 December 31, 2022 Leasehold improvements $ 72,184 $ 73,095 Laboratory equipment 62,267 67,261 Computer equipment 13,368 13,511 Furniture and fixtures 1,364 1,427 Construction-in-progress 14,186 21,006 Other 5,955 2,996 Total property and equipment, gross 169,324 179,296 Accumulated depreciation (73,879) (70,573) Total property and equipment, net $ 95,445 $ 108,723
Schedule of accrued liabilities	Accrued liabilities consisted of the following (in thousands): March 31, 2023 December 31, 2022 Accrued compensation and related expenses $ 33,424 $ 25,315 Accrued expenses 32,394 23,628 Compensation and other liabilities associated with business combinations 3,881 5,335 Deferred revenue 5,721 4,814 Accrued interest 62 6,646 Accrued royalties 2,421 3,177 Other accrued liabilities 7,228 5,473 Total accrued liabilities $ 85,131 $ 74,388

Fair value measurements (Tables

Fair value measurements (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Financial instruments at fair value on a recurring basis	The following tables set forth the fair value of our financial instruments that were measured at fair value on a recurring basis (in thousands): March 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value Level 1 Level 2 Level 3 Financial assets: Money market funds $ 169,399 $ — $ — $ 169,399 $ 169,399 $ — $ — U.S. Treasury notes 33,042 11 — 33,053 33,053 — — U.S. government agency securities 184,395 53 — 184,448 — 184,448 — Total financial assets $ 386,836 $ 64 $ — $ 386,900 $ 202,452 $ 184,448 $ — Financial liabilities: Stock payable liability $ 300 $ — $ — $ 300 Contingent consideration 25 — — 25 Convertible senior secured notes 282,938 — — 282,938 Total financial liabilities $ 283,263 $ — $ — $ 283,263 March 31, 2023 Reported as: Cash equivalents $ 159,365 Restricted cash 10,034 Marketable securities 217,501 Total cash equivalents, restricted cash, and marketable securities $ 386,900 Convertible senior secured notes, current portion $ 71,902 Convertible senior secured notes, net of current portion 211,036 Other long-term liabilities 325 Total liabilities $ 283,263 December 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Estimated Fair Value Level 1 Level 2 Level 3 Financial assets: Money market funds $ 158,931 $ — $ — $ 158,931 $ 158,931 $ — $ — U.S. Treasury notes 193,685 1 (123) 193,563 193,563 — — U.S. government agency securities 96,006 55 (13) 96,048 — 96,048 — Total financial assets $ 448,622 $ 56 $ (136) $ 448,542 $ 352,494 $ 96,048 $ — Financial liabilities: Stock payable liability $ 744 $ — $ — $ 744 Contingent consideration 25 — — 25 Total financial liabilities $ 769 $ — $ — $ 769 December 31, 2022 Reported as: Cash equivalents $ 148,901 Restricted cash 10,030 Marketable securities 289,611 Total cash equivalents, restricted cash, and marketable securities $ 448,542 Other long-term liabilities $ 769
Rollforward of stock payable liability and contingent consideration	The following tables include a rollforward of the stock payable liability, contingent consideration, and Senior Secured 2028 Notes classified within Level 3 of the fair value hierarchy (in thousands): Stock Payable Liability Contingent Consideration Convertible Senior Secured Notes Fair value at December 31, 2022 $ 744 $ 25 $ — Issuance of convertible senior secured notes at fair value — — 301,071 Changes in fair value (218) — (18,304) Changes in fair value related to instrument-specific credit risk — — 171 Settlements (226) — — Fair value at March 31, 2023 $ 300 $ 25 $ 282,938 Stock Payable Liability Contingent Consideration Fair value at December 31, 2021 $ 20,925 $ 1,875 Change in fair value (10,003) 154 Fair value at March 31, 2022 $ 10,922 $ 2,029
Summary of significant inputs in the binomial lattice model	Significant inputs into the binomial lattice model as of March 31, 2023 and March 7, 2023 were as follows: March 31, 2023 March 7, 2023 Stock price $1.35 $1.65 Conversion price $2.58 $2.58 Volatility 110.0 % 107.5 % Risk-free interest rate 3.64 % 4.35 % Credit spread 13.74 % 13.76 % Cost of debt 17.4 % 18.1 % Term (years) 4.96 5.02

Commitments and contingencies (

Commitments and contingencies (Tables)	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Components of debt	Our 2024 Notes and 2028 Notes (collectively, our "Convertible Senior Notes") consisted of the following (in thousands): March 31, 2023 December 31, 2022 Outstanding principal $ 1,194,269 $ 1,499,996 Unamortized debt discount and issuance costs (24,895) (29,213) Net carrying amount $ 1,169,374 $ 1,470,783

Stockholders' equity (Tables)

Stockholders' equity (Tables)	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Schedule of convertible preferred and common stock	Shares of common stock were as follows (in thousands): Three Months Ended March 31, 2023 2022 Common stock: Shares outstanding, beginning of period 245,562 228,116 Common stock issued in connection with the convertible senior notes exchange 14,220 — Common stock issued on exercise of stock options, net 1 87 Common stock issued pursuant to vesting of RSUs 715 621 Common stock issued pursuant to acquisitions 177 — Shares outstanding, end of period 260,675 228,824

Stock incentive plans (Tables)

Stock incentive plans (Tables)	3 Months Ended
	Mar. 31, 2023
Share-Based Payment Arrangement [Abstract]
Schedule of activity under the plans	Activity under the 2010 Plan and the 2015 Plan is set forth below (in thousands, except per share data and years): Shares Available For Grant Stock Options Outstanding Weighted-Average Exercise Price Per Share Weighted-Average Remaining Contractual Life (Years) Aggregate Intrinsic Value Balances at December 31, 2022 12,625 2,541 $ 8.49 6.6 $ 16 Additional shares reserved 9,822 — Options granted (29) 29 2.46 Options cancelled 257 (257) 8.20 Options exercised — (1) 0.86 RSUs and PRSUs granted (197) — RSUs and PRSUs cancelled 425 — Balances at March 31, 2023 22,903 2,312 $ 8.45 6.7 $ 4 Options exercisable at March 31, 2023 1,163 $ 11.94 4.2 $ 4 Options vested and expected to vest at March 31, 2023 2,118 $ 8.94 6.4 $ 4
Summary of RSU activity	The following table summarizes RSU, including PRSU, activity (in thousands, except per share data): Number of Shares Weighted- Average Grant Date Fair Value Per Share Balance at December 31, 2022 11,895 $ 11.70 RSUs granted 197 $ 2.27 RSUs vested (715) $ 10.47 RSUs cancelled (425) $ 13.54 Balance at March 31, 2023 10,952 $ 11.54
Summary of stock based compensation expense	The following table summarizes stock-based compensation expense included in the condensed consolidated statements of operations (in thousands): Three Months Ended March 31, 2023 2022 Cost of revenue $ 948 $ 1,865 Research and development 18,846 31,994 Selling and marketing 2,599 2,909 General and administrative 6,589 10,054 Restructuring and other costs 211 — Total stock-based compensation expense $ 29,193 $ 46,822

Restructuring and other costs (

Restructuring and other costs (Tables)	3 Months Ended
	Mar. 31, 2023
Restructuring and Related Activities [Abstract]
Restructuring and Related Costs	The following table summarizes the expenses related to our strategic realignment recognized in restructuring and other costs in our condensed consolidated statement of operations (in thousands): Three Months Ended March 31, 2023 Employee severance and benefits $ 1,283 Impairments and losses on disposals of long-lived assets, net 50,354 Other restructuring costs 919 Total restructuring and other costs $ 52,556 The following table summarizes the changes in liabilities associated with our strategic realignment initiatives, including restructuring and other costs incurred and cash payments as of March 31, 2023 (in thousands): Employee severance and benefits Other restructuring costs Total Beginning balance $ — $ — $ — Accruals 35,237 7,405 42,642 Payments (32,974) (5,464) (38,438) Balance at December 31, 2022 2,263 1,941 4,204 Accruals 1,072 994 2,066 Payments (2,486) (1,223) (3,709) Balance at March 31, 2023 $ 849 $ 1,712 $ 2,561

Net loss per share (Tables)

Net loss per share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Schedule of earnings per share, basic and diluted	The following table presents the calculation of basic and diluted net loss per share (in thousands, except per share data): Three Months Ended March 31, 2023 2022 Net loss $ (192,183) $ (181,859) Shares used in computing net loss per share, basic and diluted 249,907 228,470 Net loss per share, basic and diluted $ (0.77) $ (0.80) Common stock issuable in connection with our Convertible Senior Notes and the Senior Secured 2028 Notes participate in any dividends that may be declared by the Company and are therefore considered to be participating securities. The net losses were attributable entirely to common stockholders since the participating securities did not have a contractual obligation to share in the Company’s losses.
Schedule of antidilutive securities excluded from computation of earnings per share	The following common stock equivalents have been excluded from diluted net loss per share because their inclusion would be anti-dilutive (in thousands): Three Months Ended March 31, 2023 2022 Shares of common stock subject to outstanding options 2,366 2,972 Shares of common stock subject to outstanding RSUs and PRSUs 11,399 15,935 Shares of common stock pursuant to ESPP 3,528 1,428 Shares of common stock subject to convertible senior notes conversion 28,122 38,403 Shares of common stock subject to convertible senior secured notes conversion 32,866 — Total shares of common stock equivalents 78,281 58,738

Geographic information (Tables)

Geographic information (Tables)	3 Months Ended
	Mar. 31, 2023
Segments, Geographical Areas [Abstract]
Schedule of revenue by country	Revenue by country is determined based on the billing address of the customer and is summarized as follows (in thousands): Three Months Ended March 31, 2023 2022 United States $ 110,464 $ 108,295 Canada 2,101 2,297 United Kingdom 1,186 2,147 Rest of world 3,605 10,952 Total revenue $ 117,356 $ 123,691

Organization and description _2

Organization and description of business (Details)	3 Months Ended
	Mar. 31, 2023 Segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	1

Summary of significant accoun_4

Summary of significant accounting policies - Reconciliation of 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	$ 161,197	$ 257,489	$ 325,331
Restricted cash	10,034	10,030	10,275
Total cash, cash equivalents and restricted cash	$ 171,231	$ 267,519	$ 335,606	$ 933,525

Revenue, accounts receivable _3

Revenue, accounts receivable and deferred revenue - Schedule of disaggregated revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Disaggregation of Revenue [Line Items]
Total revenue	$ 117,356	$ 123,691
Patient Insurance
Disaggregation of Revenue [Line Items]
Total revenue	82,252	71,904
Patient Direct
Disaggregation of Revenue [Line Items]
Total revenue	7,506	12,157
Institution
Disaggregation of Revenue [Line Items]
Total revenue	27,598	39,630
Oncology
Disaggregation of Revenue [Line Items]
Total revenue	60,306	72,175
Oncology | Patient Insurance
Disaggregation of Revenue [Line Items]
Total revenue	50,615	48,538
Oncology | Patient Direct
Disaggregation of Revenue [Line Items]
Total revenue	1,705	3,436
Oncology | Institution
Disaggregation of Revenue [Line Items]
Total revenue	7,986	20,201
Women's health
Disaggregation of Revenue [Line Items]
Total revenue	24,881	24,791
Women's health | Patient Insurance
Disaggregation of Revenue [Line Items]
Total revenue	20,210	16,765
Women's health | Patient Direct
Disaggregation of Revenue [Line Items]
Total revenue	3,412	6,004
Women's health | Institution
Disaggregation of Revenue [Line Items]
Total revenue	1,259	2,022
Rare Diseases
Disaggregation of Revenue [Line Items]
Total revenue	20,132	15,583
Rare Diseases | Patient Insurance
Disaggregation of Revenue [Line Items]
Total revenue	11,427	6,601
Rare Diseases | Patient Direct
Disaggregation of Revenue [Line Items]
Total revenue	2,389	2,717
Rare Diseases | Institution
Disaggregation of Revenue [Line Items]
Total revenue	6,316	6,265
Data And Services
Disaggregation of Revenue [Line Items]
Total revenue	12,037	11,142
Data And Services | Patient Insurance
Disaggregation of Revenue [Line Items]
Total revenue	0	0
Data And Services | Patient Direct
Disaggregation of Revenue [Line Items]
Total revenue	0	0
Data And Services | Institution
Disaggregation of Revenue [Line Items]
Total revenue	$ 12,037	$ 11,142

Revenue, accounts receivable _4

Revenue, accounts receivable and deferred revenue - Schedule of change in estimate (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenue	$ 117,356	$ 123,691
(Loss) income from operations	175,371	213,233
Change in estimate of revenue recognition
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenue	(3,000)	1,100
(Loss) income from operations	$ (3,000)	$ 1,100
Net loss per share, basic (in dollars per share)	$ (0.01)	$ 0
Net loss per share, diluted (in dollars per share)	$ (0.01)	$ 0

Revenue, accounts receivable _5

Revenue, accounts receivable and deferred revenue - Additional information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract receivable	$ 1,100	$ 1,300
Deferred revenue, revenue recognized	2,100
Deferred revenue	5,721	4,814
Long-term contract liability	36	100
Refund liability	$ 2,500	$ 4,700
Performance obligation timing	one to six months

Intangible Assets - Schedule of

Intangible Assets - Schedule of intangible assets (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ (216,763)	$ (207,688)
Asset Disposals	(2,051)	$ (37,009)
Total estimated future amortization expense	$ 981,888
Weighted-Average Useful Life (In Years)	10 years 9 months 18 days	10 years 9 months 18 days
Cost	$ 1,200,702	$ 1,257,246
Net	981,888	1,012,549
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Cost	40,928	41,515
Accumulated Amortization	(18,577)	(17,675)
Asset Disposals	0	(359)
Total estimated future amortization expense	$ 22,351	$ 23,481
Weighted-Average Useful Life (In Years)	10 years 9 months 18 days	10 years 9 months 18 days
Developed technology
Finite-Lived Intangible Assets [Line Items]
Cost	$ 1,138,702	$ 1,174,506
Accumulated Amortization	(193,796)	(183,133)
Asset Disposals	(2,051)	(19,426)
Total estimated future amortization expense	$ 942,855	$ 971,947
Weighted-Average Useful Life (In Years)	10 years 9 months 18 days	10 years 9 months 18 days
Trade name
Finite-Lived Intangible Assets [Line Items]
Cost	$ 21,072	$ 21,085
Accumulated Amortization	(4,390)	(3,964)
Asset Disposals	0	0
Total estimated future amortization expense	$ 16,682	$ 17,121
Weighted-Average Useful Life (In Years)	12 years	12 years
Non-compete agreement
Finite-Lived Intangible Assets [Line Items]
Cost		$ 286
Accumulated Amortization		(286)
Total estimated future amortization expense		$ 0
Weighted-Average Useful Life (In Years)		0 years
Patent assets and licenses
Finite-Lived Intangible Assets [Line Items]
Cost		$ 495
Accumulated Amortization		(156)
Asset Disposals		(339)
Total estimated future amortization expense		$ 0
Weighted-Average Useful Life (In Years)		0 years
Right to develop new technology
Finite-Lived Intangible Assets [Line Items]
Cost		$ 19,359
Accumulated Amortization		(2,474)
Asset Disposals		(16,885)
Total estimated future amortization expense		$ 0
Weighted-Average Useful Life (In Years)		0 years

Intangible Assets - Additional

Intangible Assets - Additional information (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2023	Mar. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Amortization expense		$ 28,600	$ 20,200
Other restructuring costs	$ 1,000	919
Developed technology
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible assets		$ 2,100

Intangible Assets - Summary of

Intangible Assets - Summary of estimated future amortization expense of intangible assets with finite lives (Details) $ in Thousands	Mar. 31, 2023 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2023 (remainder of year)	$ 85,559
2024	113,800
2025	112,046
2026	112,012
2027	111,346
Thereafter	447,125
Total estimated future amortization expense	$ 981,888

Balance sheet components - Sche

Balance sheet components - Schedule of inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Offsetting [Abstract]
Raw materials	$ 18,913	$ 29,992
Work in progress	157	382
Finished goods	0	12
Total inventory	$ 19,070	$ 30,386

Balance sheet components - Sc_2

Balance sheet components - Schedule of property and equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Property and equipment
Total property and equipment, gross	$ 169,324	$ 179,296
Accumulated depreciation	(73,879)	(70,573)
Total property and equipment, net	95,445	108,723
Leasehold improvements
Property and equipment
Total property and equipment, gross	72,184	73,095
Laboratory equipment
Property and equipment
Total property and equipment, gross	62,267	67,261
Computer equipment
Property and equipment
Total property and equipment, gross	13,368	13,511
Furniture and fixtures
Property and equipment
Total property and equipment, gross	1,364	1,427
Construction-in-progress
Property and equipment
Total property and equipment, gross	14,186	21,006
Other
Property and equipment
Total property and equipment, gross	$ 5,955	$ 2,996

Balance sheet components - Addi

Balance sheet components - Additional information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Depreciation	$ 5,400	$ 5,600
Loss on disposal of property and equipment	$ 8,500

Balance sheet components - Sc_3

Balance sheet components - Schedule of accrued liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Accrued compensation and related expenses	$ 33,424	$ 25,315
Accrued expenses	32,394	23,628
Compensation and other liabilities associated with business combinations	3,881	5,335
Deferred revenue	5,721	4,814
Accrued interest	62	6,646
Accrued royalties	2,421	3,177
Other accrued liabilities	7,228	5,473
Total accrued liabilities	$ 85,131	$ 74,388

Fair value measurements - Finan

Fair value measurements - Financial instruments at fair value on a recurring basis (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	$ 386,836	$ 448,622
Gross Unrealized Gains	64	56
Gross Unrealized Losses	0	(136)
Financial assets:	386,900	448,542
Other long-term liabilities	325	769
Total financial liabilities	283,263
Convertible senior secured notes, current portion (at fair value)	71,902	0
Convertible senior secured notes, net of current portion (at fair value)	211,036	0
Cash equivalents	159,365	148,901
Restricted cash	10,034	10,030	$ 10,275
Marketable securities	217,501	289,611
Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets	386,900	448,542
Convertible senior secured notes, current portion	282,938
Total financial liabilities	283,263	769
Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets	202,452	352,494
Convertible senior secured notes, current portion	0
Total financial liabilities	0	0
Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets	184,448	96,048
Convertible senior secured notes, current portion	0
Total financial liabilities	0	0
Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets	0	0
Convertible senior secured notes, current portion	282,938
Total financial liabilities	283,263	769
Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	169,399	158,931
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Money market funds | Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	169,399	158,931
Money market funds | Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	169,399	158,931
Money market funds | Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
Money market funds | Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	33,042	193,685
Gross Unrealized Gains	11	1
Gross Unrealized Losses	0	(123)
U.S. Treasury notes | Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	33,053	193,563
U.S. Treasury notes | Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	33,053	193,563
U.S. Treasury notes | Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
U.S. Treasury notes | Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
U.S. government agency securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	184,395	96,006
Gross Unrealized Gains	53	55
Gross Unrealized Losses	0	(13)
U.S. government agency securities | Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	184,448	96,048
U.S. government agency securities | Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
U.S. government agency securities | Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	184,448	96,048
U.S. government agency securities | Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Financial assets:	0	0
Stock payable liability | Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	300	744
Stock payable liability | Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	0	0
Stock payable liability | Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	0	0
Stock payable liability | Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	300	744
Contingent consideration | Recurring basis
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	25	25
Contingent consideration | Recurring basis | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	0	0
Contingent consideration | Recurring basis | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	0	0
Contingent consideration | Recurring basis | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial liabilities	$ 25	$ 25

Fair value measurements - Rollf

Fair value measurements - Rollforward of liabilities at fair value (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Stock Payable Liability
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair value, beginning balance	$ 744	$ 20,925
Issuance of convertible senior secured notes at fair value	0
Changes in fair value	(218)	(10,003)
Changes in fair value related to instrument-specific credit risk	0
Settlements	(226)
Fair value, ending balance	300	10,922
Contingent consideration
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair value, beginning balance	25	1,875
Issuance of convertible senior secured notes at fair value	0
Changes in fair value	0	154
Changes in fair value related to instrument-specific credit risk	0
Settlements	0
Fair value, ending balance	25	$ 2,029
Convertible Senior Secured Notes
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Fair value, beginning balance	0
Issuance of convertible senior secured notes at fair value	301,071
Changes in fair value	(18,304)
Changes in fair value related to instrument-specific credit risk	171
Settlements	0
Fair value, ending balance	$ 282,938

Fair value measurements - Addit

Fair value measurements - Additional information (Details) - USD ($)	1 Months Ended		3 Months Ended
	Feb. 28, 2023	Apr. 30, 2020	Mar. 31, 2023	Mar. 31, 2022	Mar. 07, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Transfers of assets and liabilities between Level 1, Level 2 and Level 3			$ 0			$ 0
Interest income			2,000,000	$ 1,200,000
Fair value of investments with unrealized losses			0
Convertible Senior Secured Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Change in fair value, income (expense)			18,304,000
Changes in fair value related to instrument-specific credit risk			(171,000)
Convertible Senior Secured Notes Due in 2028
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Convertible senior secured notes, current portion			$ 282,900,000		$ 301,100,000
Convertible Senior Secured Notes Due in 2028 | Convertible Senior Secured Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Stated interest rate	4.50%		4.50%
Aggregate principal amount	$ 275,300,000
Proceeds from issuance of debt	$ 30,000,000
Genelex
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business acquisition, expected milestone duration		4 years
Change in fair value of contingent consideration			$ 0	$ 200,000
Minimum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining contractual maturities			0 years
Maximum
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Remaining contractual maturities			3 months

Fair value measurements - Summa

Fair value measurements - Summary of significant inputs in the binomial lattice model (Details)	Mar. 31, 2023	Mar. 07, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Term (years)	4 years 11 months 15 days	5 years 7 days
Level 3 | Stock price | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	1.35	1.65
Level 3 | Conversion price | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	2.58	2.58
Level 3 | Volatility | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	1.100	1.075
Level 3 | Risk-free interest rate | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	0.0364	0.0435
Level 3 | Credit spread | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	0.1374	0.1376
Level 3 | Cost of debt | Valuation Technique Bionomial Lattice Model
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Measurement input	0.174	0.181

Commitments and contingencies -

Commitments and contingencies - Leases (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($)	Mar. 31, 2022 USD ($)
Operating Leased Assets [Line Items]
Finance lease, term of contract	3 years
Impairment of leasehold improvements	$ 2,000
Sublease income	400	$ 0
Exited Leased Premises
Operating Leased Assets [Line Items]
Impairment charge	37,800
Leases Previously Impaired
Operating Leased Assets [Line Items]
Impairment charge	$ 2,300
Minimum
Operating Leased Assets [Line Items]
Remaining lease term	1 year
Minimum | Measurement Input, Discount Rate | Valuation Technique, Discounted Cash Flow | Exited Leased Premises
Operating Leased Assets [Line Items]
Measurement input	0.070
Minimum | Measurement Input, Discount Rate | Valuation Technique, Discounted Cash Flow | Leases Previously Impaired
Operating Leased Assets [Line Items]
Measurement input	0.0750
Minimum | Measurement Input, Expected Sublease Income | Valuation Technique, Discounted Cash Flow | Exited Leased Premises
Operating Leased Assets [Line Items]
Measurement input	7,600
Minimum | Measurement Input, Expected Sublease Income | Valuation Technique, Discounted Cash Flow | Leases Previously Impaired
Operating Leased Assets [Line Items]
Measurement input	300
Maximum
Operating Leased Assets [Line Items]
Remaining lease term	12 years
Maximum | Measurement Input, Discount Rate | Valuation Technique, Discounted Cash Flow | Exited Leased Premises
Operating Leased Assets [Line Items]
Measurement input	0.080
Maximum | Measurement Input, Discount Rate | Valuation Technique, Discounted Cash Flow | Leases Previously Impaired
Operating Leased Assets [Line Items]
Measurement input	0.0775
Maximum | Measurement Input, Expected Sublease Income | Valuation Technique, Discounted Cash Flow | Exited Leased Premises
Operating Leased Assets [Line Items]
Measurement input	35,700
Maximum | Measurement Input, Expected Sublease Income | Valuation Technique, Discounted Cash Flow | Leases Previously Impaired
Operating Leased Assets [Line Items]
Measurement input	1,900

Commitments and contingencies_2

Commitments and contingencies - Debt financing (Details) - USD ($)	1 Months Ended		3 Months Ended
	Feb. 28, 2023	Oct. 31, 2020	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022	Sep. 30, 2019
Long-term Purchase Commitment [Line Items]
Loss on extinguishment of debt			$ 10,822,000	$ 0
Payments for debt issuance costs and prepayment fees			28,014,000	0
Convertible Senior Secured Notes
Long-term Purchase Commitment [Line Items]
Debt discounts and issuance costs			24,895,000		$ 29,213,000
Interest expense			7,200,000	7,700,000
2020 Term Loan | Secured Debt
Long-term Purchase Commitment [Line Items]
Aggregate principal amount		$ 135,000,000
Days prior to convertible debt extended maturity date		90 days
Debt discounts and issuance costs		$ 32,800,000
Interest expense			4,100,000	$ 5,900,000
2020 Term Loan | Secured Debt | Maximum
Long-term Purchase Commitment [Line Items]
Prepayment fee percent		6%
2020 Term Loan | Secured Debt | Minimum
Long-term Purchase Commitment [Line Items]
Prepayment fee percent		4%
2020 Term Loan | Secured Debt | LIBOR
Long-term Purchase Commitment [Line Items]
Floor rate		2%
Basis spread on variable rate		8.75%
2020 Term Loan | Convertible Senior Secured Notes
Long-term Purchase Commitment [Line Items]
Repayment of term loan	$ 135,000,000
Payment of accrued interest	2,600,000
Loss on extinguishment of debt			19,300,000
Write-off of unamortized debt issuance costs			11,200,000
Payments for debt issuance costs and prepayment fees			8,100,000
2024 Notes | Convertible Senior Secured Notes
Long-term Purchase Commitment [Line Items]
Aggregate principal amount	$ 305,700,000					$ 350,000,000
Percent of debt extended		80%
Loss on extinguishment of debt			$ (8,500,000)

Commitments and contingencies_3

Commitments and contingencies - Convertible senior notes (Details) - Convertible Senior Secured Notes	1 Months Ended
	Apr. 30, 2021 USD ($) tradingDay $ / shares	Sep. 30, 2019 USD ($) tradingDay $ / shares	Mar. 31, 2023 USD ($)	Feb. 28, 2023 USD ($)	Dec. 31, 2022 USD ($)
Debt Instrument [Line Items]
Long-term debt | $			$ 1,169,374,000		$ 1,470,783,000
2024 Notes
Debt Instrument [Line Items]
Aggregate principal amount | $		$ 350,000,000		$ 305,700,000
Stated interest rate		2%
Conversion price (in dollars per share) | $ / shares		$ 29.74
Redemption price percentage		100%
Number of threshold trading days		20
Number of consecutive trading days		(30)
Threshold percentage of stock price trigger		130%
Threshold trading days immediately after five consecutive trading days		5
Maximum threshold percentage of stock price trigger		98%
Threshold trading days		30
Long-term debt | $			$ 44,300,000
Conversion ratio		0.0336293
Convertible Senior Secured Notes
Debt Instrument [Line Items]
Aggregate principal amount | $	$ 1,150,000,000
Stated interest rate	1.50%
Conversion price (in dollars per share) | $ / shares	$ 43.18
Redemption price percentage	100%
Number of threshold trading days	20
Number of consecutive trading days	(30)
Threshold percentage of stock price trigger	150%
Percent of par value	99%
Conversion ratio	0.0231589

Commitments and contingencies_4

Commitments and contingencies - Components of debt (Details) - Convertible Senior Secured Notes - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Outstanding principal	$ 1,194,269	$ 1,499,996
Unamortized debt discount and issuance costs	(24,895)	(29,213)
Net carrying amount	$ 1,169,374	$ 1,470,783

Commitments and contingencies_5

Commitments and contingencies - Convertible senior secured notes (Details)	1 Months Ended		3 Months Ended
	Feb. 28, 2023 USD ($) shares $ / shares	Sep. 30, 2019 USD ($) tradingDay $ / shares	Mar. 31, 2023 USD ($) days	Mar. 31, 2022 USD ($)	Mar. 07, 2023 USD ($)
Debt Instrument [Line Items]
Convertible shares issued (in shares) | shares	14,219,859
Loss on extinguishment of debt, net			$ (10,822,000)	$ 0
Debt issuance costs			19,859,000	0
Convertible Senior Secured Notes
Debt Instrument [Line Items]
Change in fair value, income (expense)			18,304,000
Changes in fair value related to instrument-specific credit risk			171,000
Convertible Senior Secured Notes
Debt Instrument [Line Items]
Interest expense			7,200,000	7,700,000
Debt issuance costs			1,500,000	$ 1,600,000
2024 Notes
Debt Instrument [Line Items]
Convertible senior secured notes, current portion			38,900,000
2024 Notes | Convertible Senior Secured Notes
Debt Instrument [Line Items]
Aggregate principal amount	$ 305,700,000	$ 350,000,000
Stated interest rate		2%
Conversion price (in dollars per share) | $ / shares		$ 29.74
Number of consecutive trading days | tradingDay		30
Redemption price percentage		100%
Loss on extinguishment of debt, net			8,500,000
Convertible Senior Secured Notes Due in 2028
Debt Instrument [Line Items]
Convertible senior secured notes, current portion			$ 282,900,000		$ 301,100,000
Convertible Senior Secured Notes Due in 2028 | Convertible Senior Secured Notes
Debt Instrument [Line Items]
Aggregate principal amount	$ 275,300,000
Stated interest rate	4.50%		4.50%
Proceeds from issuance of debt	$ 30,000,000
Conversion price (in dollars per share) | $ / shares	$ 2.58
Convertible shares (in shares) | shares	118,316,667
Aggregate common stock converted (in shares) | shares	141,979,975
Number of consecutive trading days | days			5
Redemption price percentage			100%
Minimum revenue in last four quarters	$ 250,000,000
Minimum liquidity	15%
Fair value of debt instrument			$ 282,900,000		$ 301,100,000
Debt issuance costs	$ 19,900,000
Minimum percentage of principal notes outstanding for warrants to be issued	0.10

Commitments and contingencies_6

Commitments and contingencies - Other commitments and contingencies (Details) - USD ($) $ in Thousands		3 Months Ended
	Aug. 27, 2021	Mar. 31, 2023	Mar. 31, 2022	Sep. 30, 2022
Debt Instrument [Line Items]
Debt issuance costs		$ 19,859	$ 0
Royalty rate				7%
Convertible Senior Secured Notes
Debt Instrument [Line Items]
Interest expense		7,200	7,700
Debt issuance costs		1,500	$ 1,600
Convertible Senior Secured Notes
Debt Instrument [Line Items]
Convertible senior secured notes, current portion		492,400
2024 Notes
Debt Instrument [Line Items]
Convertible senior secured notes, current portion		38,900
Positive outcome of litigation
Debt Instrument [Line Items]
Damages	$ 4,700
Service agreements and laboratory supplies
Debt Instrument [Line Items]
Noncancelable unconditional purchase commitments		$ 35,600

Stockholders' equity - Schedule

Stockholders' equity - Schedule of convertible preferred and common stock (Details) - shares	1 Months Ended	3 Months Ended
	Feb. 28, 2023	Mar. 31, 2023	Mar. 31, 2022
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Convertible shares issued (in shares)	14,219,859
Common stock:
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Shares outstanding, beginning of period		245,562,000	228,116,000
Convertible shares issued (in shares)		14,220,000	0
Common stock issued on exercise of stock options, net (in shares)		1,000	87,000
Common stock issued pursuant to vesting of RSUs (in shares)		715,000	621,000
Common stock issued pursuant to acquisitions (in shares)		177,000	0
Shares outstanding, end of period		260,675,000	228,824,000

Stockholders' equity - Addition

Stockholders' equity - Additional information (Details)	1 Months Ended		3 Months Ended
	Feb. 28, 2023 USD ($) shares	May 30, 2021 USD ($)	Mar. 31, 2023 USD ($) $ / shares shares	Mar. 31, 2022 USD ($) shares	Mar. 17, 2023 shares	Dec. 31, 2022 $ / shares shares	Sep. 30, 2019 USD ($)	Aug. 31, 2017 $ / shares
Class of Stock [Line Items]
Common stock, shares authorized (shares)			600,000,000			600,000,000
Common stock, par value (dollars per share) | $ / shares			$ 0.0001			$ 0.0001
Preferred stock, shares authorized (in shares)			20,000,000			20,000,000
Proceeds from issuance of common stock, net | $			$ 1,000	$ 425,000
Convertible shares issued (in shares)	14,219,859
2024 Notes | Convertible Senior Secured Notes
Class of Stock [Line Items]
Aggregate principal amount | $	$ 305,700,000						$ 350,000,000
Convertible Senior Secured Notes Due in 2028 | Convertible Senior Secured Notes
Class of Stock [Line Items]
Aggregate principal amount | $	275,300,000
Common stock registered (in shares)					111,627,888
Proceeds from issuance of debt | $	$ 30,000,000
Series A convertible preferred stock
Class of Stock [Line Items]
Preferred stock, conversion ratio								1
Preferred stock, par value (in dollars per share) | $ / shares								$ 0.0001
Liquidation preference per share (in dollars per share) | $ / shares								$ 0.001
Preferred stock, shares authorized (in shares)			3,458,823			3,458,823
Preferred stock, outstanding (in shares)			0			0
Common stock
Class of Stock [Line Items]
Convertible shares issued (in shares)			14,220,000	0
2021 Sales Agreement | Cowen and Company, LLC
Class of Stock [Line Items]
Percentage of commission payable on gross proceeds		3%
2021 Sales Agreement | Maximum | Cowen and Company, LLC
Class of Stock [Line Items]
Proceeds from issuance of common stock, net | $		$ 400,000,000

Stock incentive plans - Additio

Stock incentive plans - Additional information (Details) - USD ($) $ in Thousands, shares in Millions	1 Months Ended	3 Months Ended
	Oct. 31, 2020	Mar. 31, 2023	Mar. 31, 2022	Sep. 30, 2021	Apr. 30, 2021
Stock incentive plan
Total stock-based compensation expense		$ 29,193	$ 46,822
RSU
Stock incentive plan
Vesting period		3 years
Stock incentive plans
Stock incentive plan
Vesting period		4 years
Stock incentive plans | PRSU
Stock incentive plan
Vesting period		2 years
Stock incentive plans | Stock options
Stock incentive plan
Vesting rate upon anniversaries		25%
Monthly vesting rate thereafter		2.08%
Stock incentive plans | RSU
Stock incentive plan
Vesting period		2 years
Minimum | 2010 Plan
Stock incentive plan
Employees holding voting rights of all classes of stock		10%
Exercise price of options on common stock		110%
Maximum | 2010 Plan
Stock incentive plan
Term of options granted		10 years
ArcherDX | Stock incentive plans | Stock options
Stock incentive plan
Number of options issued and vested (in shares)	3.7
Genosity
Stock incentive plan
Total stock-based compensation expense		$ 400	400
Genosity | RSU
Stock incentive plan
Business acquisition, value of units granted					$ 5,000
Ciitizen
Stock incentive plan
Total stock-based compensation expense		$ 14,700	$ 24,900
Ciitizen | RSU
Stock incentive plan
Business acquisition, value of units granted				$ 246,900

Stock incentive plans - Schedul

Stock incentive plans - Schedule of activity under the plans (Details) - Stock incentive plans - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Stock options
Activity under the plan
Shares available for grant, beginning balance (in shares)	12,625
Stock options outstanding, beginning balance (in shares)	2,541
Additional shares reserved (in shares)	9,822
Options granted (in shares)	(29)
Options cancelled (in shares)	(257)
Options exercised (in shares)	(1)
Shares available for grant, ending balance (in shares)	22,903	12,625
Stock options outstanding, ending balance (in shares)	2,312	2,541
Weighted-Average Exercise Price
Balance at the beginning of the period (in dollars per share)	$ 8.49
Options granted (in dollars per share)	2.46
Options cancelled (in dollars per share)	8.20
Options exercised (in dollars per share)	0.86
Balance at the end of the period (in dollars per share)	$ 8.45	$ 8.49
Additional information
Weighted-average remaining contractual life	6 years 8 months 12 days	6 years 7 months 6 days
Aggregate Intrinsic Value	$ 4	$ 16
Exercisable, number of shares	1,163
Exercisable, weighted-average exercise price (in dollars per share)	$ 11.94
Exercisable, weighted-average remaining contractual life	4 years 2 months 12 days
Exercisable, aggregate intrinsic value	$ 4
Vested and expected to vest
Number of shares	2,118
Weighted-average exercise price (in dollars per share)	$ 8.94
Weighted-average remaining contractual life	6 years 4 months 24 days
Aggregate intrinsic value	$ 4
RSUs and PRSUs
Activity under the plan
RSUs and PRSUs granted (in shares)	(197)
RSUs and PRSUs cancelled (in shares)	425

Stock incentive plans - Summary

Stock incentive plans - Summary of RSU activity (Details) shares in Thousands	3 Months Ended
	Mar. 31, 2023 $ / shares shares
RSUs and PRSUs
Number of Shares
Balance at the beginning of the period (in shares) | shares	11,895
Balance at the end of the period (in shares) | shares	10,952
Weighted- Average Grant Date Fair Value Per Share
Balance at the beginning of the period (in dollars per share) | $ / shares	$ 11.70
Balance at the end of the period (in dollars per share) | $ / shares	$ 11.54
RSU
Number of Shares
RSUs granted (in shares) | shares	197
RSUs vested (in shares) | shares	(715)
RSUs cancelled (in shares) | shares	(425)
Weighted- Average Grant Date Fair Value Per Share
RSUs granted (in dollars per share) | $ / shares	$ 2.27
RSUs vested (in dollars per share) | $ / shares	10.47
RSUs cancelled (in dollars per share) | $ / shares	$ 13.54

Stock incentive plans - Summa_2

Stock incentive plans - Summary of stock based compensation expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Stock-based compensation
Total stock-based compensation expense	$ 29,193	$ 46,822
Cost of revenue
Stock-based compensation
Total stock-based compensation expense	948	1,865
Research and development
Stock-based compensation
Total stock-based compensation expense	18,846	31,994
Selling and marketing
Stock-based compensation
Total stock-based compensation expense	2,599	2,909
General and administrative
Stock-based compensation
Total stock-based compensation expense	6,589	10,054
Restructuring and other costs
Stock-based compensation
Total stock-based compensation expense	$ 211	$ 0

Restructuring and other costs -

Restructuring and other costs - Additional Information (Details) $ in Thousands	1 Months Ended	3 Months Ended
	Jul. 31, 2022 employee	Mar. 31, 2023 USD ($)
Restructuring Cost and Reserve [Line Items]
Expected employee reduction | employee	1,000
Total restructuring and other costs		$ 52,556
Employee severance and benefits
Restructuring Cost and Reserve [Line Items]
Expected remaining restructuring costs		600
Other restructuring costs
Restructuring Cost and Reserve [Line Items]
Expected remaining restructuring costs		$ 5,500

Restructuring and other costs_2

Restructuring and other costs - Restructuring Expense (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2023	Mar. 31, 2022
Restructuring and Related Activities [Abstract]
Employee severance and benefits		$ 1,283
Impairments and losses on disposals of long-lived assets, net		50,354	$ 0
Other restructuring costs	$ 1,000	919
Total restructuring and other costs		$ 52,556

Restructuring and other costs_3

Restructuring and other costs - Changes In Liabilities (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	$ 4,204	$ 0
Accruals	2,066	42,642
Payments	(3,709)	(38,438)
Restructuring reserve, ending balance	2,561	4,204
Employee severance and benefits
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	2,263	0
Accruals	1,072	35,237
Payments	(2,486)	(32,974)
Restructuring reserve, ending balance	849	2,263
Other restructuring costs
Restructuring Reserve [Roll Forward]
Restructuring reserve, beginning balance	1,941	0
Accruals	994	7,405
Payments	(1,223)	(5,464)
Restructuring reserve, ending balance	$ 1,712	$ 1,941

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Income tax benefit	$ 960	$ 34,920
Release of federal and state valuation allowances	900
Unrecognized tax benefits	59,300
Unrecognized tax benefits, portion that would affect tax rate	$ 200

Net loss per share - Schedule o

Net loss per share - Schedule of earnings per share, basic and diluted (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Net loss	$ (192,183)	$ (181,859)
Shares used in computing net loss per share, basic	249,907	228,470
Shares used in computing net loss per share, diluted	249,907	228,470
Net (loss) income per share, basic (in dollars per share)	$ (0.77)	$ (0.80)
Net (loss) income per share, diluted (in dollars per share)	$ (0.77)	$ (0.80)

Net loss per share - Schedule_2

Net loss per share - Schedule of antidilutive securities excluded from computation of earnings per share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Net loss per common share
Total shares of common stock equivalents (in shares)	78,281	58,738
Shares of common stock subject to outstanding options
Net loss per common share
Total shares of common stock equivalents (in shares)	2,366	2,972
Shares of common stock subject to outstanding RSUs and PRSUs
Net loss per common share
Total shares of common stock equivalents (in shares)	11,399	15,935
Shares of common stock pursuant to ESPP
Net loss per common share
Total shares of common stock equivalents (in shares)	3,528	1,428
Shares of common stock subject to convertible senior notes conversion | 2024 Notes
Net loss per common share
Total shares of common stock equivalents (in shares)	28,122	38,403
Shares of common stock subject to convertible senior notes conversion | Convertible Senior Secured Notes Due in 2028
Net loss per common share
Total shares of common stock equivalents (in shares)	32,866	0

Geographic information - Schedu

Geographic information - Schedule of revenue by country (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Geographic information
Total revenue	$ 117,356	$ 123,691
United States
Geographic information
Total revenue	110,464	108,295
Canada
Geographic information
Total revenue	2,101	2,297
United Kingdom
Geographic information
Total revenue	1,186	2,147
Rest of world
Geographic information
Total revenue	$ 3,605	$ 10,952