Natera (NTRA) 10-Q 8 Aug 24 2024 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2024	Aug. 01, 2024
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Jun. 30, 2024
Entity File Number	001-37478
Entity Registrant Name	Natera, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	01-0894487
Entity Address, Address Line One	13011 McCallen Pass
Entity Address, Address Line Two	Building A Suite 100
Entity Address, City or Town	Austin
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	78753
City Area Code	650
Local Phone Number	980-9190
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	NTRA
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		123,681,432
Entity Central Index Key	0001604821
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash, cash equivalents and restricted cash	$ 796,798	$ 642,095
Short-term investments	90,299	236,882
Accounts receivable, net of allowance of $7,021 and $6,481 at June 30, 2024 and December 31, 2023, respectively	335,936	278,289
Inventory	40,985	40,759
Prepaid expenses and other current assets, net	37,798	60,524
Total current assets	1,301,816	1,258,549
Property and equipment, net	133,280	111,210
Operating lease right-of-use assets	52,582	56,537
Other assets	29,311	15,403
Total assets	1,516,989	1,441,699
Current liabilities:
Accounts payable	33,100	14,998
Accrued compensation	41,487	45,857
Other accrued liabilities	141,231	149,405
Deferred revenue, current portion	18,367	16,612
Short-term debt financing	80,389	80,402
Total current liabilities	314,574	307,274
Long-term debt financing	283,604	282,945
Deferred revenue, long-term portion and other liabilities	21,066	19,128
Operating lease liabilities, long-term portion	61,225	67,025
Total liabilities	680,469	676,372
Commitments and contingencies (Note 8)
Stockholders' equity:
Common stock, $0.0001 par value: 750,000 shares authorized at both June 30, 2024 and December 31, 2023; 123,365 and 119,581 shares issued and outstanding at June 30, 2024 and December 31, 2023, respectively	12	11
Additional paid-in capital	3,320,365	3,145,837
Accumulated deficit	(2,482,499)	(2,377,436)
Accumulated other comprehensive loss	(1,358)	(3,085)
Total stockholders' equity	836,520	765,327
Total liabilities and stockholders' equity	$ 1,516,989	$ 1,441,699

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Condensed Consolidated Balance Sheets
Allowances on accounts receivable	$ 7,021	$ 6,481
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized	750,000	750,000
Common stock, shares issued	123,365	119,581
Common stock, shares outstanding	123,365	119,581

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues
Total revenues	$ 413,351,000	$ 261,404,000	$ 781,092,000	$ 503,160,000
Cost and expenses
Research and development	89,109,000	78,173,000	177,746,000	160,479,000
Selling, general and administrative	197,965,000	152,508,000	392,243,000	302,135,000
Total cost and expenses	457,253,000	373,830,000	899,308,000	753,887,000
Loss from operations	(43,902,000)	(112,426,000)	(118,216,000)	(250,727,000)
Interest expense	(3,127,000)	(3,177,000)	(6,251,000)	(6,238,000)
Interest and other income, net	10,457,000	4,518,000	20,724,000	9,103,000
Loss before income taxes	(36,572,000)	(111,085,000)	(103,743,000)	(247,862,000)
Income tax (expense) benefit	(892,000)	282,000	(1,320,000)	122,000
Net loss	(37,464,000)	(110,803,000)	(105,063,000)	(247,740,000)
Unrealized gain on available-for-sale securities, net of tax	834,000	2,595,000	1,727,000	7,159,000
Comprehensive loss	$ (36,630,000)	$ (108,208,000)	$ (103,336,000)	$ (240,581,000)
Net loss per share (Note 12):
Basic (in dollars per share)	$ (0.30)	$ (0.97)	$ (0.86)	$ (2.20)
Diluted (in dollars per share)	$ (0.30)	$ (0.97)	$ (0.86)	$ (2.20)
Weighted-average number of shares used in computing basic and diluted net loss per share:
Basic (in shares)	122,853	113,690	121,834	112,734
Diluted (in shares)	122,853	113,690	121,834	112,734
Product
Revenues
Total revenues	$ 411,364,000	$ 258,256,000	$ 776,036,000	$ 496,053,000
Cost and expenses
Cost of revenues	169,850,000	142,808,000	328,683,000	290,562,000
Licensing and other
Revenues
Total revenues	1,987,000	3,148,000	5,056,000	7,107,000
Cost and expenses
Cost of revenues	$ 329,000	$ 341,000	$ 636,000	$ 711,000

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Common stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Accumulated Deficit	Total
Balance at Dec. 31, 2022	$ 11	$ 2,664,730	$ (16,362)	$ (1,942,635)	$ 705,744
Balance (in shares) at Dec. 31, 2022	111,255
Issuance of common stock upon exercise of stock options		2,939			2,939
Issuance of common stock upon exercise of stock options (in shares)	217
Issuance of common stock under the employee stock purchase plan		8,674			8,674
Issuance of common stock under the employee stock purchase plan (in shares)	219
Issuance of common stock for bonuses		19,771			19,771
Issuance of common stock for bonuses (in shares)	349
Issuance of common stock for IPR&D milestone		14,435			14,435
Issuance of common stock for IPR&D milestone (in shares)	336
Vesting of restricted stock units (in shares)	1,675
Stock based compensation		85,165			85,165
Unrealized gain on available-for sale securities			7,159		7,159
Net loss				(247,740)	(247,740)
Balance at Jun. 30, 2023	$ 11	2,795,714	(9,203)	(2,190,375)	596,147
Balance (in shares) at Jun. 30, 2023	114,051
Balance at Mar. 31, 2023	$ 11	2,741,932	(11,798)	(2,079,572)	650,573
Balance (in shares) at Mar. 31, 2023	113,359
Issuance of common stock upon exercise of stock options		638			638
Issuance of common stock upon exercise of stock options (in shares)	48
Issuance of common stock under the employee stock purchase plan		8,674			8,674
Issuance of common stock under the employee stock purchase plan (in shares)	219
Vesting of restricted stock units (in shares)	425
Stock based compensation		44,470			44,470
Unrealized gain on available-for sale securities			2,595		2,595
Net loss				(110,803)	(110,803)
Balance at Jun. 30, 2023	$ 11	2,795,714	(9,203)	(2,190,375)	596,147
Balance (in shares) at Jun. 30, 2023	114,051
Balance at Dec. 31, 2023	$ 11	3,145,837	(3,085)	(2,377,436)	$ 765,327
Balance (in shares) at Dec. 31, 2023	119,581				119,581
Issuance of common stock upon exercise of stock options		8,648			$ 8,648
Issuance of common stock upon exercise of stock options (in shares)	1,078
Issuance of common stock under the employee stock purchase plan		8,862			8,862
Issuance of common stock under the employee stock purchase plan (in shares)	263
Issuance of common stock for bonuses		24,071			24,071
Issuance of common stock for bonuses (in shares)	270
Vesting of restricted stock units	$ 1				1
Vesting of restricted stock units (in shares)	2,173
Stock based compensation		132,947			132,947
Unrealized gain on available-for sale securities			1,727		1,727
Net loss				(105,063)	(105,063)
Balance at Jun. 30, 2024	$ 12	3,320,365	(1,358)	(2,482,499)	$ 836,520
Balance (in shares) at Jun. 30, 2024	123,365				123,365
Balance at Mar. 31, 2024	$ 12	3,241,326	(2,192)	(2,445,035)	$ 794,111
Balance (in shares) at Mar. 31, 2024	122,234
Issuance of common stock upon exercise of stock options		2,182			2,182
Issuance of common stock upon exercise of stock options (in shares)	286
Issuance of common stock under the employee stock purchase plan		8,862			8,862
Issuance of common stock under the employee stock purchase plan (in shares)	263
Vesting of restricted stock units (in shares)	582
Stock based compensation		67,995			67,995
Unrealized gain on available-for sale securities			834		834
Net loss				(37,464)	(37,464)
Balance at Jun. 30, 2024	$ 12	$ 3,320,365	$ (1,358)	$ (2,482,499)	$ 836,520
Balance (in shares) at Jun. 30, 2024	123,365				123,365

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Operating activities:
Net loss	$ (105,063)	$ (247,740)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation and amortization	14,978	10,201
Expensed in-process research and development		2,679
Premium amortization and discount accretion on investment securities	(556)	1,450
Stock-based compensation	131,858	84,789
Non-cash lease expense	7,204	7,451
Amortization of debt discount and issuance cost	658	642
Foreign exchange adjustment	377	265
Non-cash interest expense	(13)	68
Changes in operating assets and liabilities:
Accounts receivable	(57,647)	(15,680)
Inventory	(225)	(7,281)
Prepaid expenses and other assets	20,874	12,590
Accounts payable	16,668	(9,018)
Accrued compensation	19,701	9,936
Operating lease liabilities	(8,269)	(5,196)
Other accrued liabilities	(10,598)	(11,175)
Deferred revenue	1,044	6,368
Cash provided by (used in) operating activities	30,991	(159,651)
Investing activities:
Purchases of investments	(72,810)
Proceeds from maturity of investments	221,500	83,250
Purchases of property and equipment, net	(31,993)	(20,190)
Cash paid for acquisition of intangible assets	(10,495)
Cash provided by investing activities	106,202	63,060
Financing activities:
Proceeds from exercise of stock options	8,648	2,939
Proceeds from the issuance of common stock under the employee stock purchase plan	8,862	8,674
Cash provided by financing activities	17,510	11,613
Net change in cash, cash equivalents and restricted cash	154,703	(84,978)
Cash, cash equivalents and restricted cash, beginning of period	642,095	466,091
Cash, cash equivalents and restricted cash, end of period	796,798	381,113
Supplemental disclosure of cash flow information:
Cash paid for interest	5,592	5,596
Non-cash investing and financing activities:
Purchases of property and equipment in accounts payable and accruals	2,245	103
Acquisition of warrants	1,884
Amounts accrued for acquisition of intangible assets	1,400
Issuance of common stock for IPR&D acquisition		14,435
Issuance of common stock for bonuses	24,071	19,771
Stock-based compensation included in capitalized software development costs	$ 1,089	$ 376

Description of Business

Description of Business	6 Months Ended
	Jun. 30, 2024
Description of Business
Description of Business	1. Description of Business Natera, Inc. (the “Company”) was formed in the state of California as Gene Security Network, LLC in November 2003 and incorporated in the state of Delaware in January 2007. The Company is a diagnostics company with proprietary molecular and bioinformatics technology that it is applying to change the management of disease worldwide. The Company’s cell-free DNA (“cfDNA”) technology combines its novel molecular assays, which reliably measure many informative regions across the genome from samples as small as a single cell, with its statistical algorithms which incorporate data available from the broader scientific community to identify genetic variations covering a wide range of serious conditions with high accuracy and coverage. The Company focuses on applying its technology to three main areas of healthcare – women’s health, oncology and organ health. In the women’s health space, the Company develops and commercializes non- or minimally- invasive tests to evaluate risk for, and thereby enable early detection of, a wide range of genetic conditions, such as Down syndrome. In oncology, the Company commercializes, among others, a personalized blood-based DNA test to detect molecular residual disease and monitor for disease recurrence across a broad range of cancer types. The Company’s third area of focus is organ health, with tests to assess kidney, heart, and lung transplant rejection as well as genetic testing for chronic kidney disease. The Company operates laboratories in Austin, Texas and San Carlos, California certified under the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”) providing a host of cell-free DNA-based molecular testing services. The Company determines its operating segments based on the way it organizes its business to make operating decisions and assess performance. The Company operates one segment, the development and commercialization of molecular testing services, applying its proprietary technology in the fields of women’s health, oncology and organ health. ​ The Company’s key product offerings include its Panorama Non-Invasive Prenatal Test (“Panorama”) that screens for chromosomal abnormalities of a fetus as well as in twin pregnancies, typically with a blood draw from the mother; Horizon Carrier Screening (“Horizon”) to determine carrier status for a large number of severe genetic diseases that could be passed on to the carrier’s children; its Signatera molecular residual disease test (“Signatera”) to detect circulating tumor DNA in patients previously diagnosed with cancer to assess molecular residual disease, monitor for recurrence, and evaluate treatment response; and its Prospera test, to assess organ transplant rejection in patients who have undergone kidney, heart, or lung transplantation. All testing is available principally in the United States. The Company also offers its Panorama test to customers outside of the United States, primarily in Europe. The Company also offers Constellation, a cloud-based software platform that enables laboratory customers to gain access through the cloud to the Company’s algorithms and bioinformatics in order to validate and launch their own tests based on the Company’s technology.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2024
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies During the six months ended June 30, 2024, there were no material changes to the Company’s significant accounting policies as disclosed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (filed on February 29, 2024). Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the Company’s results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the six months ended June 30, 2024, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2023 has been derived from audited financial statements at that date. These financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2023 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 29, 2024. Some items in the prior period financial statements were reclassified to conform to the current presentation. Liquidity Matters The Company has incurred net losses since its inception and anticipates net losses for the near future. The Company had a net loss of $105.1 million for the six months ended June 30, 2024 and an accumulated deficit of $2.5 billion as of June 30, 2024. As of June 30, 2024, the Company had $796.8 million in cash, cash equivalents, and restricted cash, $90.3 million in marketable securities, an $80.4 million outstanding balance on its Credit Line (as defined in Note 10, Debt While the Company has introduced multiple products that are generating revenues, these revenues have not been sufficient to fund all operations and business plans. Accordingly, the Company has funded the portion of operating costs that exceeds revenues through a combination of equity issuances, debt issuances, and other financings. The Company continues to invest in the development and commercialization of its existing and future products and, consequently, it will need to generate additional revenues to achieve future profitability and may need to raise additional equity or debt financing. If the Company raises additional funds by issuing equity securities, its stockholders will experience dilution. Additional debt financing, if available, may involve covenants restricting its operations or its ability to incur additional debt. Any additional debt financing or additional equity that the Company raises may contain terms that are not favorable to it or its stockholders and requires significant debt service payments, which diverts resources from other activities. Additional financing may not be available when necessary, or in amounts or on terms acceptable to the Company. If the Company is unable to obtain additional financing, it may be required to delay the development and commercialization of its products and significantly scale back its business and operations. On July 19, 2024, the Company announced its decision to redeem all of its outstanding 2.25% Convertible Senior Notes due 2027. The redemption is scheduled for October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes is equal to 100% of the principal amount of the Convertible Notes to be redeemed plus accrued and unpaid interest to, but excluding, the Redemption Date. The Company elected physical settlement with shares of its common stock as the settlement method to apply to all conversions of the Convertible Notes. Based on the conversion terms of the Convertible Notes and the market price of its common stock, the Company expects that substantially all outstanding Convertible Notes will be converted into shares of the Company’s common stock prior to the Redemption Date. As a result, the Company does not expect that its decision to redeem the Convertible Notes will have a material effect on its liquidity. In September 2023, the Company completed an underwritten equity offering and sold 4,550,000 shares of its common stock at a price of $55 per share to the public. Before estimated offering expenses of $0.4 million, the Company received proceeds of approximately $235.8 million net of the underwriting discount. On September 10, 2021, the Company entered into an agreement with a third party for an asset acquisition where the acquired asset was in-process research and development primarily in exchange for an equity consideration payment. In addition, pursuant to the agreement, certain employees of the third party became employees of the Company. The third party was a biotechnology company focused on oncology. The total upfront acquisition consideration amounts to $35.6 million composed of the issuance of 276,346 shares of the Company's common stock with a fair value of $30.9 million, approximately $3.9 million of cash consideration, assumed net liabilities of $0.2 million, as well as $0.6 million of acquisition related legal and accounting costs directly attributable to the acquisition of the asset. The Company accounted for the transaction as an asset acquisition as substantially all of the estimated fair value of the gross assets acquired was concentrated in a single identified in-process research and development asset (“IPR&D”) thus satisfying the requirements of the screen test in Accounting Standards Update (“ASU”) 2017-01 Business Combinations (Topic 805): Clarifying the Definition of Business Further, additional consideration aggregating up to approximately $35.0 million was estimated to be paid via issuance of an estimated 269,547 additional shares of the Company’s common stock, consistent with the registration statement filed with the SEC on September 10, 2021, upon achievement of defined milestones relating to product development, commercial launch and continued employment of certain selling shareholders, each of which was revalued at each reporting date and amount of compensation expense was adjusted accordingly and reported in research and development expenses. In November 2022, the terms of the payment for any remaining consideration were modified, resulting in $10.0 million of consideration paid in December 2022 and $15.0 million of consideration paid in March 2023, with such consideration primarily consisting of the Company’s common stock. Based on the Company’s current business plan, the Company believes that its existing cash and marketable securities will be sufficient to meet its anticipated cash requirements for at least 12 months after August 8, 2024. Principles of Consolidation ​ The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. The Company established a subsidiary that operates in the state of Texas to support the Company’s laboratory and operational functions. The Company established a subsidiary that operates in Canada following the acquisition of the IPR&D asset. All intercompany balances and transactions have been eliminated. Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles (GAAP) in the United States requires management to make estimates and assumptions about future events that affect the amounts of assets and liabilities reported, disclosures about contingent assets and liabilities, and reported amounts of revenues and expenses. Significant items subject to such estimates include the allowance for doubtful accounts, the operating right-of-use assets and the associated lease liabilities, the average useful life for property and equipment including impairment estimates, deferred revenues associated with unsatisfied performance obligations, accrued liability for potential refund requests, stock-based compensation, the fair value of options, income tax uncertainties, and the expected consideration to be received from contracts with customers, insurance payors, and patients. These estimates and assumptions are based on management's best estimates and judgment. Management regularly evaluates its estimates and assumptions using historical experience and other factors, including contractual terms and statutory limits; however, actual results could differ from these estimates and could have an adverse effect on the Company's financial statements. ​ Investments Investments consist primarily of debt securities such as U.S. Treasuries, U.S. agency and municipal bonds. Management determines the appropriate classification of securities at the time of purchase and re-evaluates such determination at each balance sheet date. The Company generally classifies its entire investment portfolio as available-for-sale. The Company views its available-for-sale portfolio as available for use in current operations. Accordingly, the Company classifies all investments as short-term, irrespective of maturity date. Available-for-sale securities are carried at fair value, with unrealized gains and losses reported in accumulated other comprehensive income (loss), which is a separate component of stockholders’ equity. ​ Available-for-sale debt securities. Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments losses for available-for-sale debt securities held at the reporting date over the remaining life based on historical experience, current conditions, and reasonable and supportable forecasts. The Company evaluated its investment portfolio under the available-for-sale debt securities impairment model guidance and determined the Company’s investment portfolio is composed of low-risk, investment grade securities and thus has not recorded an expected credit loss for its investment portfolio. Further, gross unrealized losses on available for sale securities were not material at June 30, 2024. ​ Accounts Receivable Trade accounts receivable and other receivables. Balance Sheet Components Revenue from Contracts with Customers Inventory ​ Inventory is recorded at the lower of cost or net realizable value, determined on a first-in, first-out basis. Inventory consists entirely of supplies, which the Company consumes when providing its test reports, and therefore, the Company does not maintain any finished goods inventory. The Company enters into inventory purchases commitments so that it can meet future delivery schedules based on forecasted demand for its tests. ​ ​ Other Assets ​ In January 2024, the Company acquired from Invitae Corp. (“Invitae”) certain assets relating to Invitae’s non-invasive prenatal screening and carrier screening business. The transaction price of $10.5 million consisted of $10.0 million in upfront payment costs and approximately $0.5 million of other transaction costs which were capitalized as intangible assets over an estimated useful life of ten years. An additional payment of up to $42.5 million may be made should the Company achieve certain customer volume retention targets and based on certain legal outcomes. Accumulated Other Comprehensive Income (Loss) Comprehensive loss and its components encompass all changes in equity other than those with stockholders, and include net loss, unrealized gains and losses on available-for-sale marketable securities and foreign currency translation adjustments. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ June 30, ​ June 30, ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ (in thousands) Beginning balance $ (2,192) ​ $ (11,798) ​ $ (3,085) ​ $ (16,362) Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment ​ 834 ​ ​ 2,595 ​ ​ 1,727 ​ ​ 7,159 Ending balance $ (1,358) ​ $ (9,203) ​ $ (1,358) ​ $ (9,203) ​ The change in net unrealized loss on available-for-sale securities is due to increased market volatility. The Company has assessed the unrealized loss position for available-for-sale securities and determined that an allowance for credit loss was not necessary. Revenue Recognition ​ The Company recognizes revenue under, ASC 606, using the following five step process: ​ ● Identification of a contract, or contracts, with a customer; ● Identification of the performance obligations in the contract; ● Determination of the transaction price; ● Allocation of the transaction price to the performance obligations in the contract; and ● Revenue recognition when, or as, the performance obligations are satisfied. ​ ​ ​ Revenue Recognition, ​ Fair Value ​ The Company discloses the fair value of financial instruments for financial assets and liabilities for which the value is practicable to estimate. Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price). Related Party ​ On December 6, 2021, the Company participated along with certain other investors in the series B financing of MyOme, Inc. (“MyOme”), and purchased preferred shares and warrants in exchange for a cash payment of approximately $4.0 million. The Company does not hold a seat on MyOme’s board of directors. The Company’s investment in MyOme is recorded at cost and no impairment was identified as of June 30, 2024. The following are the Company’s related persons and the basis of each such related person’s relationship with MyOme: ● Matthew Rabinowitz, the Company’s executive chairman and co-founder, is the chairman of the board and founder of MyOme, and a beneficial holder of approximately 26.5% of the outstanding shares of MyOme on a fully dilutive basis; ​ ● Jonathan Sheena, the Company’s co-founder and a member of the Company’s board of directors, is a stockholder and a member of the board of directors of MyOme; ​ ● Daniel Rabinowitz, the Company’s Secretary and Chief Legal Officer, is a stockholder of MyOme; and ​ ● Roelof Botha, the Lead Independent Director of the Company’s board of directors, is a managing member of Sequoia Capital. Certain funds affiliated with Sequoia Capital also participated in MyOme’s series B financing. None of the related party investments in MyOme by our executives and directors noted above were at the behest of the Company nor funded by the Company. In February 2024, the Company entered into a collaboration and commercialization agreement (the “Collaboration Agreement”) with MyOme pursuant to which the parties will partner to offer certain genetic testing services to be developed and funded solely by MyOme and overseen by a joint steering committee. The Company will assist MyOme with commercial activities. In connection with the Collaboration Agreement, the Company received a 10-year warrant to purchase 3,058,485 shares of MyOme's common stock at an exercise price of $0.25 per share, which will vest upon a MyOme liquidity event (as such terms are defined in MyOme's certificate of incorporation). The warrants were valued using the Black-Scholes valuation model on the date of acquisition and are accounted for using the measurement alternative. No impairment was identified as of June 30, 2024. The warrants have been included within other assets and deferred revenue, long-term portion and other liabilities, which will be recognized as a reduction of selling and marketing expense upon commercialization and sale of the products contemplated under the Collaboration Agreement. Subject to the Company's achievement of certain commercialization milestones, the Company may receive additional warrants to purchase MyOme’s Series B Preferred Stock. To the extent the genetic testing services are successfully commercialized, the Company will owe certain royalty payments to MyOme. Should the Company exercise all its MyOme common stock warrants, the Company would hold an accumulated 12.4% of MyOme on a fully diluted basis. Risk and Uncertainties Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents, and restricted cash, accounts receivable and investments. The Company limits its exposure to loss by placing its cash in financial institutions with high credit ratings. The Company's cash may consist of deposits held with banks that may at times exceed federally insured limits of $250,000 per customer. The Company performs evaluations of the relative credit standing of these financial institutions and limits the amount of credit exposure with any one institution. For the three and six months ended June 30, 2024, and 2023, there were no customers exceeding 10% of total revenues on an individual basis. As of June 30, 2024 and December 31, 2023, there were no customers with an outstanding balance exceeding 10% of net accounts receivable. For the three months ended June 30, 2024 and 2023, approximately 10.3% and 12.5%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. For the six months ended June 30, 2024 and 2023, approximately 10.9% and 13.2%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. As of June 30, 2024 and December 31, 2023, approximately 8.8% and 10.2%, respectively, of accounts receivable are expected to be paid by Medicare on behalf of multiple customers. ​ Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date. Unless otherwise discussed below, the Company believes that the impact of accounting standards updates recently issued that are not yet effective will not have a material impact on its financial position or results of operations upon adoption. New Accounting Pronouncements Not Yet Adopted In March 2020, ASU 2020-04, Reference Rate Reform (Topic 848) Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848 In November 2023, ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures In December 2023, ASU 2023-09, Income Taxes - Improvements to Income Tax Disclosures

Revenue Recognition

Revenue Recognition	6 Months Ended
	Jun. 30, 2024
Revenue Recognition
Revenue Recognition	3. Revenue Recognition The Company recognizes revenues when, or as, performance obligations in the contracts are satisfied, in the amount reflecting the expected consideration to be received from the goods or services transferred to the customers. Product Revenues Product revenues are derived by performing genetic testing services and the Company’s performance obligation is complete when test results are delivered to a clinic or patient, who are considered the customer for such services as further discussed below. Additionally, the Company enters into agreements with pharmaceutical companies to utilize the Company’s Signatera tests typically to study new cancer treatments or to validate the outcomes of clinical trials for which the pharmaceutical companies are identified as customers. Such arrangements generally involve performing whole exome sequencing services and the testing of patient samples to detect cancer mutations using its Signatera test. In addition to performing Signatera tests, these agreements typically include certain activities to fulfill the contract, such as customer data setup and management and ongoing reporting. Each test result is billable to customers upon delivery and the personalized cancer profile also makes each test distinct within the context of the contract as customers can exercise control over the test results upon delivery. Accordingly, the Company recognizes test processing revenue as individual test results are delivered to customers. For certain contracts with pharmaceutical companies where the Company is developing a companion diagnostic test in addition to performing regular testing services, revenue is primarily recognized proportionally as services are performed and/or tests are delivered. A performance obligation represents a promise in a contract to transfer a distinct good or service to a customer, which represents a unit of accounting in accordance with ASC 606. A performance obligation is considered distinct from other obligations in a contract when it provides a benefit to the customer either on its own or together with other resources that are readily available to the customer and is separately identified in the contract. The Company considers a performance obligation satisfied once the Company has transferred control of a good or service to the customer, meaning the customer has the ability to use and obtain the benefit of the good or service. A portion of the consideration should be allocated to each distinct performance obligation and recognized as revenue when, or as, the performance obligation is satisfied. The Company evaluates its contracts with laboratory partners and patients and identifies the performance obligations in those contracts, which are the delivery of the test results. The total consideration which the Company expects to collect in exchange for the Company’s products is an estimate and may be fixed or variable. Consideration includes reimbursement from both patients and insurance carriers, adjusted for variable consideration related to disallowed cases, percent of patient responsibility collected, refunds and reserves, and is estimated using the most likely amount method. For insurance carriers and product types with similar reimbursement characteristics, the Company uses a portfolio of relevant historical data to estimate variable consideration and total collections for the Company’s products. The Company constrains the estimated variable consideration when it assesses it is probable that a significant reversal in the amount of cumulative revenue recognized may occur in future periods. The consideration expected from laboratory partners usually includes a fixed amount, but it can be variable depending on the volume of tests performed, and the Company determines the variable consideration using the expected value approach. For laboratory partners and patients, the Company allocates the total consideration to a single performance obligation, which is the delivery of the test results to the customers. When assessing the total consideration expected to be received from insurance carriers and patients, a certain percentage of revenues is further constrained for estimated refunds. The Company enters into contracts with insurance carriers with primarily payment terms related to tests provided to patients who have health insurance coverage. Insurance carriers are considered as third-party payers on behalf of the patients, and the patients are considered as the customers who receive genetic test services. Tests may be billed to insurance carriers, patients, or a combination of insurance carriers and patients. Further, the Company sells tests to a number of domestic and international laboratory partners and identifies the laboratory partners as customers provided that there is a test services agreement between the two parties. The Company generally bills an insurance carrier, a laboratory partner or a patient upon delivery of test results. The Company also bills patients directly for out-of-pocket costs involving co-pays and deductibles that they are responsible for. The Company may or may not get reimbursed for the full amount billed. Further, the Company may not get reimbursed at all for tests performed if such tests are not covered under the insurance carrier’s reimbursement policies or the Company is not a qualified provider to the insurance carrier, or if the tests were not previously authorized. Product revenue is recognized in an amount equal to the total consideration (as described above) expected to be received at a point in time when the test results are delivered. Approximately 90% of cash collections attributable to such product revenue occurs within nine months with the remaining collections generally taking an additional six months. During this time, management routinely reassesses its estimates of actual to expected cash collections, which are based on historical collection rates and adjusted for current information and trends. To the extent cash collections for tests delivered in prior periods are trending higher than expectations, the Company will increase revenue recognized when sufficient evidence is obtained to conclude the additional revenue will not result in a reversal of revenue in a future period. If cash collections for tests delivered in prior periods are trending below expectations, the Company will reduce revenue to the amount expected to be collected based on the latest information and expectations. Increases or decreases to the amount of cash expected to be collected for tests delivered in prior periods are recognized in product revenue with a corresponding impact to accounts receivable during the period such determination is made. During the three months ended June 30, 2024 and 2023, the Company increased revenue by a net of $39.9 million and $3.4 million, respectively, for collections related to tests delivered in prior periods that were fully collected (including an estimate of unapplied receipts). The increased revenue and decreased net loss net loss net loss As of June 30, 2024, the Company had $16.6 million in cash receipts which had not yet been applied to specific accounts receivables primarily due to the disruption to Change Healthcare’s network that occurred in February 2024. The Company reviewed the historical unapplied payment trends. Based on the historical estimation, within the unapplied cash receipt of $16.6 million, the Company estimated approximately $1.3 million was related to tests delivered in prior periods that were fully collected. Additionally, as overpayments were not material in prior periods, the Company accounted for temporary unapplied balances as of June 30, 2024, as contra accounts receivable on the Balance Sheet. As of December 31, 2023, the unapplied accounts receivable balance was $1.3 million. Product revenue is constrained for refunds estimated to be paid to insurance carriers. Certain refunds are recognized in accrued liabilities until they are either paid to the respective insurance carrier or it is determined the refund will not ultimately be paid, at which time the related accrual is reduced with a corresponding increase to revenue. During the three months ended June 30, 2024 and 2023, the reserves for refunds to insurance carriers were reduced and product revenue increased by $1.7 million and $0.8 million, respectively, for amounts the Company determined would not be refunded to insurance carriers. The increased revenue and corresponding decreased net loss decreased net loss In addition, certain other refunds are recognized as a reduction to accounts receivable until they are either paid to the respective insurance carrier or it is determined the refund will not ultimately be paid, at which time the related reserve is reduced with a corresponding increase to revenue. During the three months ended June 30, 2024, the reserves for refunds to insurance carriers were reduced and product revenue increased by $1.9 million for amounts the Company determined would not be refunded to insurance carriers. The increased revenue and corresponding decreased net loss net loss Licensing and Other Revenues ​ The Company recognizes licensing revenues from its cloud-based distribution service offering, Constellation, by granting licenses to its licensees to use certain of the Company’s proprietary intellectual properties and cloud-based software and in vitro diagnostic (“IVD”) kits. The Company also recognizes revenues from its strategic collaboration agreements, such as those with BGI Genomics Co., Ltd. (“BGI Genomics”) and Foundation Medicine, Inc. (“Foundation Medicine”). The Company recognizes licensing and other revenues through agreements with pharmaceutical companies in support of potential clinical trials managed by the pharmaceutical companies. Constellation The laboratory partners with whom the Company enters into a licensing arrangement represent the licensees and are identified as customers. The licensees do not have the right to possess the Company’s software, but rather receive services through the cloud software. These arrangements often include: (i) the delivery of the services through the cloud software, (ii) the necessary support and training, and (iii) the IVD kits to be consumed as tests are processed. The Company does not consider the software as a service, the support or the training as being distinct in the context of such arrangements, and therefore they are combined as a single performance obligation. The software, support and training are delivered simultaneously to the licensees over the term of the arrangement. The Company bills the majority of licensees, who process the tests in their laboratories, a fixed price for each test processed. Licensing revenues are recognized as the performance obligations are satisfied (i.e., upon the delivery of each test) and reported in licensing and other revenues in the Company’s statements of operations and comprehensive loss. BGI Genomics In February 2019, the Company entered into a License Agreement (the “BGI Genomics Agreement”) with BGI Genomics to develop, manufacture, and commercialize next generation sequencing-based genetic testing assays for clinical and commercial use. The BGI Genomics Agreement has a term of ten years and expires in February 2029. Pursuant to the BGI Genomics Agreement, the Company licensed its intellectual property to and provided development services for BGI Genomics. Following completion of development services, the Company began providing assay interpretation services over the term of the agreement. According to the BGI Genomics Agreement, the Company is entitled to a total of $50.0 million, comprised of upfront technology license fees, prepaid royalties relating to future sales of licensed products and performance of assay interpretation services, and milestone payments. Due to uncertainties in achieving certain milestones, $6.0 million of the $50.0 million was constrained. A net of $44.0 million has been collected by the Company in cash, which includes $20.0 million in prepaid royalties. The Company concluded that the license is not a distinct performance obligation as it does not have a stand-alone value to BGI Genomics apart from the related development services. Therefore, license and related development services, for each of the non-invasive prenatal tests (“NIPTs”) and Oncology products, representing two separate performance obligations, to which $24.0 million of transaction consideration was allocated. This performance obligation was fully satisfied in March 2023 and no further related amounts will be recognized as revenue. As of December 31, 2023, the Company's performance obligation to provide ongoing NIPT assay interpretation services was removed. Therefore, the Company now has a single remaining performance obligation related to Oncology assay interpretation services, to which $20.0 million of transaction consideration was allocated and prepaid by BGI Genomics. During the six months ended June 30, 2023, the Company recognized $0.6 million related to oncology assay interpretation services, of which $0.2 million was recognized against deferred royalties. During the six months ended June 30, 2024, the Company did not record any material amounts related to oncology assay interpretation services. The Company currently has $18.9 million in deferred revenue as of June 30, 2024. As required by the BGI Genomics Agreement, in June 2019 the Company prepaid $6.0 million to BGI Genomics for future sequencing services and $4.0 million for future sequencing equipment. These advance payments are for equipment and services to be received in future periods, which was assessed as a standalone transaction that did not reduce revenue, aggregated to $10.0 million and was originally recorded in long-term advances on the Company’s Consolidated Balance Sheet and will be periodically assessed for impairment. During both the three and six months ended June 30, 2024, $0.4 million in equipment and services was received. During the three and six months ended June 30, 2023, $1.0 million and $2.6 million, respectively, in equipment and services was received. As of June 30, 2024, the remaining advanced payments were $4.5 million, with $0.6 million recorded in prepaid expenses and other current assets and $3.8 million recorded in other assets. Foundation Medicine, Inc. ​ In August 2019, the Company entered into a License and Collaboration Agreement (the “Foundation Medicine Agreement”) with Foundation Medicine to develop and commercialize personalized circulating tumor DNA monitoring assays, for use by biopharmaceutical and clinical customers who order Foundation Medicine’s FoundationOne CDx. The Company and Foundation Medicine will share the revenues generated from both biopharmaceutical and clinical customers in accordance with the terms of the Foundation Medicine Agreement. The Foundation Medicine Agreement has an initial term of five years, expiring in August 2024, with automatic renewals thereafter for successive one-year terms, unless the Foundation Medicine Agreement is earlier terminated in accordance with its terms. The Company and Foundation Medicine have elected not to renew the agreement beyond the initial term. Pursuant to the Foundation Medicine Agreement, the Company will provide development services that are required to customize its proprietary Signatera test to work with Foundation Medicine’s FoundationOne CDx in conjunction with granting the use of the Company’s intellectual property. Following completion of those development services, the Company is currently providing assay testing services over the term of the agreement. The intellectual property has been licensed to Foundation Medicine for the customized test. In addition, the Company is responsible for delivering clinical study plans in order to demonstrate efficacy of the customized test which commenced in the second quarter of 2021. The Company is entitled to a total of $32.0 million, comprised of upfront technology license fees, prepaid royalties relating to future sales of licensed products and performance of assay interpretation services, and milestone payments. $7.7 million is constrained due to uncertainties in achieving certain milestones. A net of $24.3 million has been collected by the Company in cash, which includes $5.0 million of prepaid royalties. The Company concluded that the license is not a distinct performance obligation as it does not have a stand-alone value to Foundation Medicine apart from the related development services. Therefore, license and related development services, for Oncology products, represent a single performance obligation, to which $19.3 million of transaction consideration was allocated. Of this amount, $0.2 million was recognized in the three months ended March 31, 2023. This performance obligation was fully satisfied in March 2023 and no further related amounts will be recognized as revenue. Royalties related to assay interpretation services represent separate performance obligations for Oncology products, to which $5.0 million of transaction consideration was allocated and prepaid by Foundation Medicine. During the three and six months ended June 30, 2023, the Company recognized $0.1 million and $0.4 million, respectively, related to oncology assay interpretation services. During the three and six months ended June 30, 2024, the Company recognized $0.2 million related to oncology assay interpretation services. The Company currently has $3.0 million in deferred revenue related to this agreement as of June 30, 2024. Disaggregation of Revenues ​ The Company measures its performance results primarily based on revenues recognized from the three categories described below. The following table shows disaggregation of revenues by payer types: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ ​ June 30, ​ June 30, ​ ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ ​ (in thousands) Insurance carriers ​ $ 384,128 ​ $ 226,521 ​ $ 725,156 ​ $ 436,899 Laboratory and other partners ​ ​ 22,254 ​ ​ 27,449 ​ ​ 42,530 ​ ​ 50,254 Patients ​ ​ 6,969 ​ ​ 7,434 ​ ​ 13,406 ​ ​ 16,007 Total revenues ​ $ 413,351 ​ $ 261,404 ​ $ 781,092 ​ $ 503,160 ​ The following table presents total revenues by geographic area based on the location of the Company’s payers: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ ​ June 30, ​ June 30, ​ 2024 2023 2024 ​ 2023 ​ ​ (in thousands) ​ United States $ 404,872 ​ $ 253,296 ​ $ 764,285 ​ $ 486,550 ​ Americas, excluding U.S. ​ 1,601 ​ ​ 1,206 ​ ​ 3,082 ​ ​ 2,364 ​ Europe, Middle East, India, Africa ​ 5,439 ​ ​ 5,620 ​ ​ 10,617 ​ ​ 10,816 ​ Asia Pacific and Other ​ 1,439 ​ ​ 1,282 ​ ​ 3,108 ​ ​ 3,430 ​ Total revenues $ 413,351 ​ $ 261,404 ​ $ 781,092 ​ $ 503,160 ​ ​ The following table summarizes the Company’s beginning and ending balances of accounts receivable and deferred revenues: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ June 30, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Assets: ​ ​ ​ ​ ​ ​ Accounts receivable, net ​ $ 335,936 ​ $ 278,289 Liabilities: ​ ​ ​ ​ ​ ​ Deferred revenue, current portion ​ $ 18,367 ​ $ 16,612 Deferred revenue, long-term portion ​ ​ 18,416 ​ ​ 19,128 Total deferred revenues ​ $ 36,783 ​ $ 35,740 ​ The following table summarizes the changes in the balance of deferred revenues during the six months ended June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ June 30, ​ ​ 2024 ​ ​ 2023 ​ (in thousands) Beginning balance ​ $ 35,740 ​ $ 30,778 Increase in deferred revenues ​ ​ 14,826 ​ ​ 17,402 Revenue recognized during the period that was included in deferred revenues at the beginning of the period ​ ​ (9,646) ​ ​ (7,521) Revenue recognized from performance obligations satisfied within the same period ​ ​ (4,137) ​ ​ (3,513) Ending balance ​ $ 36,783 ​ $ 37,146 ​ During the six months ended June 30, 2024, revenue recognized that was included in the deferred revenue balance at the beginning of the period totaled $9.6 million. This balance consisted of approximately a net $0.1 million related to BGI Genomics and Foundation Medicine and $9.5 million related to genetic testing services. The current portion of deferred revenue includes $14.8 million from genetic testing services, $0.5 million from BGI Genomics, and $3.0 million from the Foundation Medicine Agreement as of June 30, 2024. The non-current portion of deferred revenue consists of $18.4 million from the BGI Genomics Agreement as of June 30, 2024.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2024
Fair Value Measurements
Fair Value Measurements	4. Fair Value Measurements The Company's financial assets and liabilities carried at fair value are comprised of investment assets that include money market and investments. The fair value accounting guidance requires that assets and liabilities be carried at fair value and classified in one of the following three categories: Level I: Quoted prices in active markets for identical assets and liabilities that the Company has the ability to access. Level II: Observable market-based inputs or unobservable inputs that are corroborated by market data, such as quoted prices, interest rates, and yield curves; and Level III: Inputs that are unobservable data points that are not corroborated by market data. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities That Are Measured at Fair Value on a Recurring Basis ​ The following table represents the fair value hierarchy for the Company’s financial assets and financial liabilities measured at fair value on a recurring basis: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ Level I ​ Level II ​ Level III Total Level I ​ Level II ​ Level III Total ​ ​ (in thousands) Financial Assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (1) ​ $ 796,798 ​ $ — ​ $ — ​ $ 796,798 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 U.S. Treasury securities ​ ​ 58,814 ​ ​ — ​ ​ — ​ ​ 58,814 ​ ​ 200,418 ​ ​ — ​ ​ — ​ ​ 200,418 Municipal securities ​ ​ — ​ ​ 31,485 ​ ​ — ​ ​ 31,485 ​ ​ — ​ ​ 36,464 ​ ​ — ​ ​ 36,464 Total financial assets ​ $ 855,612 ​ $ 31,485 ​ $ — ​ $ 887,097 ​ $ 842,513 ​ $ 36,464 ​ $ — ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ (1) Cash equivalents includes money market deposits and liquid demand deposits. Fair Value of Short-Term and Long-Term Debt: As of June 30, 2024 and December 31, 2023, the estimated fair value of the total principal outstanding and accrued interest of the Credit Line was $80.4 million, and were based upon observable Level 2 inputs, including the interest rate based on the 30-day Secured Overnight Financing Rate (“SOFR”) average, plus 0.5%. The estimated fair value approximates the carrying value due to the short term duration and variable interest rate. As of June 30, 2024 and December 31, 2023, the estimated fair value of the Convertible Notes was $800.7 million and $491.8 million, respectively, based upon observable, Level 2 inputs, including pricing information from recent trades of the Convertible Notes. See Note 10, Debt

Financial Instruments

Financial Instruments	6 Months Ended
	Jun. 30, 2024
Financial Instruments
Financial Instruments	5. Financial Instruments The Company elected to invest a portion of its cash assets in conservative, income earning, and liquid investments. Cash, cash equivalents, restricted cash and investments, which are classified as available-for-sale securities, consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ Amortized Cost Gross Unrealized Gain Gross Unrealized Loss Estimated Fair Value Amortized Cost Gross Unrealized Gain Gross Unrealized Loss Estimated Fair Value ​ ​ (in thousands) ​ ​ Cash, cash equivalents and restricted cash (2) ​ $ 796,798 ​ $ — ​ $ — ​ $ 796,798 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 U.S. Treasury securities (1) ​ 58,923 ​ — ​ ​ (109) ​ 58,814 ​ 201,522 ​ 14 ​ (1,118) ​ 200,418 Municipal securities (1) ​ ​ 32,556 ​ ​ — ​ ​ (1,071) ​ ​ 31,485 ​ ​ 38,091 ​ ​ — ​ ​ (1,627) ​ ​ 36,464 Total ​ $ 888,277 ​ $ — ​ $ (1,180) ​ $ 887,097 ​ $ 881,708 ​ $ 14 ​ $ (2,745) ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Classified as: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (2) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 796,798 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 642,095 Short-term investments ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 90,299 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 236,882 Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 887,097 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 878,977 ​ (1) Per the Company’s investment policy, all debt securities are classified as short-term investments irrespective of holding period. (2) Cash equivalents includes liquid demand deposits, and money market funds. ​ The Company invests in U.S. Treasuries, U.S. agency and high-quality municipal bonds which mature at par value and are all paying their coupons on schedule. The Company has therefore concluded an allowance for expected credit losses of its investments was not necessary and will continue to recognize unrealized gains and losses in other comprehensive income (loss). During the six months ended June 30, 2024, the Company did not sell any investments. The Company uses the specific investment identification method to calculate realized gains and losses and amounts reclassified out of other comprehensive income (loss) to net loss. As of June 30, 2024, the Company had 15 investments in an unrealized loss position in its portfolio. Gross unrealized losses were not material as of June 30, 2024. Gross unrealized losses were primarily due to declines in the value of fixed rate instruments as interest rates in the broader market increased, and were not indictive of a decline in the credit worthiness of the underlying issuer, and as such, the Company did not record a credit loss reserve as of June 30, 2024. The following table presents debt securities available-for-sale that were in an unrealized loss position as of June 30, 2024, aggregated by major security type in a continuous loss position. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Less Than 12 Months ​ 12 Months or Longer ​ Total ​ ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ (in thousands) U.S. Treasury securities ​ $ 23,923 ​ $ — ​ $ 34,891 ​ $ (109) ​ $ 58,814 ​ $ (109) Municipal securities ​ ​ — ​ ​ — ​ ​ 31,485 ​ ​ (1,071) ​ ​ 31,485 ​ ​ (1,071) Total ​ $ 23,923 ​ $ — ​ $ 66,376 ​ $ (1,180) ​ $ 90,299 ​ $ (1,180) ​ The following table summarizes the Company’s portfolio of available-for-sale securities by contractual maturity as of June 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ ​ Amortized Cost ​ Fair Value ​ ​ (in thousands) Less than or equal to one year ​ $ 75,440 ​ $ 75,003 Greater than one year but less than five years ​ ​ 16,039 ​ ​ 15,296 Total ​ $ 91,479 ​ $ 90,299 ​

Balance Sheet Components

Balance Sheet Components	6 Months Ended
	Jun. 30, 2024
Balance Sheet Components
Balance Sheet Components	6. Balance Sheet Components ​ Allowance for doubtful accounts ​ The following is a roll-forward of the allowances for doubtful accounts related to trade accounts receivable for the three and six months ended June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ June 30, ​ ​ 2024 ​ ​ 2023 ​ ​ ​ (in thousands) Beginning balance ​ $ 7,252 ​ $ 5,134 (Reversal of) Provision for doubtful accounts ​ ​ (185) ​ ​ 446 Write-offs ​ ​ (46) ​ ​ — Total ​ $ 7,021 ​ $ 5,580 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six Months Ended ​ June 30, ​ ​ 2024 ​ 2023 ​ ​ ​ (in thousands) Beginning balance ​ $ 6,481 ​ $ 3,830 Provision for doubtful accounts ​ ​ 744 ​ ​ 1,750 Write-offs ​ ​ (204) ​ ​ — Total ​ $ 7,021 ​ $ 5,580 ​ Property and Equipment, net ​ The Company’s property and equipment consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ December 31, ​ Useful Life 2024 2023 ​ ​ (in thousands) Machinery and equipment 3- 5 $ 94,785 ​ $ 85,626 Computer equipment 3 years ​ 3,040 ​ 1,850 Purchased and capitalized software held for internal use 3 years ​ 10,672 ​ ​ 11,636 Leasehold improvements Lesser of useful life or lease term ​ 47,666 ​ 38,999 Construction-in-process ​ ​ 41,577 ​ 29,392 ​ ​ ​ 197,740 ​ 167,503 Less: Accumulated depreciation and amortization ​ ​ (64,460) ​ (56,293) Total Property and Equipment, net ​ $ 133,280 ​ $ 111,210 ​ The Company’s long-lived assets are located in the United States. During the six months ended June 30, 2024, the increase in net property and equipment was due to expansion projects and purchases of new equipment for the Company’s laboratories located in Texas and California to expand testing capabilities, offset by depreciation expense of $13.3 million recorded in the six months ended June 30, 2024. Depreciation expense of $10.2 million was recorded in the six months ended June 30, 2023. The Company did not incur any impairment charges during the six months ended June 30, 2024 or 2023. Other Accrued Liabilities ​ The Company’s other accrued liabilities consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ June 30, December 31, ​ 2024 2023 ​ (in thousands) Reserves for refunds to insurance carriers $ 16,465 ​ $ 23,245 Accrued charges for third-party testing ​ 10,574 ​ ​ 14,823 Testing and laboratory materials from suppliers ​ 14,142 ​ ​ 11,229 Marketing and corporate affairs ​ 11,792 ​ ​ 10,085 Short term advances ​ 13,899 ​ ​ — Legal, audit and consulting fees ​ 31,979 ​ 43,897 Accrued shipping charges ​ 1,800 ​ ​ 3,646 Sales and income tax payable ​ 4,053 ​ ​ 3,731 Accrued third-party service fees ​ 8,173 ​ ​ 7,111 Clinical trials and studies 7,502 ​ ​ 12,126 Operating lease liabilities, current portion ​ 12,384 ​ ​ 11,621 Property and equipment purchases ​ 5,330 ​ ​ 4,316 Other accrued interest ​ 1,078 ​ ​ 1,078 Other accrued expenses 2,060 ​ ​ 2,497 Total other accrued liabilities $ 141,231 ​ $ 149,405 ​ Reserves for refunds to insurance carriers include overpayments from and amounts to be refunded to insurance carriers, and additional amounts that the Company estimates for potential refund requests during the period. When the Company releases these previously accrued amounts, they are recognized as product revenues in the condensed statements of operations and comprehensive loss. ​ The following table summarizes the reserve balance and activities for refunds to insurance carriers for the six months ending June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ 2024 2023 ​ (in thousands) Beginning balance $ 23,245 ​ $ 18,948 Additional reserves 1,065 ​ 5,148 Refunds to carriers (3,095) ​ ​ (963) Reserves released to revenue ​ (4,750) ​ ​ (7,653) Ending balance $ 16,465 ​ $ 15,480 ​ ​ ​ ​ ​ ​ ​ As of June 30, 2024, the Company had $13.9 million in short term advances obtained as a result of the disruption to Change Healthcare’s network in February 2024 which are due and payable within ten days of demand.

Leases

Leases	6 Months Ended
	Jun. 30, 2024
Leases.
Leases	7. Leases ​ Operating Leases In September 2015, the Company entered into a long-term lease agreement for laboratory and office space totaling approximately 94,000 square feet in Austin, Texas. The original lease term was 132 months beginning in December 2015 and expiring in November 2026 with monthly payments beginning in December 2016. In December 2021, the Company entered into an amendment of the Austin lease agreement which extended the lease of the current premises through March 2033. The amendment also includes two additional office spaces (the “First Expansion Premises” and the “Second Expansion Premises”). The First Expansion Premises consists of 32,500 rentable square feet and commenced in February 2022. The Second Expansion Premises consists of 65,222 rentable square feet and commenced in September 2022. The terms of the First and Second Expansion Premises expire in March 2033. In October 2016, the Company entered into a lease directly with its landlord for laboratory and office spaces at its facilities located in San Carlos, California. The Company currently occupies approximately 136,000 square feet comprised of two office spaces (the “First Space” and the “Second Space”). The First Space covers approximately 88,000 square feet, and the Second Space totals approximately 48,000 square feet. In January 2021, the Company entered into an amendment of the lease to extend the term for 48 months to October 2027. The combined annual rent for the First Space and Second Space is $9.3 million which commenced in October 2023. The Company entered into a lease agreement commencing June 2018 for its cord blood tissue storage facility in Tukwila, Washington that covers approximately 10,000 square feet. The lease term is 62 months and expired in July 2023. The Company had the option to extend this lease for five years, and the fair market rent upon renewal was not determinable. However, since the Company sold its business related to cord blood and tissue storage in September 2019, the Company has subleased the facility and did not exercise its option to renew the facility upon expiration. The Company entered into a lease agreement in November 2020 to lease 11,395 square feet of space located in South San Francisco, California over a 36 The Company entered into a lease agreement in September 2023 to lease 16,319 square feet of space located in Pleasanton, California over a 60-month term. The premises are used for laboratory and research use and commenced in December 2023. The annual lease payment starts at $0.5 million and escalates annually. As part of the IPR&D asset acquisition in September 2021, the Company inherited a 24 The Company has also historically entered into leases of individual workspaces and storage spaces at various locations on both a month-to-month basis without an established lease term, and more recently for certain locations, has committed to terms approximating one For the six months ended June 30, 2024, the Company had $0.6 million in noncash operating activities related to additional right-of-use assets accounted from a new lease and extending existing leases under ASC, Topic 842, Leases (“ASC 842”). For the six months ended June 30, 2023, the Company did not have any noncash operating activities related to additional right-of-use assets. The operating lease right-of-use assets are classified as noncurrent assets in the balance sheet. The corresponding lease liabilities are separated into current and long-term portions as follows: ​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ December 31, ​ 2024 ​ 2023 ​ ​ (in thousands) Operating lease liabilities, current portion included in other accrued liabilities $ 12,384 ​ $ 11,621 Operating lease liabilities, long-term portion ​ 61,225 ​ ​ 67,025 Total operating lease liabilities $ 73,609 ​ $ 78,646 ​ The initial recognition of the operating lease liabilities was measured as the present value of the future minimum lease payments using a discount rate determined as of January 1, 2019. The operating right-of-use assets was calculated as the operating lease liabilities discounted at the present value, less the amount of unamortized tenant improvement allowance and deferred rent. The discount rate used was the Company’s incremental borrowing rate given that the implicit rate to each lease was not readily determinable. In accordance with ASC 842, the incremental borrowing rate was estimated as the annual percentage yield resulting from a corporate debt financing over a loan term approximating the remaining term of each lease, with the effect of certain credit risk rating. As of June 30, 2024, the weighted-average remaining lease term was 6.30 The Company continues to recognize lease expense on a straight-line basis. The lease expense includes the amortization of the right-of-use assets with the associated interest component estimated by applying the effective interest method. For the three months ended June 30, 2024 and 2023, total lease expense of $3.6 million and $3.7 million was recognized in the condensed statements of operations and comprehensive loss, respectively. For the six months ended June 30, 2024 and 2023, total lease expense of $7.2 million and $7.5 million was recognized in the condensed statements of operations and comprehensive loss, respectively. Cash paid for amounts in the measurement of operating lease liabilities totaled $4.1 million and $3.0 million for the three months ended June 30, 2024 and 2023, respectively. Cash paid for amounts in the measurement of operating lease liabilities totaled $8.3 million and $5.2 million for the six months ended June 30, 2024 and 2023, respectively. The present value of the future annual minimum lease payments under all non-cancellable operating leases as of June 30, 2024 are as follows: ​ ​ ​ ​ ​ Operating Leases ​ (in thousands) As of June 30, 2024 ​ ​ 2024 (remaining 6 months) $ 8,449 2025 ​ 17,155 2026 ​ 17,450 2027 ​ 14,345 2028 ​ 6,675 2029 and thereafter ​ 27,928 ​ ​ 92,002 Less: imputed interest ​ (18,393) Operating lease liabilities $ 73,609 ​

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies
Commitments and Contingencies	8. Commitments and Contingencies Legal Proceedings The Company is involved in legal matters, including investigations, subpoenas, demands, disputes, litigation, requests for information, and other regulatory or administrative actions or proceedings, including those with respect to intellectual property, testing and test performance, billing, reimbursement, marketing, short seller and media allegations, employment, and other matters. ​ The Company is responding to ongoing regulatory and governmental investigations, subpoenas and inquiries, and contesting its current legal matters, but cannot provide any assurance as to the ultimate outcome with respect to any of the foregoing. There are many uncertainties associated with these matters. Such matters may cause the Company to incur costly litigation and/or substantial settlement charges, divert management attention, result in adverse judgments, fines, penalties, injunctions or other relief, and may result in loss of customer or investor confidence regardless of their merit or ultimate outcome. In addition, the resolution of any intellectual property litigation may require the Company to make royalty payments, which could adversely affect gross margins in future periods. If any of the foregoing were to occur, the Company’s business, financial condition, results of operations, cash flows, prospects, or stock price could be adversely affected. ​ The Company assesses legal contingencies to determine the degree of probability and range of possible loss for potential accrual in its financial statements. When evaluating legal contingencies, the Company may be unable to provide a meaningful estimate due to a number of factors, including the procedural status of the matter in question, the presence of complex or novel legal theories, and/or the ongoing discovery and development of information important to the matters. In addition, damage amounts claimed in litigation or other matters may be unsupported, exaggerated or unrelated to possible outcomes, and as such are not meaningful indicators of its potential liability. Loss contingencies, including claims and legal actions arising in the ordinary course of business, are recorded as liabilities when the likelihood of loss is probable and an amount or range of loss can be reasonably estimated. During the periods presented, the Company does not believe there are such matters that will have a material effect on its financial condition. Intellectual Property Litigation Matters. The Company has been involved in two patent litigations against CareDx, Inc. (“CareDx”) in the United States District Court for the District of Delaware (“CareDx Patent Cases”). In the first CareDx Patent Case, CareDx alleged, in a complaint filed jointly with the Board of Trustees of the Leland Stanford Junior University in March 2019 and amended in March 2020, that the Company infringed three patents (the “CareDx Patents”). The complaint sought unspecified damages and injunctive relief. In September 2021, the Court granted the Company’s motion for summary judgment, finding all three CareDx Patents invalid. This finding was affirmed on appeal by the United States Court of Appeals for the Federal Circuit. CareDx’s petition for rehearing by the Federal Circuit, and its subsequent petition for certiorari to the United States Supreme Court, were both denied. In the second CareDx Patent Case, the Company alleged, in suits filed in January 2020 and May 2022, infringement by CareDx of certain of the Company’s patents, seeking unspecified damages and injunctive relief. In January 2024, after trial, the jury returned a verdict in favor of the Company, finding both asserted patents valid and one patent infringed by CareDx. The jury awarded damages to the Company for lost profits and past royalties totaling $96.3 million. In January 2020, the Company filed suit against ArcherDX, Inc. (“ArcherDX”) in the United States District Court for the District of Delaware. In January 2021, the Company named an additional Archer DX entity, ArcherDx LLC, and Invitae as defendants. The Company alleged, among other things, that certain ArcherDX products, including the Personalized Cancer Monitoring (“PCM”) test, infringed three of the Company’s patents (the “ArcherDX Case”) and sought unspecified monetary damages and injunctive relief. Following a jury trial in May 2023 and a bench trial in June 2023, all three asserted patents were found to be valid and infringed by ArcherDX and Invitae, and the jury awarded damages totaling $19.35 million to the Company. In November 2023, the Court granted in part the Company’s motion for a permanent injunction against the PCM test, which the defendants have appealed. In February 2024, Invitae and ArcherDX filed a voluntary Chapter 11 petition in the U.S. Bankruptcy Court for the District of New Jersey, resulting in an automatic bankruptcy stay in the case. The Company is the subject of a lawsuit filed against it by Ravgen, Inc. (“Ravgen”) in June 2020 in the United States District Court for the Western District of Texas, alleging infringement of two Ravgen patents and seeking monetary damages and injunctive relief. In January 2024, after trial, the jury returned a verdict of non-willful infringement by the Company and found damages of $57 million. The Company intends to appeal certain of the rulings. In addition, various parties, including the Company, have filed petitions challenging the validity of the asserted patents with the United States Patent and Trademark Office, all of which were instituted for review, and some of which were decided in favor of upholding the challenged claims. The petitions filed by the Company and certain others remain pending. In October 2020, the Company filed suit against Genosity Inc. (“Genosity”), in the United States District Court for the District of Delaware, alleging that various Genosity products infringe one of the Company’s patents and seeking unspecified monetary damages and injunctive relief. The case has been stayed pending the entry of a final judgment in the ArcherDX Case, in which the subject patent is also asserted. In February 2024, Genosity filed a voluntary Chapter 11 petiion in the U.S. Bankruptcy Court for the District of New Jersey. The Company is the subject of lawsuits filed against it by Invitae in the United States District Court of the District of Delaware alleging, in complaints filed in May and November of 2021, infringement of three patents and seeking monetary damages and injunctive relief. The parties have filed cross-motions for summary judgment, which motions are currently pending before the Court. In February 2024, subsequent to Invitae’s voluntary Chapter 11 petition described above, the Court granted Invitae’s request to continue the trial, which is now scheduled for September 2025. The Company filed suits against Inivata, Inc. and Inivata Ltd. (collectively “Inivata”) in the United States District Court for the District of Delaware in January 2021 and December 2022, alleging that certain of Inivata’s oncology products infringe certain of the Company’s patents and seeking unspecified monetary damages and injunctive relief. The two suits have been consolidated. Inivata has filed a motion to dismiss the Company’s complaint with respect to one patent, which motion is currently pending before the Court. In March 2024, the Court stayed the case in light of the Company’s case against NeoGenomics Laboratories, Inc. (“NeoGenomics”), which acquired Inivata in 2021, discussed below. In July 2023, the Company filed suit against NeoGenomics in the United States District Court for the Middle District of North Carolina (the “District Court”), alleging infringement of certain Natera patents by NeoGenomics’ commercialization of the RaDaR test. The complaint seeks monetary damages and injunctive relief. In December 2023, the Court denied NeoGenomics’ motion to dismiss the complaint, and granted the Company’s motion for preliminary injunction. The injunction went into effect as of January 12, 2024. NeoGenomics filed a motion to modify and stay the injunction, which was denied by the District Court and affirmed on appeal in July 2024 by the Federal Circuit Court of Appeals. NeoGenomics has also filed petitions challenging the validity of both of the asserted patents with the United States Patent and Trademark Office. One of the petitions has been denied. Other Litigation Matters. CareDx filed suit against the Company in April 2019 in the United States District Court for the District of Delaware, alleging false advertising, and related claims based on statements describing studies that concern the Company’s technology and CareDx’s technology, seeking unspecified damages and injunctive relief. The Company filed a counterclaim against CareDx in the United States District Court for the District of Delaware, alleging false advertising, unfair competition and deceptive trade practices and seeking unspecified damages and injunctive relief. In March 2022, after trial, the jury returned a verdict that the Company was liable to CareDx and found damages of $44.9 million. The jury also returned a verdict against CareDx, finding that CareDx had engaged in false advertising. In July 2023, the Court granted in part the Company’s motion for judgment as a matter of law requesting that the Court set aside the portions of the jury verdict adverse to the Company, ruling that CareDx is not entitled to any damages. The jury verdict of false advertising by CareDx remains in place. Both parties are appealing. In May 2021, Guardant. Inc. (“Guardant”) filed suit against the Company in the United States District Court of the Northern District of California alleging false advertising and related claims and seeking unspecified damages and injunctive relief. Also in May 2021, the Company filed suit against Guardant in the Western District of Texas, alleging false advertising and related claims. The Company has voluntarily dismissed its Texas suit against Guardant and has asserted the claims from the Texas action as counterclaims in the California action, seeking unspecified damages and injunctive relief. In August 2021, Guardant moved to dismiss the Company’s counterclaims, which motion was denied in all material respects. Both parties filed cross-motions for summary judgment, which were granted in part and denied in part. Trial is currently scheduled for November 2024. In November 2021, a purported class action lawsuit was filed against the Company in the United States District Court for the Northern District of California, by a patient alleging various causes of action relating to the Company’s patient billing and seeks, among other relief, class certification, injunctive relief, restitution and/or disgorgement, attorneys’ fees, and costs. In May 2023, the Court granted the Company’s motion to dismiss the lawsuit, and the case was dismissed without prejudice. In July 2023, the plaintiff filed analogous claims in the Superior Court of California, County of San Mateo, and subsequently filed an amended claim with an additional plaintiff. Based on the additional plaintiff, the case was transferred back to the United States District Court for the Northern District of California. The parties subsequently agreed that claims brought by the original plaintiff be remanded back to the Superior Court of California, County of San Mateo, and that the action be stayed pending the outcome of the action in the United States District Court for the Northern District of California. In February 2022, two purported class action lawsuits were filed against the Company in the United States District Court for the Northern District of California. Each suit was filed by an individual patient alleging various causes of action related to the marketing of Panorama and seeking, among other relief, class certification, monetary damages, attorneys’ fees, and costs. These matters have been consolidated. The Company filed a motion to dismiss the consolidated lawsuit, which resulted in the plaintiffs filing an amended complaint in April 2023. In March 2022, a purported class action lawsuit was filed against the Company and certain of its management in the Supreme Court of the State of New York, County of New York, asserting claims under Sections 11, 12, and 15 of the Securities Act of 1933. The complaint alleges, among other things, that the Company failed to disclose certain information regarding its Panorama test. The complaint seeks, among other relief, monetary damages, attorneys’ fees, and costs. This matter has been dismissed and the claims raised in this matter have been included in the lawsuit discussed below. A purported class action lawsuit was filed against the Company and certain of its management in the United States District Court for the Western District of Texas, asserting claims under Sections 10(b) and 20(a) of the Securities Act of 1934 and Rule 10b-5 thereunder. The complaint, filed in April 2022 and amended in October 2022 (to include, among others, the claims raised in the lawsuit discussed in the preceding paragraph), alleges, among other things, that the management defendants made materially false or misleading statements, and/or omitted material information that was required to be disclosed, about certain of the Company’s products and operations. The complaint seeks, among other relief, monetary damages, attorneys’ fees, and costs. The Company filed a motion to dismiss this lawsuit, which was granted in part and denied in part. In each of October 2023 and January 2024, shareholder derivative complaints were filed in the United States District Court for the Western District of Texas and the United States District Court for the District of Delaware, respectively, against the Company as nominal defendant and certain of the Company’s management. Each complaint alleges, among other things, that the management defendants made materially false or misleading statements, and/or omitted material information that was required to be disclosed, about certain of the Company’s products and operations. Each complaint seeks, among other relief, monetary damages, attorneys’ fees, and costs. Director and Officer Indemnifications As permitted under Delaware law, and as set forth in the Company’s Amended and Restated Certificate of Incorporation and its Amended and Restated Bylaws, the Company indemnifies its directors, executive officers, other officers, employees and other agents for certain events or occurrences that may arise while in such capacity. The maximum potential future payments the Company could be required to make under this indemnification is unlimited; however, the Company has insurance policies that may limit its exposure and may enable it to recover a portion of any future amounts paid. Assuming the applicability of coverage, the willingness of the insurer to assume coverage, and subject to certain retention, loss limits and other policy provisions, the Company believes any obligations under this indemnification would not be material, other than standard retention amounts for securities related claims. However, no assurances can be given that the covering insurers will not attempt to dispute the validity, applicability, or amount of coverage without expensive litigation against these insurers, in which case the Company may incur substantial liabilities as a result of these indemnification obligations. Third-Party Payer Reimbursement Audits From time to time, the Company receives recoupment requests from third-party payers for alleged overpayments. The Company disagrees with the contentions of pending requests and/or has recorded an estimated reserve for the alleged overpayments if probable and estimable. ​ Contractual Commitments The following table sets forth the Company’s material contractual commitments as of June 30, 2024: ​ ​ ​ ​ ​ Party Commitments ​ Expiry Date ​ (in thousands) ​ ​ Laboratory instruments supplier $ 4,404 ​ December 2024 Material suppliers ​ 35,581 ​ December 2024 Application service providers ​ 4,191 ​ March 2026 Cloud platform service provider ​ 36,599 ​ December 2028 Leases (1) ​ 420 ​ March 2029 Other material suppliers ​ 22,323 ​ Various Total $ 103,518 ​ ​ (1) Leases

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2024
Stock-Based Compensation
Stock-Based Compensation	9. Stock-Based Compensation Stock-Based Compensation Expense The following tables present the stock-based compensation expense recorded for equity classified awards on selected statements of operations line items for the three and six months ended June 30, 2024 and 2023. ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended June 30, ​ ​ ​ 2024 ​ ​ 2023 ​ ​ (in thousands) Cost of revenues ​ $ 4,046 ​ $ 2,838 Research and development ​ 21,957 ​ 15,337 Selling, general and administrative ​ 41,408 ​ 26,137 Total ​ $ 67,411 ​ $ 44,312 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six months ended June 30, ​ ​ 2024 ​ 2023 ​ (in thousands) ​ Cost of revenues ​ $ 7,823 ​ $ 5,394 ​ Research and development ​ 42,606 ​ 29,977 ​ Selling, general and administrative ​ 81,429 ​ 49,418 ​ Total ​ $ 131,858 ​ $ 84,789 ​ ​ Stock Options The following table summarizes option activity for the six months ended June 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ Number of ​ Average ​ Shares ​ Exercise ​ Outstanding ​ Price ​ (in thousands, except for per share data) December 31, 2023 5,501 ​ $ 23.65 Options exercised (1,078) ​ $ 8.02 June 30, 2024 4,423 ​ $ 27.45 ​ Restricted Stock Units and Performance-Based Awards ​ The following table summarizes unvested RSU and performance-based awards for the six months ended June 30, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ ​ Shares ​ Fair Value ​ ​ (in thousands, except for per share data) Balance at December 31, 2023 ​ 9,248 ​ $ 49.50 Granted ​ 4,786 ​ $ 68.59 Vested ​ (2,443) ​ $ 54.93 Cancelled/forfeited ​ (253) ​ $ 54.27 Balance at June 30, 2024 ​ 11,338 ​ $ 56.59 ​ The Company grants certain senior-level executives performance stock units which vest based on performance and time-based service conditions, which are referred to herein as performance-based awards. During the six months ended June 30, 2024, the Company granted 0.8 million performance-based awards with an aggregate grant date fair value of $55.0 million. Achievement at 200% of target is deemed probable and as a result, the Company expects to recognize a total of $110.0 million over the requisite service period of which $9.4 million and $16.0 million has been recognized for the three and six months ended June 30, 2024, respectively. The Company has recognized $22.1 million and $10.2 million in stock-based compensation for performance-based awards for the three months ended June 30, 2024 and 2023, respectively. The Company has recognized $42.8 million and $17.5 million in stock-based compensation for performance-based awards for the six months ended June 30, 2024 and 2023, respectively.

Debt

Debt	6 Months Ended
	Jun. 30, 2024
Debt
Debt	10 . Debt Credit Line Agreement In September 2015, the Company entered into a credit line with UBS (the “Credit Line”) providing for a $50.0 million revolving line of credit which was fully drawn down in 2016. The Credit Line was amended in July 2017 and bears interest at 30-day LIBOR plus 1.10%. The interest rate was subsequently changed to the 30-day SOFR average, plus 1.21%. The SOFR rate is variable. The interest rate as of June 30, 2024 was 5.84%. The Credit Line was subsequently increased from $50.0 million to $150.0 million in 2020. In November 2022, the Company drew down $30.0 million from the $100.0 million available from the Credit Line. The Credit Line is secured by a first priority lien and security interest in the Company’s money market and marketable securities held in its managed investment account with UBS. The Company is required to maintain a minimum of at least $150.0 million in its UBS accounts as collateral. UBS has the right to demand full or partial payment of the Credit Line obligations and terminate the Credit Line, in its discretion and without cause, at any time. In June 2023, the Credit Line decreased from $150.0 million to $100.0 million. In October 2023, the interest rate for the Credit Line was subsequently changed to the 30-day SOFR average, plus 0.5%. As of June 30, 2024, the Company has drawn down a total of $80.0 million and there is $20.0 million remaining and available on the Credit Line. For both the three months ended June 30, 2024 and 2023, the Company recorded interest expense on the Credit Line of $1.2 million. For both the six months ended June 30, 2024 and 2023, the Company recorded interest expense on the Credit Line of $2.4 million. Interest payments on the Credit Line were made within the same periods. As of June 30, 2024 and December 31, 2023, the total principal amount outstanding with accrued interest was $80.4 million. Convertible Notes ​ In April 2020, the Company issued $287.5 million aggregate principal amount of Convertible Notes due 2027 in a private placement offering to qualified institutional buyers pursuant to Rule 144A under the Securities Act of 1933, as amended. The Convertible Notes are senior, unsecured obligations of the Company and bear interest at a rate of 2.25% per year, payable in cash semi-annually. The Convertible Notes mature in May 2027, unless earlier converted, repurchased or redeemed in accordance with their terms. Upon conversion, the Convertible Notes are convertible into cash, shares of the Company’s common stock or a combination of cash and shares of the Company’s common stock, at the Company’s election. The Company received net proceeds from the Convertible Notes of $278.3 million, after deducting the initial purchasers’ discounts and debt issuance costs. In 2020, the Company used approximately $79.2 million of the net proceeds from the Convertible Notes offering to repay its obligations under its credit agreement with OrbiMed Royalty Opportunities II, LP. The holders of the Convertible Notes may convert all or a portion of their Convertible Notes at their option at any time prior to the close of business on the business day immediately preceding February 1, 2027 in multiples of $1,000 principal amount, under any the following circumstances: ● During any fiscal quarter commencing after September 30, 2020 (and only during such fiscal quarter), if the last reported sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during the period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding fiscal quarter is greater than or equal to 130% of the conversion price on each applicable trading day. ● During the five business day period after any five consecutive trading day period in which the trading price per $1,000 principal amount of Convertible Notes for each trading day of that five-day consecutive trading period was less than 98% of the product of the last reported sale price of the Company’s common stock and the conversion rate on each such trading day. ● If the Company calls any or all of the Convertible Notes for redemption at any time prior to the close of business on the second business day prior to the redemption date. ● Upon the occurrence of certain distributions. ● Upon the occurrence of specified corporate transactions. The first circumstance has been met as of June 30, 2024. However, there were no conversions for the period ending June 30, 2024. The Convertible Notes are convertible into shares of the Company’s common stock, par value $0.0001 per share, at an initial conversion rate of 25.7785 shares of common stock per $1,000 principal amount of the Convertible Notes, which is equivalent to an initial conversion price of approximately $38.79 per share of common stock, convertible to 7,411,704 shares of common stock. The conversion rate and corresponding conversion price are subject to adjustment upon the occurrence of certain events but will not be adjusted for any accrued or unpaid interest. The holders of the Convertible Notes who redeem their Convertible Notes in connection with a make-whole fundamental change are, under certain circumstances, entitled to an increase in the conversion rate. Additionally, in the event of a fundamental change, the holders of the Convertible Notes may require the Company to repurchase for cash all or a portion of their Convertible Notes at a price equal to 100% of the principal amount, plus any accrued and unpaid interest. The Company may not redeem the Convertible Notes prior to May 2024, and no sinking fund is provided for the Convertible Notes. The Company may redeem for cash all or any portion of the Convertible Notes, at the Company’s option, on or after May 2024, if the last reported sale price of the Company’s common stock has been at least 130% of the conversion price then in effect for at least 20 trading days during any 30 consecutive trading day period ending on the trading day immediately preceding the date on which the Company provides notice of redemption. The redemption price will be equal to 100% of the principal amount of the Convertible Notes to be redeemed plus accrued and unpaid interest. Upon adoption of ASU 2020-06, Debt with Conversion and Other Options (Subtopic 470-20) and Derivative and Heading-Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in Entity’s Own Equity ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ (in thousands) Long-Term Debt ​ ​ ​ ​ ​ Outstanding Principal $ 287,500 ​ $ 287,500 Unamortized debt discount and issuance cost ​ (3,896) ​ ​ (4,555) Net carrying amount $ 283,604 ​ $ 282,945 ​ ​ ​ ​ ​ ​ ​ The following tables present total interest expense recognized related to the Convertible Notes during the three and six months ended June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ June 30, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) ​ Cash interest expense ​ ​ ​ ​ ​ ​ Contractual interest expense $ 1,617 ​ $ 1,617 ​ Non-cash interest expense ​ ​ ​ ​ ​ ​ Amortization of debt discount and debt issuance cost ​ 330 ​ ​ 322 ​ Total interest expense $ 1,947 ​ $ 1,939 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six months ended June 30, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) ​ Cash interest expense ​ ​ ​ ​ ​ ​ Contractual interest expense $ 3,234 ​ $ 3,234 ​ Non-cash interest expense ​ ​ ​ ​ ​ ​ Amortization of debt discount and debt issuance cost ​ 658 ​ ​ 642 ​ Total interest expense $ 3,892 ​ $ 3,876 ​ ​

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2024
Income Taxes
Income Taxes	11. Income Taxes During the three months ended June 30, 2024 and 2023, the Company recorded total income tax expense (benefit) of approximately $892,000 and ($282,000), respectively. During the six months ended June 30, 2024 and 2023, the Company recorded total income tax expense (benefit) of approximately $1,320,000 and ($122,000), respectively. The income tax expense is primarily attributable to state income tax and foreign income tax. Due to the Company’s history of cumulative operating losses, the Company concluded that, after considering all the available objective evidence, it is not more likely than not that all of the Company’s net deferred tax assets will be realized. Accordingly, all of the Company’s deferred tax assets, which includes net operating loss carryforwards and tax credits related primarily to research and development, continue to be subjected to a full valuation allowance as of June 30, 2024. The Company will continue to maintain a full valuation allowance until there is sufficient evidence to support recoverability of its deferred tax assets. Interest and/or penalties related to income tax matters are recognized as a component of income tax expense. As of June 30, 2024 and December 31, 2023, there were no accrued interest and penalties related to uncertain tax positions.

Net Loss per Share

Net Loss per Share	6 Months Ended
	Jun. 30, 2024
Net Loss per Share
Net Loss per Share	12. Net Loss per Share The Convertible Notes are convertible by the holders as of June 30, 2024. Upon conversion, the Company has the option to pay cash, issue shares of common stock, or any combination thereof for the aggregate amount due upon conversion. If converted, the fair value of the shares issued to settle the Convertible Notes would exceed the Convertible Note principle by $504.2 million based on the closing price of the Company’s common stock as of June 30, 2024. Since the Company is in a net loss position in the periods presented, the shares which would be issued upon conversion of the Convertible Notes are excluded from the net loss per share calculation as it would have an antidilutive effect. As such, the 7.4 million shares underlying the conversion option of the Convertible Notes have been excluded from the calculation of diluted earnings per share. If converted, the Company does not intend to settle the obligation in cash. The following table shows total outstanding potentially dilutive shares excluded from the computation of diluted loss per share as their effect would be anti-dilutive, as of June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ 2024 2023 ​ (in thousands) Options to purchase common stock ​ 4,423 5,427 Performance-based awards and restricted stock units ​ 11,338 ​ 9,658 Employee stock purchase plan ​ 41 ​ 72 Convertible Notes ​ 7,411 ​ 7,411 Total ​ 23,213 22,568 ​

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2024
Subsequent Events
Subsequent Events	13. Subsequent Events ​ redemption of the Convertible Notes is October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes is equal to 100% of the principal amount of the Convertible Notes to be redeemed plus accrued and unpaid interest to, but excluding, the Redemption Date. The Company elected physical settlement with the Company’s shares of common stock as the settlement method to apply to all conversions of the Convertible Notes. All terms and conditions associated with physical settlement are noted within the terms of the original Indenture Agreement.The conversion rate for holders who convert their Convertible Notes in connection with the Company’s election to redeem the Convertible Notes will be increased by 0.4284 additional shares pursuant to the Indenture Agreement. Based on the conversion terms of the Convertible Notes and the market price of its common stock, the Company expects that substantially all outstanding Convertible Notes will be converted into shares of its common stock prior to the Redemption Date. Should all holders elect to convert their Convertible Notes, approximately 7,534,000 shares of common stock would be issued for settlement. ​

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (37,464)	$ (110,803)	$ (105,063)	$ (247,740)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2024
Summary of Significant Accounting Policies
Basis of Presentation	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the Company’s results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the six months ended June 30, 2024, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2023 has been derived from audited financial statements at that date. These financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2023 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 29, 2024. Some items in the prior period financial statements were reclassified to conform to the current presentation.
Liquidity Matters	Liquidity Matters The Company has incurred net losses since its inception and anticipates net losses for the near future. The Company had a net loss of $105.1 million for the six months ended June 30, 2024 and an accumulated deficit of $2.5 billion as of June 30, 2024. As of June 30, 2024, the Company had $796.8 million in cash, cash equivalents, and restricted cash, $90.3 million in marketable securities, an $80.4 million outstanding balance on its Credit Line (as defined in Note 10, Debt While the Company has introduced multiple products that are generating revenues, these revenues have not been sufficient to fund all operations and business plans. Accordingly, the Company has funded the portion of operating costs that exceeds revenues through a combination of equity issuances, debt issuances, and other financings. The Company continues to invest in the development and commercialization of its existing and future products and, consequently, it will need to generate additional revenues to achieve future profitability and may need to raise additional equity or debt financing. If the Company raises additional funds by issuing equity securities, its stockholders will experience dilution. Additional debt financing, if available, may involve covenants restricting its operations or its ability to incur additional debt. Any additional debt financing or additional equity that the Company raises may contain terms that are not favorable to it or its stockholders and requires significant debt service payments, which diverts resources from other activities. Additional financing may not be available when necessary, or in amounts or on terms acceptable to the Company. If the Company is unable to obtain additional financing, it may be required to delay the development and commercialization of its products and significantly scale back its business and operations. On July 19, 2024, the Company announced its decision to redeem all of its outstanding 2.25% Convertible Senior Notes due 2027. The redemption is scheduled for October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes is equal to 100% of the principal amount of the Convertible Notes to be redeemed plus accrued and unpaid interest to, but excluding, the Redemption Date. The Company elected physical settlement with shares of its common stock as the settlement method to apply to all conversions of the Convertible Notes. Based on the conversion terms of the Convertible Notes and the market price of its common stock, the Company expects that substantially all outstanding Convertible Notes will be converted into shares of the Company’s common stock prior to the Redemption Date. As a result, the Company does not expect that its decision to redeem the Convertible Notes will have a material effect on its liquidity. In September 2023, the Company completed an underwritten equity offering and sold 4,550,000 shares of its common stock at a price of $55 per share to the public. Before estimated offering expenses of $0.4 million, the Company received proceeds of approximately $235.8 million net of the underwriting discount. On September 10, 2021, the Company entered into an agreement with a third party for an asset acquisition where the acquired asset was in-process research and development primarily in exchange for an equity consideration payment. In addition, pursuant to the agreement, certain employees of the third party became employees of the Company. The third party was a biotechnology company focused on oncology. The total upfront acquisition consideration amounts to $35.6 million composed of the issuance of 276,346 shares of the Company's common stock with a fair value of $30.9 million, approximately $3.9 million of cash consideration, assumed net liabilities of $0.2 million, as well as $0.6 million of acquisition related legal and accounting costs directly attributable to the acquisition of the asset. The Company accounted for the transaction as an asset acquisition as substantially all of the estimated fair value of the gross assets acquired was concentrated in a single identified in-process research and development asset (“IPR&D”) thus satisfying the requirements of the screen test in Accounting Standards Update (“ASU”) 2017-01 Business Combinations (Topic 805): Clarifying the Definition of Business Further, additional consideration aggregating up to approximately $35.0 million was estimated to be paid via issuance of an estimated 269,547 additional shares of the Company’s common stock, consistent with the registration statement filed with the SEC on September 10, 2021, upon achievement of defined milestones relating to product development, commercial launch and continued employment of certain selling shareholders, each of which was revalued at each reporting date and amount of compensation expense was adjusted accordingly and reported in research and development expenses. In November 2022, the terms of the payment for any remaining consideration were modified, resulting in $10.0 million of consideration paid in December 2022 and $15.0 million of consideration paid in March 2023, with such consideration primarily consisting of the Company’s common stock. Based on the Company’s current business plan, the Company believes that its existing cash and marketable securities will be sufficient to meet its anticipated cash requirements for at least 12 months after August 8, 2024.
Principles of Consolidation	Principles of Consolidation ​ The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. The Company established a subsidiary that operates in the state of Texas to support the Company’s laboratory and operational functions. The Company established a subsidiary that operates in Canada following the acquisition of the IPR&D asset. All intercompany balances and transactions have been eliminated.
Use of Estimates	Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles (GAAP) in the United States requires management to make estimates and assumptions about future events that affect the amounts of assets and liabilities reported, disclosures about contingent assets and liabilities, and reported amounts of revenues and expenses. Significant items subject to such estimates include the allowance for doubtful accounts, the operating right-of-use assets and the associated lease liabilities, the average useful life for property and equipment including impairment estimates, deferred revenues associated with unsatisfied performance obligations, accrued liability for potential refund requests, stock-based compensation, the fair value of options, income tax uncertainties, and the expected consideration to be received from contracts with customers, insurance payors, and patients. These estimates and assumptions are based on management's best estimates and judgment. Management regularly evaluates its estimates and assumptions using historical experience and other factors, including contractual terms and statutory limits; however, actual results could differ from these estimates and could have an adverse effect on the Company's financial statements. ​
Investments	Investments Investments consist primarily of debt securities such as U.S. Treasuries, U.S. agency and municipal bonds. Management determines the appropriate classification of securities at the time of purchase and re-evaluates such determination at each balance sheet date. The Company generally classifies its entire investment portfolio as available-for-sale. The Company views its available-for-sale portfolio as available for use in current operations. Accordingly, the Company classifies all investments as short-term, irrespective of maturity date. Available-for-sale securities are carried at fair value, with unrealized gains and losses reported in accumulated other comprehensive income (loss), which is a separate component of stockholders’ equity. ​ Available-for-sale debt securities. Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments losses for available-for-sale debt securities held at the reporting date over the remaining life based on historical experience, current conditions, and reasonable and supportable forecasts. The Company evaluated its investment portfolio under the available-for-sale debt securities impairment model guidance and determined the Company’s investment portfolio is composed of low-risk, investment grade securities and thus has not recorded an expected credit loss for its investment portfolio. Further, gross unrealized losses on available for sale securities were not material at June 30, 2024.
Accounts Receivable	Accounts Receivable Trade accounts receivable and other receivables. Balance Sheet Components Revenue from Contracts with Customers
Inventory	Inventory ​ Inventory is recorded at the lower of cost or net realizable value, determined on a first-in, first-out basis. Inventory consists entirely of supplies, which the Company consumes when providing its test reports, and therefore, the Company does not maintain any finished goods inventory. The Company enters into inventory purchases commitments so that it can meet future delivery schedules based on forecasted demand for its tests. ​
Other Assets	Other Assets ​ In January 2024, the Company acquired from Invitae Corp. (“Invitae”) certain assets relating to Invitae’s non-invasive prenatal screening and carrier screening business. The transaction price of $10.5 million consisted of $10.0 million in upfront payment costs and approximately $0.5 million of other transaction costs which were capitalized as intangible assets over an estimated useful life of ten years. An additional payment of up to $42.5 million may be made should the Company achieve certain customer volume retention targets and based on certain legal outcomes.
Accumulated Other Comprehensive Income (Loss)	Accumulated Other Comprehensive Income (Loss) Comprehensive loss and its components encompass all changes in equity other than those with stockholders, and include net loss, unrealized gains and losses on available-for-sale marketable securities and foreign currency translation adjustments. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ June 30, ​ June 30, ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ (in thousands) Beginning balance $ (2,192) ​ $ (11,798) ​ $ (3,085) ​ $ (16,362) Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment ​ 834 ​ ​ 2,595 ​ ​ 1,727 ​ ​ 7,159 Ending balance $ (1,358) ​ $ (9,203) ​ $ (1,358) ​ $ (9,203) ​ The change in net unrealized loss on available-for-sale securities is due to increased market volatility. The Company has assessed the unrealized loss position for available-for-sale securities and determined that an allowance for credit loss was not necessary.
Revenue Recognition	Revenue Recognition ​ The Company recognizes revenue under, ASC 606, using the following five step process: ​ ● Identification of a contract, or contracts, with a customer; ● Identification of the performance obligations in the contract; ● Determination of the transaction price; ● Allocation of the transaction price to the performance obligations in the contract; and ● Revenue recognition when, or as, the performance obligations are satisfied. ​ ​ ​ Revenue Recognition,
Fair Value	Fair Value ​ The Company discloses the fair value of financial instruments for financial assets and liabilities for which the value is practicable to estimate. Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (exit price).
Related Party	Related Party ​ On December 6, 2021, the Company participated along with certain other investors in the series B financing of MyOme, Inc. (“MyOme”), and purchased preferred shares and warrants in exchange for a cash payment of approximately $4.0 million. The Company does not hold a seat on MyOme’s board of directors. The Company’s investment in MyOme is recorded at cost and no impairment was identified as of June 30, 2024. The following are the Company’s related persons and the basis of each such related person’s relationship with MyOme: ● Matthew Rabinowitz, the Company’s executive chairman and co-founder, is the chairman of the board and founder of MyOme, and a beneficial holder of approximately 26.5% of the outstanding shares of MyOme on a fully dilutive basis; ​ ● Jonathan Sheena, the Company’s co-founder and a member of the Company’s board of directors, is a stockholder and a member of the board of directors of MyOme; ​ ● Daniel Rabinowitz, the Company’s Secretary and Chief Legal Officer, is a stockholder of MyOme; and ​ ● Roelof Botha, the Lead Independent Director of the Company’s board of directors, is a managing member of Sequoia Capital. Certain funds affiliated with Sequoia Capital also participated in MyOme’s series B financing. None of the related party investments in MyOme by our executives and directors noted above were at the behest of the Company nor funded by the Company. In February 2024, the Company entered into a collaboration and commercialization agreement (the “Collaboration Agreement”) with MyOme pursuant to which the parties will partner to offer certain genetic testing services to be developed and funded solely by MyOme and overseen by a joint steering committee. The Company will assist MyOme with commercial activities. In connection with the Collaboration Agreement, the Company received a 10-year warrant to purchase 3,058,485 shares of MyOme's common stock at an exercise price of $0.25 per share, which will vest upon a MyOme liquidity event (as such terms are defined in MyOme's certificate of incorporation). The warrants were valued using the Black-Scholes valuation model on the date of acquisition and are accounted for using the measurement alternative. No impairment was identified as of June 30, 2024. The warrants have been included within other assets and deferred revenue, long-term portion and other liabilities, which will be recognized as a reduction of selling and marketing expense upon commercialization and sale of the products contemplated under the Collaboration Agreement. Subject to the Company's achievement of certain commercialization milestones, the Company may receive additional warrants to purchase MyOme’s Series B Preferred Stock. To the extent the genetic testing services are successfully commercialized, the Company will owe certain royalty payments to MyOme. Should the Company exercise all its MyOme common stock warrants, the Company would hold an accumulated 12.4% of MyOme on a fully diluted basis.
Risk and Uncertainties	Risk and Uncertainties Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents, and restricted cash, accounts receivable and investments. The Company limits its exposure to loss by placing its cash in financial institutions with high credit ratings. The Company's cash may consist of deposits held with banks that may at times exceed federally insured limits of $250,000 per customer. The Company performs evaluations of the relative credit standing of these financial institutions and limits the amount of credit exposure with any one institution. For the three and six months ended June 30, 2024, and 2023, there were no customers exceeding 10% of total revenues on an individual basis. As of June 30, 2024 and December 31, 2023, there were no customers with an outstanding balance exceeding 10% of net accounts receivable. For the three months ended June 30, 2024 and 2023, approximately 10.3% and 12.5%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. For the six months ended June 30, 2024 and 2023, approximately 10.9% and 13.2%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. As of June 30, 2024 and December 31, 2023, approximately 8.8% and 10.2%, respectively, of accounts receivable are expected to be paid by Medicare on behalf of multiple customers.
Recent Accounting Pronouncements	Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date. Unless otherwise discussed below, the Company believes that the impact of accounting standards updates recently issued that are not yet effective will not have a material impact on its financial position or results of operations upon adoption. New Accounting Pronouncements Not Yet Adopted In March 2020, ASU 2020-04, Reference Rate Reform (Topic 848) Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848 In November 2023, ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures In December 2023, ASU 2023-09, Income Taxes - Improvements to Income Tax Disclosures

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2024
Summary of Significant Accounting Policies
Schedule of Accumulated Other Comprehensive Income (Loss)	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ June 30, ​ June 30, ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ (in thousands) Beginning balance $ (2,192) ​ $ (11,798) ​ $ (3,085) ​ $ (16,362) Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment ​ 834 ​ ​ 2,595 ​ ​ 1,727 ​ ​ 7,159 Ending balance $ (1,358) ​ $ (9,203) ​ $ (1,358) ​ $ (9,203)

Revenue Recognition (Tables)

Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2024
Revenue Recognition
Schedule of disaggregation of revenues by payer types	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ ​ June 30, ​ June 30, ​ ​ 2024 ​ 2023 ​ 2024 ​ 2023 ​ ​ (in thousands) Insurance carriers ​ $ 384,128 ​ $ 226,521 ​ $ 725,156 ​ $ 436,899 Laboratory and other partners ​ ​ 22,254 ​ ​ 27,449 ​ ​ 42,530 ​ ​ 50,254 Patients ​ ​ 6,969 ​ ​ 7,434 ​ ​ 13,406 ​ ​ 16,007 Total revenues ​ $ 413,351 ​ $ 261,404 ​ $ 781,092 ​ $ 503,160
Schedule of total revenue by geographic area	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ Six months ended ​ ​ June 30, ​ June 30, ​ 2024 2023 2024 ​ 2023 ​ ​ (in thousands) ​ United States $ 404,872 ​ $ 253,296 ​ $ 764,285 ​ $ 486,550 ​ Americas, excluding U.S. ​ 1,601 ​ ​ 1,206 ​ ​ 3,082 ​ ​ 2,364 ​ Europe, Middle East, India, Africa ​ 5,439 ​ ​ 5,620 ​ ​ 10,617 ​ ​ 10,816 ​ Asia Pacific and Other ​ 1,439 ​ ​ 1,282 ​ ​ 3,108 ​ ​ 3,430 ​ Total revenues $ 413,351 ​ $ 261,404 ​ $ 781,092 ​ $ 503,160 ​
Schedule of beginning and ending balances of accounts receivable and deferred revenues	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ June 30, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Assets: ​ ​ ​ ​ ​ ​ Accounts receivable, net ​ $ 335,936 ​ $ 278,289 Liabilities: ​ ​ ​ ​ ​ ​ Deferred revenue, current portion ​ $ 18,367 ​ $ 16,612 Deferred revenue, long-term portion ​ ​ 18,416 ​ ​ 19,128 Total deferred revenues ​ $ 36,783 ​ $ 35,740
Schedule of changes in the balance of deferred revenues	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ ​ June 30, ​ ​ 2024 ​ ​ 2023 ​ (in thousands) Beginning balance ​ $ 35,740 ​ $ 30,778 Increase in deferred revenues ​ ​ 14,826 ​ ​ 17,402 Revenue recognized during the period that was included in deferred revenues at the beginning of the period ​ ​ (9,646) ​ ​ (7,521) Revenue recognized from performance obligations satisfied within the same period ​ ​ (4,137) ​ ​ (3,513) Ending balance ​ $ 36,783 ​ $ 37,146

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2024
Fair Value Measurements
Summary of financial assets and liabilities measured on recurring basis	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ Level I ​ Level II ​ Level III Total Level I ​ Level II ​ Level III Total ​ ​ (in thousands) Financial Assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (1) ​ $ 796,798 ​ $ — ​ $ — ​ $ 796,798 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 U.S. Treasury securities ​ ​ 58,814 ​ ​ — ​ ​ — ​ ​ 58,814 ​ ​ 200,418 ​ ​ — ​ ​ — ​ ​ 200,418 Municipal securities ​ ​ — ​ ​ 31,485 ​ ​ — ​ ​ 31,485 ​ ​ — ​ ​ 36,464 ​ ​ — ​ ​ 36,464 Total financial assets ​ $ 855,612 ​ $ 31,485 ​ $ — ​ $ 887,097 ​ $ 842,513 ​ $ 36,464 ​ $ — ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​

Financial Instruments (Tables)

Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2024
Financial Instruments
Schedule of available-for-sale securities	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ Amortized Cost Gross Unrealized Gain Gross Unrealized Loss Estimated Fair Value Amortized Cost Gross Unrealized Gain Gross Unrealized Loss Estimated Fair Value ​ ​ (in thousands) ​ ​ Cash, cash equivalents and restricted cash (2) ​ $ 796,798 ​ $ — ​ $ — ​ $ 796,798 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 U.S. Treasury securities (1) ​ 58,923 ​ — ​ ​ (109) ​ 58,814 ​ 201,522 ​ 14 ​ (1,118) ​ 200,418 Municipal securities (1) ​ ​ 32,556 ​ ​ — ​ ​ (1,071) ​ ​ 31,485 ​ ​ 38,091 ​ ​ — ​ ​ (1,627) ​ ​ 36,464 Total ​ $ 888,277 ​ $ — ​ $ (1,180) ​ $ 887,097 ​ $ 881,708 ​ $ 14 ​ $ (2,745) ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Classified as: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (2) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 796,798 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 642,095 Short-term investments ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 90,299 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 236,882 Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 887,097 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 878,977 ​ (1) Per the Company’s investment policy, all debt securities are classified as short-term investments irrespective of holding period. (2) Cash equivalents includes liquid demand deposits, and money market funds.
Schedule of debt securities available-for-sale in unrealized loss position	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Less Than 12 Months ​ 12 Months or Longer ​ Total ​ ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ (in thousands) U.S. Treasury securities ​ $ 23,923 ​ $ — ​ $ 34,891 ​ $ (109) ​ $ 58,814 ​ $ (109) Municipal securities ​ ​ — ​ ​ — ​ ​ 31,485 ​ ​ (1,071) ​ ​ 31,485 ​ ​ (1,071) Total ​ $ 23,923 ​ $ — ​ $ 66,376 ​ $ (1,180) ​ $ 90,299 ​ $ (1,180)
Summarized portfolio of available-for-sale securities by contractual maturity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ ​ Amortized Cost ​ Fair Value ​ ​ (in thousands) Less than or equal to one year ​ $ 75,440 ​ $ 75,003 Greater than one year but less than five years ​ ​ 16,039 ​ ​ 15,296 Total ​ $ 91,479 ​ $ 90,299 ​

Balance Sheet Components (Table

Balance Sheet Components (Tables)	6 Months Ended
	Jun. 30, 2024
Balance Sheet Components
Schedule of allowances for credit losses related to trade accounts receivable and other receivables	​ The following is a roll-forward of the allowances for doubtful accounts related to trade accounts receivable for the three and six months ended June 30, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ June 30, ​ ​ 2024 ​ ​ 2023 ​ ​ ​ (in thousands) Beginning balance ​ $ 7,252 ​ $ 5,134 (Reversal of) Provision for doubtful accounts ​ ​ (185) ​ ​ 446 Write-offs ​ ​ (46) ​ ​ — Total ​ $ 7,021 ​ $ 5,580 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six Months Ended ​ June 30, ​ ​ 2024 ​ 2023 ​ ​ ​ (in thousands) Beginning balance ​ $ 6,481 ​ $ 3,830 Provision for doubtful accounts ​ ​ 744 ​ ​ 1,750 Write-offs ​ ​ (204) ​ ​ — Total ​ $ 7,021 ​ $ 5,580
Schedule of property and equipment	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ December 31, ​ Useful Life 2024 2023 ​ ​ (in thousands) Machinery and equipment 3- 5 $ 94,785 ​ $ 85,626 Computer equipment 3 years ​ 3,040 ​ 1,850 Purchased and capitalized software held for internal use 3 years ​ 10,672 ​ ​ 11,636 Leasehold improvements Lesser of useful life or lease term ​ 47,666 ​ 38,999 Construction-in-process ​ ​ 41,577 ​ 29,392 ​ ​ ​ 197,740 ​ 167,503 Less: Accumulated depreciation and amortization ​ ​ (64,460) ​ (56,293) Total Property and Equipment, net ​ $ 133,280 ​ $ 111,210
Schedule of other accrued liabilities	​ ​ ​ ​ ​ ​ ​ ​ June 30, December 31, ​ 2024 2023 ​ (in thousands) Reserves for refunds to insurance carriers $ 16,465 ​ $ 23,245 Accrued charges for third-party testing ​ 10,574 ​ ​ 14,823 Testing and laboratory materials from suppliers ​ 14,142 ​ ​ 11,229 Marketing and corporate affairs ​ 11,792 ​ ​ 10,085 Short term advances ​ 13,899 ​ ​ — Legal, audit and consulting fees ​ 31,979 ​ 43,897 Accrued shipping charges ​ 1,800 ​ ​ 3,646 Sales and income tax payable ​ 4,053 ​ ​ 3,731 Accrued third-party service fees ​ 8,173 ​ ​ 7,111 Clinical trials and studies 7,502 ​ ​ 12,126 Operating lease liabilities, current portion ​ 12,384 ​ ​ 11,621 Property and equipment purchases ​ 5,330 ​ ​ 4,316 Other accrued interest ​ 1,078 ​ ​ 1,078 Other accrued expenses 2,060 ​ ​ 2,497 Total other accrued liabilities $ 141,231 ​ $ 149,405
Summary of reserve balance and activities for refunds to insurance carriers	​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ 2024 2023 ​ (in thousands) Beginning balance $ 23,245 ​ $ 18,948 Additional reserves 1,065 ​ 5,148 Refunds to carriers (3,095) ​ ​ (963) Reserves released to revenue ​ (4,750) ​ ​ (7,653) Ending balance $ 16,465 ​ $ 15,480 ​ ​ ​ ​ ​ ​

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2024
Leases.
Schedule of lease liabilities	​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ December 31, ​ 2024 ​ 2023 ​ ​ (in thousands) Operating lease liabilities, current portion included in other accrued liabilities $ 12,384 ​ $ 11,621 Operating lease liabilities, long-term portion ​ 61,225 ​ ​ 67,025 Total operating lease liabilities $ 73,609 ​ $ 78,646
Schedule of annual minimum lease payments	​ ​ ​ ​ ​ Operating Leases ​ (in thousands) As of June 30, 2024 ​ ​ 2024 (remaining 6 months) $ 8,449 2025 ​ 17,155 2026 ​ 17,450 2027 ​ 14,345 2028 ​ 6,675 2029 and thereafter ​ 27,928 ​ ​ 92,002 Less: imputed interest ​ (18,393) Operating lease liabilities $ 73,609 ​

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies
Schedule of material contractual commitments	Contractual Commitments The following table sets forth the Company’s material contractual commitments as of June 30, 2024: ​ ​ ​ ​ ​ Party Commitments ​ Expiry Date ​ (in thousands) ​ ​ Laboratory instruments supplier $ 4,404 ​ December 2024 Material suppliers ​ 35,581 ​ December 2024 Application service providers ​ 4,191 ​ March 2026 Cloud platform service provider ​ 36,599 ​ December 2028 Leases (1) ​ 420 ​ March 2029 Other material suppliers ​ 22,323 ​ Various Total $ 103,518 ​ ​ (1) Leases

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2024
Stock-Based Compensation
Summary of stock-based compensation expenses	The following tables present the stock-based compensation expense recorded for equity classified awards on selected statements of operations line items for the three and six months ended June 30, 2024 and 2023. ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended June 30, ​ ​ ​ 2024 ​ ​ 2023 ​ ​ (in thousands) Cost of revenues ​ $ 4,046 ​ $ 2,838 Research and development ​ 21,957 ​ 15,337 Selling, general and administrative ​ 41,408 ​ 26,137 Total ​ $ 67,411 ​ $ 44,312 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six months ended June 30, ​ ​ 2024 ​ 2023 ​ (in thousands) ​ Cost of revenues ​ $ 7,823 ​ $ 5,394 ​ Research and development ​ 42,606 ​ 29,977 ​ Selling, general and administrative ​ 81,429 ​ 49,418 ​ Total ​ $ 131,858 ​ $ 84,789 ​
Summary of stock option activity	​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ Number of ​ Average ​ Shares ​ Exercise ​ Outstanding ​ Price ​ (in thousands, except for per share data) December 31, 2023 5,501 ​ $ 23.65 Options exercised (1,078) ​ $ 8.02 June 30, 2024 4,423 ​ $ 27.45
RSU and performance-based awards	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ Average ​ ​ ​ ​ Grant Date ​ ​ Shares ​ Fair Value ​ ​ (in thousands, except for per share data) Balance at December 31, 2023 ​ 9,248 ​ $ 49.50 Granted ​ 4,786 ​ $ 68.59 Vested ​ (2,443) ​ $ 54.93 Cancelled/forfeited ​ (253) ​ $ 54.27 Balance at June 30, 2024 ​ 11,338 ​ $ 56.59

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2024
Debt
Schedule of outstanding Convertible Notes	​ ​ ​ ​ ​ ​ ​ ​ June 30, 2024 ​ December 31, 2023 ​ (in thousands) Long-Term Debt ​ ​ ​ ​ ​ Outstanding Principal $ 287,500 ​ $ 287,500 Unamortized debt discount and issuance cost ​ (3,896) ​ ​ (4,555) Net carrying amount $ 283,604 ​ $ 282,945 ​ ​ ​ ​ ​ ​
Summary of interest expense	​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ June 30, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) ​ Cash interest expense ​ ​ ​ ​ ​ ​ Contractual interest expense $ 1,617 ​ $ 1,617 ​ Non-cash interest expense ​ ​ ​ ​ ​ ​ Amortization of debt discount and debt issuance cost ​ 330 ​ ​ 322 ​ Total interest expense $ 1,947 ​ $ 1,939 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Six months ended June 30, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) ​ Cash interest expense ​ ​ ​ ​ ​ ​ Contractual interest expense $ 3,234 ​ $ 3,234 ​ Non-cash interest expense ​ ​ ​ ​ ​ ​ Amortization of debt discount and debt issuance cost ​ 658 ​ ​ 642 ​ Total interest expense $ 3,892 ​ $ 3,876 ​ ​

Net Loss per Share (Tables)

Net Loss per Share (Tables)	6 Months Ended
	Jun. 30, 2024
Net Loss per Share
Total outstanding potentially dilutive shares	​ ​ ​ ​ ​ ​ ​ ​ June 30, ​ 2024 2023 ​ (in thousands) Options to purchase common stock ​ 4,423 5,427 Performance-based awards and restricted stock units ​ 11,338 ​ 9,658 Employee stock purchase plan ​ 41 ​ 72 Convertible Notes ​ 7,411 ​ 7,411 Total ​ 23,213 22,568 ​

Description of Business (Detail

Description of Business (Details)	6 Months Ended
	Jun. 30, 2024 segment
Description of Business
Number of operating segments	1

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Details) - USD ($) $ / shares in Units, $ in Thousands			1 Months Ended		3 Months Ended		6 Months Ended
	Jul. 19, 2024	Apr. 30, 2020	Sep. 30, 2023	Apr. 30, 2020	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022
Policies
Net Income (Loss)					$ (37,464)	$ (110,803)	$ (105,063)	$ (247,740)
Accumulated deficit					2,482,499		2,482,499		$ 2,377,436
Cash, cash equivalents and restricted cash					796,798	$ 381,113	796,798	$ 381,113	642,095	$ 466,091
Marketable securities					90,299		90,299		236,882
Short-term Credit Line, outstanding balance					80,389		80,389		$ 80,402
Collateral amount					150,000		150,000
Remaining borrowing capacity					$ 20,000		$ 20,000
Common stock, shares issued					123,365,000		123,365,000		119,581,000
Payment of offering expenses			$ 400
Proceeds from issuance of common stock			$ 235,800
Convertible Notes
Policies
Outstanding principal balance		$ 287,500		$ 287,500	$ 287,500		$ 287,500
Per annum interest rate (as a percent)				2.25%			2.25%
Percentage of principal amount converted		100%
Convertible Notes | Subsequent event
Policies
Per annum interest rate (as a percent)	2.25%
Percentage of principal amount converted	100%
Equity offering
Policies
Common stock, shares issued			4,550,000
Stock issued (in dollars per share)			$ 55

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Other Assets (Details) - USD ($) $ in Millions		1 Months Ended
	Sep. 10, 2021	Jan. 31, 2024	Mar. 31, 2023	Dec. 31, 2022
In-process research and development acquisition
Asset Acquisition [Line Items]
Asset acquisition, consideration	$ 35.6		$ 15	$ 10
Issuance of common stock	276,346
Value of common stock issued	$ 30.9
Cash consideration	3.9
Net liabilities assumed	0.2
Acquisition related costs	0.6
Value of additional shares potentially issuable	$ 35
Number of additional shares potentially issuable	269,547
Assets acquired from Invitae
Asset Acquisition [Line Items]
Asset acquisition, consideration		$ 10.5
Cash consideration		10
Potential milestone payments		42.5
Acquisition related costs		$ 0.5
Estimated useful life (in years)		10 years

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - AOCIL (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	$ (2,192)	$ (11,798)	$ (3,085)	$ (16,362)
Ending balance	(1,358)	(9,203)	(1,358)	(9,203)
Net unrealized gain on available-for-sale securities, net of tax and foreign currency translation adjustment
Accumulated Other Comprehensive Income (Loss) [Line Items]
Increase (decrease) in other comprehensive loss	$ 834	$ 2,595	$ 1,727	$ 7,159

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Related Party (Details) - MyOme, Inc. - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	6 Months Ended
	Feb. 29, 2024	Jun. 30, 2024	Dec. 06, 2021
Related Party Transaction [Line Items]
Investment in equity securities without readily determinable fair value			$ 4
Equity securities without readily determinable fair value, impairment loss		$ 0
Warrants term	10 years
Warrants convertible into number of common stock shares	3,058,485
Warrants exercise price (in dollars per share)	$ 0.25
Warrants impairment		$ 0
Ownership percentage if warrants are exercised	12.40%
Executive chairman
Related Party Transaction [Line Items]
Ownership percentage			26.50%

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Risks and Uncertainties (Details) - Customer - customer	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Sales
Risk and Uncertainties
Number of customers exceeding 10% of benchmark	0	0	0	0
Sales | Medicare
Risk and Uncertainties
Concentration risk (as a percent)	10.30%	12.50%	10.90%	13.20%
Accounts receivable
Risk and Uncertainties
Number of customers exceeding 10% of benchmark			0		0
Accounts receivable | Medicare
Risk and Uncertainties
Concentration risk (as a percent)			8.80%		10.20%

Revenue Recognition (Details)

Revenue Recognition (Details) $ / shares in Units, $ in Thousands	1 Months Ended			3 Months Ended			6 Months Ended
	Mar. 31, 2023 USD ($) item	Aug. 31, 2019	Feb. 28, 2019 USD ($)	Jun. 30, 2024 USD ($) $ / shares	Jun. 30, 2023 USD ($) $ / shares	Mar. 31, 2023 USD ($)	Jun. 30, 2024 USD ($) $ / shares	Jun. 30, 2023 USD ($) $ / shares	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Jun. 30, 2019 USD ($)
Allowances on accounts receivable									$ 1,300
Other assets				$ 29,311			$ 29,311		15,403
Deferred revenue				36,783	$ 37,146		36,783	$ 37,146	35,740	$ 30,778
Disruption at Change Healthcare
Allowances on accounts receivable				16,600			$ 16,600
Product
Approximate percentage of revenue collected within 9 months							90%
Billing collection period (in months)							9 months
Extended billing collection period (in months)							6 months
Increased (decreased) revenues				1,700	800		$ 3,800	6,500
(Increased) decreased net loss				$ 1,700	$ 800		$ 3,800	$ 6,500
(Increased) decreased net loss per share | $ / shares				$ 0.01	$ 0.01		$ 0.03	$ 0.06
Tests delivered in prior periods that were fully collected
Increased (decreased) revenues				$ 39,900	$ 3,400		$ 73,700	$ (5,800)
(Increased) decreased net loss				$ 39,900	$ 3,400		$ 73,700	$ (5,800)
(Increased) decreased net loss per share | $ / shares				$ 0.32	$ 0.03		$ 0.60	$ (0.05)
Tests delivered in prior periods that were fully collected | Disruption at Change Healthcare
Allowances on accounts receivable				$ 1,300			$ 1,300
Amounts not refunded to insurance carriers
Increased (decreased) revenues				1,900			4,100
(Increased) decreased net loss				$ 1,900			$ 4,100
(Increased) decreased net loss per share | $ / shares				$ 0.02			$ 0.03
BGI Genomics
Revenue recognized			$ 44,000
Agreement term			10 years
Revenue, remaining performance obligation			$ 6,000
Transaction price			50,000
Contract asset				$ 4,500			$ 4,500
Other assets				3,800			3,800
Prepaid expenses and other current assets				600			600
Prepaid royalties			$ 20,000
BGI Genomics | License and related development services
Number of performance obligations | item	2
Revenue, remaining performance obligation	$ 24,000					$ 24,000
BGI Genomics | Sequencing services
Other assets											$ 6,000
BGI Genomics | Sequencing products
Other assets											4,000
BGI Genomics | Sequencing products and services
Other assets											$ 10,000
BGI Genomics | Oncology assay interpretation services
Revenue recognized								$ 600
Revenue, remaining performance obligation									$ 20,000
Deferred revenue				18,900	$ 200		18,900	200
BGI Genomics | Equipment and Services
Equipment and services received				400	1,000		400	2,600
Foundation Medicine ("FMI")
Revenue recognized							24,300
Agreement term		5 years
Automatic renewals, successive period thereafter		1 year
Revenue, remaining performance obligation				7,700			7,700
Transaction price				32,000			32,000
Prepaid royalties				5,000			5,000
Foundation Medicine ("FMI") | Oncology assay interpretation services
Revenue recognized				200	$ 100		200	$ 400
Revenue, remaining performance obligation				5,000			5,000
Deferred revenue				$ 3,000			$ 3,000
Foundation Medicine ("FMI") | Oncology products
Revenue recognized						200
Revenue, remaining performance obligation	$ 19,300					$ 19,300

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Disaggregation of Revenue [Line Items]
Total revenues	$ 413,351	$ 261,404	$ 781,092	$ 503,160
United States
Disaggregation of Revenue [Line Items]
Total revenues	404,872	253,296	764,285	486,550
Americas, excluding U.S.
Disaggregation of Revenue [Line Items]
Total revenues	1,601	1,206	3,082	2,364
Europe, Middle East, India, Africa
Disaggregation of Revenue [Line Items]
Total revenues	5,439	5,620	10,617	10,816
Asia Pacific and Other
Disaggregation of Revenue [Line Items]
Total revenues	1,439	1,282	3,108	3,430
Insurance carriers
Disaggregation of Revenue [Line Items]
Total revenues	384,128	226,521	725,156	436,899
Laboratory partners
Disaggregation of Revenue [Line Items]
Total revenues	22,254	27,449	42,530	50,254
Patients
Disaggregation of Revenue [Line Items]
Total revenues	6,969	7,434	13,406	16,007
Licensing and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 1,987	$ 3,148	$ 5,056	$ 7,107

Revenue Recognition - Accounts

Revenue Recognition - Accounts Receivable and Deferred Revenue (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
Assets
Accounts receivable, net	$ 335,936	$ 278,289
Liabilities:
Deferred revenue, current portion	18,367	16,612
Deferred revenue, long-term portion	18,416	19,128
Total deferred revenues	$ 36,783	$ 35,740	$ 37,146	$ 30,778

Revenue Recognition - Changes i

Revenue Recognition - Changes in Balance of Deferred Revenues (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Revenue Recognition
Beginning balance	$ 35,740	$ 30,778
Increase in deferred revenues	14,826	17,402
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	(9,646)	(7,521)
Revenue recognized from performance obligations satisfied within the same period	(4,137)	(3,513)
Ending Balance	$ 36,783	$ 37,146

Revenue Recognition - Deferred

Revenue Recognition - Deferred Revenues (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	$ 9,646	$ 7,521
Deferred revenue, current portion	18,367		$ 16,612
Deferred revenue, Long-term	18,416		$ 19,128
BGI Genomics
Deferred revenue, current portion	500
Deferred revenue, Long-term	18,400
Foundation Medicine ("FMI")
Deferred revenue, current portion	3,000
BGI Genomics and Foundation Medicine ("FMI")
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	100
Genetic testing services
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	9,500
Deferred revenue, current portion	$ 14,800

Fair Value Measurements (Detail

Fair Value Measurements (Details) - USD ($) $ in Thousands	1 Months Ended	6 Months Ended	21 Months Ended
	Oct. 31, 2023	Jun. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Line Of Credit-UBS
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Line of credit facility, fair value of amount outstanding		$ 80,400		$ 80,400
Line Of Credit-UBS | SOFR
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Spread on interest rate (as a percent)	0.50%	0.50%	1.21%
Level 2 | Convertible Notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of long-term debt		$ 800,700		491,800
Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		887,097		878,977
Recurring | Cash, cash equivalents, and restricted cash
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		796,798		642,095
Recurring | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		58,814		200,418
Recurring | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		31,485		36,464
Recurring | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		855,612		842,513
Recurring | Level 1 | Cash, cash equivalents, and restricted cash
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		796,798		642,095
Recurring | Level 1 | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		58,814		200,418
Recurring | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		31,485		36,464
Recurring | Level 2 | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		$ 31,485		$ 36,464

Financial Instruments (Details)

Financial Instruments (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($) position	Dec. 31, 2023 USD ($)	Jun. 30, 2023 USD ($)	Dec. 31, 2022 USD ($)
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	$ 888,277	$ 881,708
Gross Unrealized Gain		14
Gross Unrealized Loss	(1,180)	(2,745)
Estimated Fair Value	887,097	878,977
Cash, cash equivalents and restricted cash	796,798	642,095	$ 381,113	$ 466,091
Short-term investments	90,299	236,882
Securities Sold	$ 0
Number of investments, unrealized loss position | position	15
Credit loss reserve	$ 0
Less than 12 Months, Fair value	23,923
12 Months or Longer, Fair value	66,376
Fair value	90,299
12 Months or Longer, Unrealized loss	(1,180)
Unrealized loss	(1,180)
Amortized Cost
Less than or equal to one year	75,440
Greater than one year but less than five years	16,039
Total	91,479
Fair Value
Less than or equal to one year	75,003
Greater than one year but less than five years	15,296
Total	90,299
Cash, cash equivalents, and restricted cash
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	796,798	642,095
Estimated Fair Value	796,798	642,095
U.S. Treasury securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	58,923	201,522
Gross Unrealized Gain		14
Gross Unrealized Loss	(109)	(1,118)
Estimated Fair Value	58,814	200,418
Less than 12 Months, Fair value	23,923
12 Months or Longer, Fair value	34,891
Fair value	58,814
12 Months or Longer, Unrealized loss	(109)
Unrealized loss	(109)
Municipal securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	32,556	38,091
Gross Unrealized Loss	(1,071)	(1,627)
Estimated Fair Value	31,485	$ 36,464
12 Months or Longer, Fair value	31,485
Fair value	31,485
12 Months or Longer, Unrealized loss	(1,071)
Unrealized loss	$ (1,071)

Balance Sheet Components - Allo

Balance Sheet Components - Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Balance Sheet Components
Beginning balance	$ 7,252	$ 5,134	$ 6,481	$ 3,830
(Reversal of) Provision for doubtful accounts	(185)	446	744	1,750
Write-offs	(46)		(204)
Total	$ 7,021	$ 5,580	$ 7,021	$ 5,580

Balance Sheet Components - Prop

Balance Sheet Components - Property and Equipment, net (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Property and Equipment, net
Property and equipment, gross	$ 197,740		$ 167,503
Less: Accumulated depreciation and amortization	(64,460)		(56,293)
Total Property and Equipment, net	133,280		111,210
Depreciation expense	13,300	$ 10,200
Impairment charge	0
Equipment pledged	150,000
Machinery and equipment
Property and Equipment, net
Property and equipment, gross	94,785		85,626
Computer equipment
Property and Equipment, net
Property and equipment, gross	$ 3,040		1,850
Useful Life	3 years
Software held for internal use
Property and Equipment, net
Property and equipment, gross	$ 10,672		11,636
Useful Life	3 years
Leasehold improvements
Property and Equipment, net
Property and equipment, gross	$ 47,666		38,999
Construction-in-process
Property and Equipment, net
Property and equipment, gross	$ 41,577		$ 29,392
Minimum | Machinery and equipment
Property and Equipment, net
Useful Life	3 years
Maximum | Machinery and equipment
Property and Equipment, net
Useful Life	5 years

Balance Sheet Components - Othe

Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023	Jun. 30, 2023	Dec. 31, 2022
Balance Sheet Components
Reserves for refunds to insurance carriers	$ 16,465	$ 23,245	$ 15,480	$ 18,948
Accrued charges for third-party testing	10,574	14,823
Testing and laboratory materials from suppliers	14,142	11,229
Marketing and corporate affairs	11,792	10,085
Short term advances	13,899
Legal, audit and consulting fees	31,979	43,897
Accrued shipping charges	1,800	3,646
Sales and income tax payable	4,053	3,731
Accrued third-party service fees	8,173	7,111
Clinical trials and studies	7,502	12,126
Operating lease liabilities, current portion	12,384	11,621
Property and equipment purchases	5,330	4,316
Other accrued interest	1,078	1,078
Other accrued expenses	2,060	2,497
Total other accrued liabilities	$ 141,231	$ 149,405

Balance Sheet Components - Rese

Balance Sheet Components - Reserve Balance and Activities for Refunds (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Balance Sheet Components
Beginning balance	$ 23,245	$ 18,948
Additional reserves	1,065	5,148
Refunds to carriers	(3,095)	(963)
Reserves released to revenue	(4,750)	(7,653)
Ending balance	16,465	$ 15,480
Short term advances	$ 13,900

Leases (Details)

Leases (Details) $ in Thousands	1 Months Ended			3 Months Ended		6 Months Ended
	Oct. 31, 2027 USD ($)	Sep. 30, 2023 USD ($) ft²	Sep. 30, 2021 USD ($) ft²	Jun. 30, 2024 USD ($) ft²	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) ft² lease item	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Lessee, Lease, Description [Line Items]
Operating lease liabilities, current portion included in other accrued liabilities				$ 12,384		$ 12,384		$ 11,621
Operating lease liabilities, long-term portion				61,225		61,225		67,025
Operating lease liabilities				$ 73,609		73,609		$ 78,646
Noncash operating activities related to right-of-use assets						$ 600	$ 0
Weighted average remaining lease term				6 years 3 months 18 days		6 years 3 months 18 days
Weighted average discount rate (as a percent)				6.80%		6.80%
Lease expense				$ 3,600	$ 3,700	$ 7,200	7,500
Operating lease payments				$ 4,100	$ 3,000	$ 8,300	$ 5,200
Austin TX, Long-term Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				94,000		94,000
Number of office space locations | lease						2
Term of lease				132 months		132 months
First Expansion Premises
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				32,500		32,500
Second Expansion Premises
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				65,222		65,222
Corporate Headquarters Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				136,000		136,000
Number of office space locations | item						2
"First Space" Sublease
Lessee, Lease, Description [Line Items]
Number of office space locations | ft²						88,000
"Second Space" Sublease
Lessee, Lease, Description [Line Items]
Number of office space locations | ft²						48,000
Corporate Headquarters Lease Amendment
Lessee, Lease, Description [Line Items]
Annual lease payment						$ 9,300
Term of lease				48 months		48 months
Tukwila, WA Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				10,000		10,000
Term of lease				62 months		62 months
Renewal term of lease				5 years		5 years
San Carlos, CA Sublease Amendment | Forecast
Lessee, Lease, Description [Line Items]
Annual lease payment	$ 10,600
South San Francisco, CA Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²				11,395		11,395
Annual lease payment						$ 900
Term of lease				36 months		36 months
Renewal term of lease				3 years		3 years
Pleasanton, CA Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²		16,319
Annual lease payment		$ 500
Term of lease		60 months
Laboratory space in Canada
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²			7,107
Annual lease payment			$ 200
Term of lease			24 months
Certain workspaces and storage spaces | Minimum
Lessee, Lease, Description [Line Items]
Term of lease				1 year		1 year
Certain workspaces and storage spaces | Maximum
Lessee, Lease, Description [Line Items]
Term of lease				5 years		5 years

Leases - Payments (Details)

Leases - Payments (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Leases.
2024 (remaining 6 months)	$ 8,449
2025	17,155
2026	17,450
2027	14,345
2028	6,675
2029 and thereafter	27,928
Total future minimum lease payments	92,002
Less: imputed interest	(18,393)
Operating lease liabilities	$ 73,609	$ 78,646

Commitments and Contingencies_2

Commitments and Contingencies (Details) $ in Thousands	1 Months Ended
	Jan. 31, 2024 USD ($) patent	Jun. 30, 2023 USD ($) patent	Dec. 31, 2022 patent lawsuit	Mar. 31, 2022 USD ($)	Oct. 31, 2020 patent	Mar. 31, 2020 lawsuit patent	Jun. 30, 2024 USD ($)	Feb. 28, 2022 lawsuit
Other commitments
Loss contingency, patents allegedly infringed, number | patent	2
Amount awarded to other party	$ 57,000
Total commitments							$ 103,518
Laboratory instruments supplier
Other commitments
Total commitments							4,404
Material suppliers
Other commitments
Total commitments							35,581
Application service providers
Other commitments
Total commitments							4,191
Cloud platform service provider
Other commitments
Total commitments							36,599
Leases
Other commitments
Total commitments							420
Other material suppliers
Other commitments
Total commitments							$ 22,323
CareDX Patent Case
Other commitments
Loss contingency, patents allegedly infringed, number | patent						3
Number of invalid patents | patent						3
Gain contingency, patents allegedly infringed, number | patent	1
Number of lawsuits | lawsuit						2
Amount awarded to other party				$ 44,900
Amount awarded from other party	$ 96,300
ArcherDX Case
Other commitments
Gain contingency, patents allegedly infringed, number | patent		3
Amount awarded from other party		$ 19,350
Genosity Inc. Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number | patent					1
Inivata Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number | patent			1
Number of lawsuits | lawsuit			2
Class action
Other commitments
Number of lawsuits | lawsuit								2

Stock-Based Compensation - Comp

Stock-Based Compensation - Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Stock based compensation expense
Stock-based compensation expense	$ 67,411	$ 44,312	$ 131,858	$ 84,789
Cost of revenues
Stock based compensation expense
Stock-based compensation expense	4,046	2,838	7,823	5,394
Research and development
Stock based compensation expense
Stock-based compensation expense	21,957	15,337	42,606	29,977
Selling, general and administrative
Stock based compensation expense
Stock-based compensation expense	41,408	26,137	81,429	49,418
Liability classified awards
Stock based compensation expense
Stock-based compensation expense	$ 200	$ 300	$ 400	$ 500

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Stock Based Compensation
Stock-based compensation expense	$ 67,411	$ 44,312	$ 131,858	$ 84,789
Performance-based awards
Stock Based Compensation
Stock-based compensation expense	$ 22,100	10,200	$ 42,800	17,500
Shares granted			800
Options to purchase common stock
Stock Based Compensation
Options outstanding (in shares)	4,423		4,423		5,501
Liability classified awards
Stock Based Compensation
Stock-based compensation expense	$ 200	$ 300	$ 400	$ 500

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options (Details) - Options to purchase common stock shares in Thousands	6 Months Ended
	Jun. 30, 2024 $ / shares shares
Number of shares Outstanding
Outstanding, beginning balance (in shares) | shares	5,501
Options exercised (in shares) | shares	(1,078)
Outstanding, end balance (in shares) | shares	4,423
Weighted-Average Exercise Price
Outstanding, beginning balance (in dollars per share) | $ / shares	$ 23.65
Exercised (in dollars per share) | $ / shares	8.02
Outstanding, end balance (in dollars per share) | $ / shares	$ 27.45

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Units (Details) - RSU and performance-based awards shares in Thousands	6 Months Ended
	Jun. 30, 2024 $ / shares shares
Shares
Balance (in shares) | shares	9,248
Granted (in shares) | shares	4,786
Vested (in shares) | shares	(2,443)
Canceled/Forfeited (in shares) | shares	(253)
Balance (in shares) | shares	11,338
Weighted Average Grant Date Fair Value
Balance (in dollars per share) | $ / shares	$ 49.50
Granted (in dollars per share) | $ / shares	68.59
Vested (in dollars per share) | $ / shares	54.93
Canceled/Forfeited (in dollars per share) | $ / shares	54.27
Balance (in dollars per share) | $ / shares	$ 56.59

Stock-Based Compensation - Perf

Stock-Based Compensation - Performance-based Awards (Details) - USD ($) $ in Thousands, shares in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 67,411	$ 44,312	$ 131,858	$ 84,789
Performance-based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			0.8
Aggregate value	55,000		$ 55,000
Aggregate value recognized	9,400		$ 16,000
Target (percentage)			200%
Expected compensation expense recognition over requisite service period			$ 110,000
Stock-based compensation expense	$ 22,100	$ 10,200	$ 42,800	$ 17,500

Debt (Details)

Debt (Details) $ / shares in Units, shares in Thousands		1 Months Ended				3 Months Ended		6 Months Ended		21 Months Ended
	Apr. 30, 2020 USD ($) $ / shares	Oct. 31, 2023	Nov. 30, 2022 USD ($)	Apr. 30, 2020 USD ($) D $ / shares	Jul. 31, 2017	Jun. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2023 USD ($)	Sep. 30, 2023	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2020 USD ($)	Sep. 30, 2015 USD ($)
Debt Instrument [Line Items]
Remaining borrowing capacity						$ 20,000,000		$ 20,000,000
Collateral amount						$ 150,000,000		$ 150,000,000
Common Stock, Par or Stated Value Per Share | $ / shares						$ 0.0001		$ 0.0001			$ 0.0001
Common stock, shares issued | shares						123,365		123,365			119,581
Accrued Interest						$ 1,078,000		$ 1,078,000			$ 1,078,000
Amortization of debt discount and issuance cost								658,000	$ 642,000
Interest expense						3,127,000	$ 3,177,000	6,251,000	6,238,000
Convertible Notes
Debt Instrument [Line Items]
Principal amount	$ 287,500,000			$ 287,500,000		287,500,000		$ 287,500,000
Proceeds from Convertible Note, net of issuance costs				$ 278,300,000
Per annum interest rate (as a percent)				2.25%				2.25%
Interest expense						$ 1,947,000	1,939,000	$ 3,892,000	3,876,000
Common Stock, Par or Stated Value Per Share | $ / shares	$ 0.0001			$ 0.0001
Debt instrument, term								7 years
Effective interest rate (as a percent)						2.72%		2.72%
Principal amount per convertible note				$ 1,000
Number of threshold consecutive trading days | D				30
Threshold business days | D				5
Conversion price (in dollars per share) | $ / shares	$ 38.79			$ 38.79
Initial conversion rate	25.7785
Convertible to shares of common stock	7,411,704
Percentage of principal amount converted	100%
Carrying value						$ 283,604,000		$ 283,604,000			282,945,000
5 consecutive trading day period | Convertible Notes
Debt Instrument [Line Items]
Threshold trading days | D				5
Percentage of conversion price				98%
20 trading days period | Convertible Notes
Debt Instrument [Line Items]
Threshold trading days | D				20
Percentage of conversion price				130%
Redeemable for cash on or after May 2024
Debt Instrument [Line Items]
Number of threshold consecutive trading days | D				20
Threshold trading days | D				30
Percentage of conversion price				130%
Percentage of principal amount converted				100%
Level 2 | Convertible Notes
Debt Instrument [Line Items]
Fair value of long-term debt						800,700,000		800,700,000			491,800,000
Line Of Credit-UBS
Debt Instrument [Line Items]
Maximum borrowing capacity			$ 100,000,000				100,000,000		100,000,000			$ 150,000,000	$ 50,000,000
Outstanding balance						80,400,000		80,400,000			$ 80,400,000
Credit facility drawn down								80,000,000
Remaining borrowing capacity						20,000,000		20,000,000
Borrowings under credit facility			$ 30,000,000
Collateral amount						$ 150,000,000		150,000,000
Interest expense								$ 2,400,000	$ 2,400,000
Interest rate (as a percent)						5.84%		5.84%
Interest expense						$ 1,200,000	$ 1,200,000
Line Of Credit-UBS | LIBOR
Debt Instrument [Line Items]
Spread on interest rate (as a percent)					1.10%
Line Of Credit-UBS | SOFR
Debt Instrument [Line Items]
Spread on interest rate (as a percent)		0.50%						0.50%		1.21%
2017 Term Loan
Debt Instrument [Line Items]
Debt, repayment amount				$ 79,200,000

Debt - Discount and Issuance Co

Debt - Discount and Issuance Costs (Details) - Convertible Notes	6 Months Ended
	Jun. 30, 2024
Effective interest rate (as a percent)	2.72%
Debt instrument, term	7 years

Debt - Convertible Notes Balanc

Debt - Convertible Notes Balances (Details) - Convertible Notes - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Outstanding principle	$ 287,500	$ 287,500
Unamortized debt discount and issuance cost	(3,896)	(4,555)
Net carrying amount	$ 283,604	$ 282,945

Debt - Interest Expense Recogni

Debt - Interest Expense Recognized Related To Convertible Notes (Details) - Convertible Notes - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Cash interest expense
Contractual interest expense	$ 1,617	$ 1,617	$ 3,234	$ 3,234
Non-cash interest expense
Amortization of debt discount and debt issuance cost	330	322	658	642
Total interest expense	$ 1,947	$ 1,939	$ 3,892	$ 3,876

Income Taxes (Details)

Income Taxes (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Income Taxes
Income tax expense	$ 892,000	$ (282,000)	$ 1,320,000	$ (122,000)
Interest and penalties accrued	$ 0		$ 0		$ 0

Net Loss per Share - Loss per S

Net Loss per Share - Loss per Share (Details) $ in Millions	6 Months Ended
	Jun. 30, 2024 USD ($)
Convertible Notes
Earnings or Loss per Share [Line Items]
Convertible, If-converted value in excess of principal	$ 504.2

Net Loss per Share - Potentiall

Net Loss per Share - Potentially Dilutive Shares (Details) - shares shares in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	23,213	22,568
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	4,423	5,427
Performance-based awards and restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	11,338	9,658
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	41	72
Convertible Notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	7,411	7,411

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ in Millions			1 Months Ended		6 Months Ended
	Jul. 19, 2024	Apr. 30, 2020	Oct. 31, 2027	Apr. 30, 2020	Jun. 30, 2024	Jul. 31, 2024
San Carlos, CA Sublease Amendment | Forecast
Subsequent Event [Line Items]
Annual lease payment			$ 10.6
Convertible Notes
Subsequent Event [Line Items]
Per annum interest rate (as a percent)				2.25%	2.25%
Percentage of principal amount converted		100%
Subsequent event | San Carlos, CA Sublease Amendment
Subsequent Event [Line Items]
Renewal term of lease						60 months
Subsequent event | Convertible Notes
Subsequent Event [Line Items]
Convertible, if converted common shares aggregate value	$ 287.5
Per annum interest rate (as a percent)	2.25%
Percentage of principal amount converted	100%
Conversion rate increase	0.4284
Subsequent event | Convertible Notes | Maximum
Subsequent Event [Line Items]
Conversion, shares to be issued	7,534,000