Natera (NTRA) 10-K 27 Feb 25 2024 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Feb. 21, 2025	Jun. 30, 2024
Document and Entity Information
Document Type	10-K
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 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 Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
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
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Entity Public Float			$ 13,150
Entity Common Stock, Shares Outstanding		135,186,184
Entity Central Index Key	0001604821
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false
Auditor Name	Ernst & Young LLP
Auditor Location	San Jose, California
Auditor Firm ID	42

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Cash, cash equivalents and restricted cash	$ 945,587	$ 642,095
Short-term investments	22,689	236,882
Accounts receivable, net of allowance of $7,259 in 2024 and $6,481 in 2023	314,165	278,289
Inventory	44,744	40,759
Prepaid expenses and other current assets	48,635	60,524
Total current assets	1,375,820	1,258,549
Property and equipment, net	162,046	111,210
Operating lease right-of-use assets	86,149	56,537
Other assets	36,720	15,403
Total assets	1,660,735	1,441,699
Current liabilities:
Accounts payable	34,922	14,998
Accrued compensation	62,114	45,857
Other accrued liabilities	146,893	149,405
Deferred revenue, current portion	19,754	16,612
Short-term debt financing	80,362	80,402
Total current liabilities	344,045	307,274
Long-term debt financing		282,945
Deferred revenue, long-term portion and other liabilities	24,682	19,128
Operating lease liabilities, long-term portion	96,588	67,025
Total liabilities	465,315	676,372
Commitments and contingencies (Note 8)
Stockholders' equity:
Common stock, $0.0001 par value: 750,000 shares authorized at both December 31, 2024 and 2023; 132,646 and 119,581 shares issued and outstanding at December 31, 2024 and 2023, respectively	12	11
Additional paid-in capital	3,763,614	3,145,837
Accumulated deficit	(2,567,862)	(2,377,436)
Accumulated other comprehensive loss	(344)	(3,085)
Total stockholders' equity	1,195,420	765,327
Total liabilities and stockholders' equity	$ 1,660,735	$ 1,441,699

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Consolidated Balance Sheets
Allowances on accounts receivable	$ 7,259	$ 6,481
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized	750,000,000	750,000,000
Common stock, shares issued	132,646,000	119,581,000
Common stock, shares outstanding	132,646,000	119,581,000

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenues
Total revenues	$ 1,696,911	$ 1,082,571	$ 820,222
Cost and expenses
Research and development	404,138	320,678	316,415
Selling, general and administrative	841,314	618,307	588,591
Total cost and expenses	1,919,205	1,528,816	1,361,262
Loss from operations	(222,294)	(446,245)	(541,040)
Interest expense	(10,685)	(12,638)	(9,319)
Interest and other income, net	43,248	24,353	3,538
Loss before income taxes	(189,731)	(434,530)	(546,821)
Income tax expense	(695)	(271)	(978)
Net loss	(190,426)	(434,801)	(547,799)
Unrealized gain (loss) on available-for-sale securities, net of tax	2,741	13,277	(14,075)
Comprehensive loss	$ (187,685)	$ (421,524)	$ (561,874)
Net loss per share (Note 13):
Basic (in dollars per share)	$ (1.53)	$ (3.78)	$ (5.57)
Diluted (in dollars per share)	$ (1.53)	$ (3.78)	$ (5.57)
Weighted-average number of shares used in computing basic and diluted net loss per share:
Basic (in shares)	124,718	114,997	98,408
Diluted (in shares)	124,718	114,997	98,408
Product
Revenues
Total revenues	$ 1,685,074	$ 1,068,522	$ 797,307
Cost and expenses
Cost of revenues	672,304	588,564	453,632
Licensing and other
Revenues
Total revenues	11,837	14,049	22,915
Cost and expenses
Cost of revenues	$ 1,449	$ 1,267	$ 2,624

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit	Total
Balance at Dec. 31, 2021	$ 10	$ 2,050,417	$ (2,287)	$ (1,394,836)	$ 653,304
Balance (in shares) at Dec. 31, 2021	95,140,000
Issuance of common stock upon exercise of stock options		6,411			6,411
Issuance of common stock upon exercise of stock options (in shares)	828,000
Issuance of common stock under the employee stock purchase plan		13,037			13,037
Issuance of common stock under the employee stock purchase plan (in shares)	437,000
Issuance of common stock for IPR&D milestone		9,290			9,290
Issuance of common stock for IPR&D milestone (in shares)	225,000
Vesting of restricted stock units (in shares)	1,480,000
Stock based compensation		152,384			152,384
Unrealized gain (loss) on available-for sale securities			(14,075)		(14,075)
Issuance of common stock for public offering, net	$ 1	433,191			433,192
Issuance of common stock for public offering, net (in shares)	13,145,000
Net loss				(547,799)	(547,799)
Balance at Dec. 31, 2022	$ 11	2,664,730	(16,362)	(1,942,635)	705,744
Balance (in shares) at Dec. 31, 2022	111,255,000
Issuance of common stock upon exercise of stock options		3,892			3,892
Issuance of common stock upon exercise of stock options (in shares)	298,000
Issuance of common stock under the employee stock purchase plan		15,128			15,128
Issuance of common stock under the employee stock purchase plan (in shares)	392,000
Issuance of stock for bonuses		19,774			19,774
Issuance of stock for bonuses (in shares)	349,000
Issuance of common stock for IPR&D milestone	$ 336	14,435			14,435
Vesting of restricted stock units (in shares)	2,401,000
Stock based compensation		192,437			192,437
Unrealized gain (loss) on available-for sale securities			13,277		13,277
Issuance of common stock for public offering, net		235,441			235,441
Issuance of common stock for public offering, net (in shares)	4,550,000
Net loss				(434,801)	(434,801)
Balance at Dec. 31, 2023	$ 11	3,145,837	(3,085)	(2,377,436)	$ 765,327
Balance (in shares) at Dec. 31, 2023	119,581,000				119,581,000
Issuance of common stock upon exercise of stock options		12,988			$ 12,988
Issuance of common stock upon exercise of stock options (in shares)	1,626,000
Issuance of common stock under the employee stock purchase plan		17,298			17,298
Issuance of common stock under the employee stock purchase plan (in shares)	369,000
Issuance of stock for bonuses		24,071			24,071
Issuance of stock for bonuses (in shares)	270,000
Issuance of common stock for Convertible Notes and accrued interest	$ 1	286,729			286,730
Issuance of common stock for Convertible Notes and accrued interest, (in shares)	7,532,000
Vesting of restricted stock units (in shares)	3,268,000
Stock based compensation		276,691			276,691
Unrealized gain (loss) on available-for sale securities			2,741		2,741
Net loss				(190,426)	(190,426)
Balance at Dec. 31, 2024	$ 12	$ 3,763,614	$ (344)	$ (2,567,862)	$ 1,195,420
Balance (in shares) at Dec. 31, 2024	132,646,000				132,646,000

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating activities:
Net loss	$ (190,426)	$ (434,801)	$ (547,799)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	30,968	24,097	16,702
Expensed in-process research and development		2,679	9,290
Non-cash lease expense	15,325	14,519	13,770
Stock-based compensation	274,428	191,808	152,384
Amortization of premiums and accretion of purchase discounts on investment securities	(618)	1,087	4,837
Loss on investments			906
Foreign exchange adjustment	462	265	(2)
Amortization of debt discount and issuance cost	991	1,292	1,259
Non-cash interest expense	2,835	52	302
Non-cash expense recovery	(442)
Changes in operating assets and liabilities:
Accounts receivable	(35,876)	(33,904)	(122,311)
Inventory	(3,985)	(5,353)	(8,497)
Operating lease right-of-use assets		8,354	622
Prepaid expenses and other assets	10,807	(26,072)	(1,202)
Accounts payable	13,210	(15,458)	5,462
Accrued compensation	40,328	21,619	3,069
Operating lease liabilities	(16,819)	(12,448)	(9,999)
Other accrued liabilities	(6,376)	10,347	47,650
Deferred revenue	852	4,962	2,056
Net cash provided by (used in) operating activities	135,664	(246,955)	(431,501)
Investing activities:
Purchases of investments	(122,010)	(98,303)	(86,947)
Proceeds from sale of investments	24,822		248,482
Proceeds from maturity of investments	314,400	306,000	216,500
Purchases of property and equipment	(66,423)	(39,199)	(47,697)
Investment in related party	(2,670)
Cash paid for acquisition of intangible assets	(10,495)
Net cash provided by investing activities	137,624	168,498	330,338
Financing activities:
Proceeds from exercise of stock options	12,988	3,892	6,411
Proceeds from the issuance of common stock under the employee stock purchase plan	17,298	15,128	13,037
Proceeds from public offering, net of issuance cost		235,441	433,192
Proceeds from Credit Line			30,000
Cash redemption on Convertible Note	(82)
Net cash provided by financing activities	30,204	254,461	482,640
Net change in cash, cash equivalents and restricted cash	303,492	176,004	381,477
Beginning cash, cash equivalents and restricted cash	642,095	466,091	84,614
Ending cash, cash equivalents and restricted cash	945,587	642,095	466,091
Supplemental disclosure of cash flow information:
Cash paid for income taxes	1,307	295	549
Cash paid for interest	7,897	11,346	8,060
Non-cash activities:
Purchases of property and equipment in accounts payable and accruals	9,374	1,582	$ (1,940)
Acquisition of warrants	9,424
Amounts accrued for acquisition of intangible assets	1,400
Issuance of common stock for IPR&D milestone		14,435
Issuance of common stock for bonuses	24,071	19,774
Stock-based compensation included in capitalized software development costs	2,263	$ 629
Debt and interest converted into equity	$ 286,730

Description of Business

Description of Business	12 Months Ended
	Dec. 31, 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	12 Months Ended
	Dec. 31, 2024
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2 Summary of Significant Accounting Policies ​ Basis of Presentation ​ The accompanying consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”). ​ 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 $190.4 million for the year ended December 31, 2024 and an accumulated deficit of $2.6 billion as of December 31, 2024. As of December 31, 2024, the Company had $945.6 million in cash, cash equivalents, and restricted cash, $22.7 million in marketable securities, and $80.4 million of outstanding balance on the Credit Line (as defined in Note 10, Debt) including accrued interest. The Company is required to maintain a minimum of at least $150.0 million in its UBS accounts as collateral for its Credit Line which is classified as cash, cash equivalents, and short-term investments in the consolidated balance sheets. As of December 31, 2024, the Company had $20.0 million remaining and available on its Credit Line. ​ 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 or slow its investment in 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 (the “Convertible Notes”) due 2027. The redemption was completed on October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes equaled 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. On the Redemption Date, $287.4 million of Convertible Notes were redeemed for approximately 7.5 million shares of the Company’s common stock under the terms of the redemption notice. The remaining Convertible Notes not redeemed under the redemption notice were converted in exchange for cash at face value plus accrued interest totaling $0.1 million. As such, the Company’s redemption of its Convertible Notes did not 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. In November 2022, the Company completed an underwritten equity offering and sold 13,144,500 shares of its common stock at a price of $35 per share to the public. After estimated offering expenses of $0.5 million, the Company received proceeds of approximately $433.2 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. The total upfront acquisition consideration amounted 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. Further, additional consideration aggregating up to approximately $35.0 million was estimated to be paid via issuance of an estimated 269,547 additional Natera common shares, 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 Natera 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 February 27, 2025. Principles of Consolidation ​ The accompanying consolidated financial statements include all the accounts of the Company and its subsidiaries. All intercompany balances and transactions have been eliminated. Use of Estimates ​ ​ Cash, Cash Equivalents, and Restricted Cash ​ Cash, cash equivalents, and restricted cash consist of cash, liquid demand deposits, and money market funds whose fund policies require the weighted average maturity of the fund's securities holdings not to exceed 90 days. Restricted cash as of December 31, 2024 and 2023 was immaterial. Cash equivalents do not include U.S. Treasuries. ​ Investments ​ ​ Available-for-sale debt securities. Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments ​ Accounts Receivable, net of allowance Trade accounts receivable and other receivables. Balance Sheet Components With respect to revenue recognized related to genetic test services provided to patient customers whereby consideration is expected to be received from insurance or patient payors, the Company recognizes a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. 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. After applying the ASC 606 constraint, the Company assessed for credit losses under ASC 326 and determined an incremental credit loss was not needed given the quality of the insurance payors from whom such receivables are expected to be collectible and the relatively short duration over which the majority of receivables are collected. Accordingly, the Company currently does not have an incremental credit loss reserve nor allowance for doubtful accounts against accounts receivable for insurance and patient payors due to the average selling price calculations which incorporate these risks as net receivables are recorded. 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 are consumed at the point biologic samples are collected and as the Company provides genetic testing services, and therefore, the Company does not maintain any work-in-process or 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. ​ ​ The following is a roll-forward of the inventory reserve for the years ended December 31, 2024 and 2023. ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ 872 ​ $ 748 Write-offs ​ ​ (454) ​ ​ (2,175) Net additions to reserve ​ ​ 141 ​ ​ 2,299 Ending balance ​ $ 559 ​ $ 872 ​ Property and Equipment ​ Property and equipment, including purchased and internally developed software, are recorded at cost less accumulated depreciation and amortization. Depreciation and amortization are calculated using the straight-line method over the estimated useful lives of the assets, which are generally three to five years determined by the classification of the property and equipment class in accordance with the Company’s fixed asset policy. Leasehold improvements are amortized using the straight-line method over the estimated useful lives of the assets or the remaining term of the lease, whichever is shorter. The Company periodically reviews the useful lives assigned to property and equipment placed in service in accordance with the Company’s fixed asset policy and changes the estimates of useful lives to reflect the results of such reviews. ​ Capitalized Software Held for Internal Use ​ The Company capitalizes salaries and related costs of employees and consultants who devote time to the development of internal-use software development projects. Capitalization begins during the application development stage, once the preliminary project stage has been completed, which includes successful validation and approval from management. If a project constitutes an enhancement to previously developed software, the Company assesses whether the enhancement is significant and creates additional functionality to the software, thus qualifying the work incurred for capitalization. Once the project is available for general release, the asset is placed in service and the Company estimates the useful life of the asset and begins amortization. The Company periodically assesses whether triggering events are present to review internal-use software for impairment. Changes in estimates related to internal-use software would increase or decrease operating expenses or amortization recorded during the reporting period. ​ The Company amortizes its internal-use software over the estimated useful lives of three years. The net book value of capitalized software held for internal use was $17.1 million and $8.7 million as of December 31, 2024 and 2023, respectively. Amortization expense for amounts previously capitalized for the years ended December 31, 2024, 2023, and 2022, was $3.5 million, $2.4 million, and $0.2 million, respectively. ​ Impairment of Long-lived Assets ​ The Company evaluates its long-lived assets for indicators of possible impairment when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. The Company then compares the carrying amounts of the assets with the future net undiscounted cash flows expected to be generated by such asset. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value determined using discounted estimates of future cash flows. The Company did not incur any material impairment charges during the years ended December 31, 2024, 2023, and 2022. ​ Operating Lease Right-of-Use Assets ​ The Company determines if an arrangement is or contains a lease at inception and classify each lease as operating or financing. Operating lease right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments made during the lease term, net of any tenant improvement allowance. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of committed lease payments, the Company uses its incremental borrowing rate based on the information available at the lease commencement date, which includes significant assumptions made including the Company’s estimated credit rating, annual percentage yields from corporate debt financings of companies of similar size and credit rating over a loan term approximating the remaining term of each lease, and government bond yields for terms approximating the remaining term of each lease in countries where the leased assets are located. Certain leases include payments of operating expenses that are dependent on the landlord’s estimate, and these variable payments are therefore excluded from the lease payments used to determine the operating lease right-of-use asset and lease liability. Lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise any such options. Operating lease right-of-use assets are adjusted for prepaid lease payments, lease incentives and initial direct costs incurred. Lease expense is recognized on a straight-line basis over the expected lease term. ​ The Company elected to not apply the recognition requirements of Topic 842 to short-term leases with terms of 12 months or less. For short-term leases, lease payments are recognized as operating expenses on a straight-line basis over the lease term. ​ 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. During the year ended December 31, 2024, the Company recorded $1.0 million in amortization expense. 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. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ (3,085) ​ $ (16,362) Net unrealized gain (loss) on available-for-sale securities, net of tax and foreign currency translation adjustment ​ ​ 2,741 ​ ​ 13,277 Ending balance ​ $ (344) ​ $ (3,085) ​ ​ ​ ​ ​ ​ ​ ​ The change in net unrealized loss on available-for-sale securities is due to the impact of changes in interest rates on the value of fixed-rate investments and not due to any credit deterioration. Further, due to the short-term nature of these investments, the Company has the ability and intention to hold any such investments until maturity and does not expect to realize any material investment losses. As such, 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, ​ Cost of Product Revenues ​ The components of our cost of product revenues are material and service costs, impairment charges associated with testing equipment, personnel costs, including stock-based compensation expense, equipment and infrastructure expenses associated with testing samples, electronic medical records, order and delivery systems, shipping charges to transport samples, costs incurred from third party test processing fees, and allocated overhead such as rent, information technology costs, equipment depreciation and utilities. Costs associated with Whole Exome Sequencing (“WES”) are also included, as well as labor costs, relating to our Signatera CLIA offering. Costs associated with performing tests are recorded when the test is accessioned. Costs associated with collection kits are recorded upon shipment to the clinics. ​ Cost of Licensing and Other Revenues ​ The components of our cost of licensing and other revenues are material costs associated with test kits sold to clients using Constellation, the Company’s cloud software product clients, development and support services relating to our strategic partnership agreements, and other costs. ​ Research and Development ​ The Company records research and development costs in the period incurred. Research and development costs consist of personnel costs, including stock-based compensation expense, contract services, cost of materials utilized in performing tests, costs of clinical trials, cost of clinical samples and related clinical data, asset acquisition of in-process research and development, and allocated facilities and related overhead expenses. ​ Advertising Costs ​ The Company expenses advertising costs as incurred. The Company incurred advertising costs of $2.3 million, $1.1 million, and $1.8 million for the years ended December 31, 2024, 2023, and 2022, respectively. ​ Product Shipment Costs ​ The Company expenses product shipment costs, which include biological samples for processing, in cost of product revenues in the accompanying statements of operations. Shipping and handling costs for the years ended December 31, 2024, 2023, and 2022 were $43.5 million, $42.2 million, and $36.0 million, respectively. ​ Income Taxes ​ Income taxes are recorded in accordance with Financial Accounting Standards Board ASC Topic 740, Income Taxes Income Taxes ​ Defined Contribution Plan Costs ​ The Company has a defined contribution plan (the “Defined Contribution Plan”) for its employees which complies with section 401(k) of the Internal Revenue Code. The Company provides a discretionary match to all participants who make 401(k) contributions pursuant to the Defined Contribution Plan. The discretionary match provided to participants is equivalent to 50% of a participant’s pre-tax contributions up to a maximum of 6% of eligible compensation per pay period. Total consolidated contribution expense under these plans was $10.7 million, $8.6 million and $9.1 million for the years ended December 31, 2024, 2023 and 2022, respectively. ​ Stock-Based Compensation ​ Stock-based compensation related to stock options, restricted stock units (“RSUs”), performance-based awards (“PSUs”), market-based awards, and stock purchase rights under an Employee Stock Purchase Plan (“ESPP”) granted to the Company’s employees is measured at the grant date based on the fair value of the award. The fair value is recognized as expense over the requisite service period, which is generally the vesting period of the respective awards. If awards have both a service condition and performance or market condition, then a graded attribution method is used to recognize expense. No compensation cost is recognized when the requisite service has not been met and the awards are therefore forfeited. ​ Employee stock-based compensation expense is calculated based on awards ultimately expected to vest and has been reduced for estimated forfeitures. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods, if actual forfeitures differ from those estimates. Non-employee stock-based compensation expense is not adjusted for estimated forfeitures up until the occurrence of the actual forfeiture of the associated awards. ​ ​ ​ For stock options with market conditions, the Company derives the requisite service period using the Monte Carlo simulation model. For stock options and RSUs that vest upon meeting performance conditions or market conditions in combination with performance conditions, the Company derives the requisite service period from the grant date to the date it is probable that the vesting conditions will be met. ​ ​ ​ Net Loss Per Share ​ ​ 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 Transactions ​ 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 which was allocated $2.2 million for preferred shares and $1.8 million for warrants. In August 2024, the Company participated in a subsequent round of the series B financing and purchased an additional $2.7 million of series B preferred shares at the same valuation as the initial round of financing in December 2021. The Company does not hold a seat on MyOme’s board of directors and does not participate or direct the day to day activities of MyOme. Because MyOme is a privately-held company without readily determinable fair values, the Company elected to account for its preferred Series B share investment in MyOme using the measurement alternative, which is cost, less any impairment, adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer as of the respective transaction dates. When indicators exist and the estimated fair value of the investment is below its carrying amount, the Company would adjust the investment to fair value. The change in carrying value, resulting from the remeasurements, would be recognized in interest and other income, net on the consolidated statements of operations. During the years ended December 31, 2024, 2023, and 2022, no upward nor downward adjustments have been recorded. 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 22.6% 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 is exercisable in whole or in part, commencing in February 2024, and can be converted to MyOme’s common stock upon the occurrence of MyOme’s initial public offering or a liquidation event (as such terms are defined in MyOme's certificate of incorporation). Additionally, upon the achievement of certain product commercialization milestones, the Company is eligible to receive an additional warrant exercisable for 2,080,565 shares of MyOme’s series B preferred stock with an exercise price of $0.01 per share. During September 2024, the Company achieved certain product commercialization milestones such that the warrant for 2,080,565 shares of MyOme’s series B preferred stock was due from MyOme to the Company. These warrants were granted and issued by MyOme to the Company during the fourth quarter of 2024, and are exercisable in whole or in part commencing in December 2024. However, the Company needs to perform ongoing collaboration in exchange for the warrant consideration. Accordingly, the warrants have been included within other assets and allocated between short-term and long-term liabilities on the consolidated balance sheets. The Company is amortizing the liability as a reduction of selling and marketing expense upon commercialization and sale of the products contemplated under the Collaboration Agreement over the life of the contract. For the year ended December 31, 2024, the amortization of the non-cash liability was $0.4 million. The warrants issued to the Company in 2021 and 2024 are accounted for as derivative instruments and recorded within other assets on the consolidated balance sheets at fair value. The warrants were valued using the Black-Scholes valuation model as of each reporting period, including the date of issuance. No material changes to fair value were identified during the years ended December 31, 2024, 2023 and 2022. 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. For the year ended December 31, 2024, the royalties to MyOme were not material. As of December 31, 2024 and December 31, 2023, the Company’s carrying amount of preferred shares in MyOme was $4.9 million and $2.2 million, respectively, on its consolidated balance sheets. The fair market value of the warrants as of December 31, 2024 and 2023 was $11.2 million and $1.8 million, respectively, on the consolidated balance sheets. 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 credit 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. 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 years ended December 31, 2024, 2023, and 2022, there were no customers exceeding 10% of total revenues on an individual basis. As of December 31, 2024 and 2023, there were no customers with an outstanding balance exceeding 10% of net accounts receivable. ​ For the years ended December 2024, 2023, and 2022, approximately 12.1%, 12.8%, and 11.2%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. For the years ended December 2024 and 2023, approximately 11.5% and 10.2% respectively, of accounts receivable 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. Recently Adopted Accounting Pronouncements In November 2023, ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, was issued which requires disclosure of incremental segment information on an interim and annual basis that are regularly provided to the chief operating decision maker (the “CODM”) and included within each reported measure of segment profit or loss. The Company has adopted this ASU as of December 31, 2024. The Company currently operates as a single reporting segment entity with the Chief Executive Officer as the CODM. The CODM relies on the financial statements as presented within the annual report Form 10-K to evaluate the Company’s financial performance and make key operating decisions. The key area of focus by the CODM for allocation of resources is the cash used in operations. These financial statements provide a comprehensive view of the Company’s overall financial condition, including information on expenses, assets and liabilities. The significant expense categories are consistent with those presented on the face of the statements of operations and comprehensive loss. The CODM does not receive or use any other segmented or disaggregated financial or any significant expense information for decision making purposes. Additionally, gross margin is regularly provided to the CODM and is derived based on the consolidated statements of operations and comprehensive loss as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands except percentages) Revenue ​ $ 1,696,911 ​ $ 1,082,571 ​ $ 820,222 Cost of product revenues ​ ​ 672,304 ​ ​ 588,564 ​ ​ 453,632 Cost of licensing and other revenues ​ ​ 1,449 ​ ​ 1,267 ​ ​ 2,624 Gross margin ​ $ 1,023,158 ​ $ 492,740 ​ $ 363,966 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Gross margin percentage ​ ​ 60.3% ​ ​ 45.5% ​ ​ 44.4% ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 December 2023, ASU 2023-09, Income Taxes - Improvements to Income Tax Disclosures In November 2024, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40)

Revenue Recognition

Revenue Recognition	12 Months Ended
	Dec. 31, 2024
Revenue Recognition
Revenue Recognition	3. Revenue Recognition ​ ​ 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 laboratory or patient (each a customer). 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 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 expected value 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 determines 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 third-party payers on behalf of the patients, and the patients are considered 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 9 months, with the remaining collections generally taking an additional 6 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 significant 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 years ended December 31, 2024, 2023 and 2022, the Company increased revenue by a net of $151.2 million, $5.3 million, and $19.5 million, respectively, for changes in estimate that increased revenue for tests delivered in prior periods that were fully collected, which increased revenue and decreased net loss Product revenue was constrained via refunds estimated to be paid to insurance carriers. Certain refunds were 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 year ended December 31, 2024, 2023 and 2022, the reserves for refunds to insurance carriers were reduced and product revenue increased by $4.2 million, $13.1 million and $5.8 million, respectively, for amounts the Company determined would not be refunded to insurance carriers. The increased revenue and corresponding decreased net loss Under the Company's current policy, certain estimated future 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. The allowance is released in future quarters to offset the credits and refunds paid to insurance carriers. During the year ended December 31, 2024, the reserves for refunds to insurance carriers were reduced and product revenue increased by $10.5 million for amounts the Company determined would not be refunded to insurance carriers. The increased revenue and decreased net loss resulted in a decreased loss per share by $0.08 for the year ended December 31, 2024. There was no such adjustment in the years ended December 31, 2023 and 2022. 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 NIPT and Oncology products, representing two separate performance obligations, to which $24.0 million of transaction consideration was allocated. Of this amount, $0.1 million and $8.0 million were recognized in the years ended December 31, 2023 and 2022, respectively. This performance obligation was fully satisfied in March 2023 and no further related amounts were recognized as revenue. As of December 31, 2024, 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 years ended December 31, 2024 and 2023, the Company recognized $1.6 million and $1.5 million, respectively, related to oncology assay interpretation services, of which $1.4 million and $1.2 million, respectively, were recognized against deferred royalties. The Company did not recognize any revenues during 2022. The Company currently has $17.3 million in deferred revenue as of December 31, 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 sheets and will be periodically assessed for impairment. During the years ended December 31, 2024 and 2023, $0.8 million and $5.1 million in equipment and services was received, which brought the remaining advanced payments to $4.1 million as of December 31, 2024, with $0.8 million recorded in prepaid expenses and other current assets and $3.3 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 had an initial term of five years that expired in August 2024. There was an option for automatic renewals thereafter for successive one-year terms, unless the Foundation Medicine Agreement is 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 provided development services that were 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 provided assay testing services over the term of the agreement. The intellectual property had been licensed to Foundation Medicine for the customized test. In addition, the Company was 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 was not a distinct performance obligation as it did 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 and $3.5 million were recognized in the years ended December 31, 2023 and 2022, respectively. This performance obligation was fully satisfied in March 2023 and no further related amounts were 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 years ended December 31, 2024, 2023, and 2022, the Company recognized $1.5 million, $1.0 million and $0.4 million, respectively, related to oncology assay interpretation services. The Company currently has $1.7 million in deferred revenue as of December 31, 2024. Disaggregation of Revenues ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands) Insurance carriers ​ $ 1,571,817 ​ $ 954,155 ​ $ 690,754 Laboratory partners ​ ​ 97,210 ​ ​ 98,891 ​ ​ 94,910 Patients ​ ​ 27,884 ​ ​ 29,525 ​ ​ 34,558 Total revenues ​ $ 1,696,911 ​ $ 1,082,571 ​ $ 820,222 ​ The following table presents total revenues by geographic area based on the location of the Company’s payers: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, ​ ​ 2024 2023 2022 ​ ​ (in thousands) United States ​ $ 1,657,745 $ 1,047,636 $ 785,849 Americas, excluding U.S. ​ ​ 6,620 ​ 4,908 ​ 3,705 Europe, Middle East, India, Africa ​ ​ 23,884 ​ 22,811 ​ 16,640 Asia Pacific and Other ​ ​ 8,662 ​ 7,216 ​ 14,028 Total ​ $ 1,696,911 $ 1,082,571 ​ $ 820,222 ​ The following table summarizes the Company’s beginning and ending balances of accounts receivable and deferred revenues: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ Balance at ​ ​ December 31, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Assets: ​ ​ ​ ​ ​ ​ Accounts receivable, net ​ $ 314,165 ​ $ 278,289 Liabilities: ​ ​ ​ ​ ​ ​ Deferred revenue, current portion ​ $ 19,754 ​ $ 16,612 Deferred revenue, long-term portion (1) ​ ​ 16,838 ​ ​ 19,128 Total deferred revenues ​ $ 36,592 ​ $ 35,740 ​ (1) The deferred revenue, long-term portion is included within the “Deferred revenue, long-term portion and other liabilities” line item on the consolidated balance sheets. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ Balance at ​ ​ December 31, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ 35,740 ​ $ 30,778 Increase in deferred revenues ​ ​ 35,440 ​ ​ 35,573 Reclasses from deferred revenues to other short-term liabilities ​ ​ — ​ ​ (522) Revenue recognized during the period that was included in ​ ​ (13,693) ​ ​ (10,564) Revenue recognized from performance obligations satisfied ​ ​ (20,895) ​ ​ (19,525) Ending balance ​ $ 36,592 ​ $ 35,740 ​ During the year ended December 31, 2024, revenue recognized that was included in the deferred revenue balance at the beginning of the period totaled $13.7 million with approximately $2.9 million related to BGI Genomics and Foundation Medicine, and the remaining $10.8 million related to genetic testing services. During the year ended December 31, 2024, $20.9 million was recognized as deferred revenue related to genetic testing services. The current portion of deferred revenue includes $17.6 million from genetic testing services, $1.7 million from Foundation Medicine and $0.5 million from the BGI Genomics agreement. The non-current portion of deferred revenue consists of $16.8 million from the BGI Genomics agreement.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 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 MyOme warrants issued to the Company are accounted for as derivatives and recorded at fair value on a recurring basis and are classified within Level 3 of the fair value hierarchy because the valuation methods include certain unobservable inputs. ​ The following table represents the fair value hierarchy for the Company’s financial assets measured at fair value on a recurring basis: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 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) ​ $ 945,587 ​ $ — ​ $ — ​ $ 945,587 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 ​ U.S. Treasury securities ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ 200,418 ​ ​ — ​ ​ — ​ ​ 200,418 ​ Municipal securities ​ ​ — ​ ​ 22,689 ​ ​ — ​ ​ 22,689 ​ ​ — ​ ​ 36,464 ​ ​ — ​ ​ 36,464 ​ Total financial assets ​ $ 945,587 ​ $ 22,689 ​ $ — ​ $ 968,276 ​ $ 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 December 31, 2024 and 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. The estimated fair value of the Convertible Notes as of December 31, 2024 and 2023, were zero 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	12 Months Ended
	Dec. 31, 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: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 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) ​ $ 945,587 ​ $ — ​ $ — ​ $ 945,587 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 ​ U.S. Treasury securities (1) ​ — ​ — ​ — ​ — ​ 201,522 ​ 14 ​ (1,118) ​ 200,418 ​ Municipal securities (1) ​ ​ 23,019 ​ ​ — ​ ​ (330) ​ ​ 22,689 ​ ​ 38,091 ​ ​ — ​ ​ (1,627) ​ ​ 36,464 ​ Total ​ $ 968,606 ​ $ — ​ $ (330) ​ $ 968,276 ​ $ 881,708 ​ $ 14 ​ $ (2,745) ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Classified as: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (2) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 945,587 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 642,095 ​ Short-term investments ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 22,689 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 236,882 ​ Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 968,276 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 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 year ended December 31, 2024, the Company sold one investment for $24.8 million, which resulted in an immaterial gain. The Company did not sell any investments in the year ending December 31, 2023. During the year ended December 31, 2022, the Company sold $248.5 million of investments resulting in a gross realized loss of $0.9 million. The Company uses the specific investment identification method to calculate realized gains and losses and amounts reclassified out of other comprehensive income to net income. As of December 31, 2024, the Company had 6 investments in an unrealized loss position in its portfolio. Gross unrealized losses were not material as of December 31, 2024 or December 31, 2023. 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 issuers. Accordingly, the Company did not record a credit loss reserve as of December 31, 2024 or December 31, 2023. ​ The following table presents debt securities available-for-sale that were in an unrealized loss position as of December 31, 2024, aggregated by major security type and length of time in a continuous loss position. There were no debt securities available-for-sale in an unrealized loss position for less than 12 months as of December 31, 2024. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Less Than 12 Months ​ 12 Months or Longer ​ Total ​ ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ Fair Value ​ Unrealized Loss ​ (in thousands) Municipal securities ​ $ — ​ $ — ​ $ 17,688 ​ $ (330) ​ $ 17,688 ​ $ (330) Total ​ $ — ​ $ — ​ $ 17,688 ​ $ (330) ​ $ 17,688 ​ $ (330) ​ The following table summarizes the Company’s portfolio of available-for-sale securities by contractual maturity as of December 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 ​ ​ ​ Amortized Cost ​ Fair Value ​ ​ ​ (in thousands) ​ Less than or equal to one year ​ $ 23,019 ​ $ 22,689 ​ Greater than one year but less than five years ​ ​ — ​ ​ — ​ Total ​ $ 23,019 ​ $ 22,689 ​ ​

Balance Sheet Components

Balance Sheet Components	12 Months Ended
	Dec. 31, 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 years ended December 31, 2024, 2023 and 2022: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands) Beginning balance ​ $ 6,481 ​ $ 3,830 ​ $ 2,429 Provision for doubtful accounts ​ ​ 1,279 ​ ​ 2,645 ​ ​ 1,770 (Write-offs) / Recoveries ​ ​ (501) ​ ​ 6 ​ ​ (369) Total ​ $ 7,259 ​ $ 6,481 ​ $ 3,830 ​ Property and Equipment, net ​ The Company’s property and equipment consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ December 31, ​ ​ Useful Life 2024 2023 ​ ​ ​ ​ ​ (in thousands) ​ Machinery and equipment 3-5 years $ 117,076 ​ $ 85,626 ​ Computer equipment 3 years ​ 3,178 ​ 1,850 ​ Purchased and capitalized software held for internal use ​ 3 years ​ ​ 13,178 ​ ​ 11,636 ​ Leasehold improvements Lesser of useful life or lease term ​ 48,569 ​ 38,999 ​ Construction-in-process ​ ​ ​ 58,461 ​ 29,392 ​ ​ ​ ​ ​ 240,462 ​ 167,503 ​ Less: Accumulated depreciation and amortization ​ ​ ​ (78,416) ​ (56,293) ​ Total Property and Equipment, net ​ ​ ​ $ 162,046 ​ $ 111,210 ​ ​ The Company’s long-lived assets are located in the United States. ​ During the year ended December 31, 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. During the years ended December 31, 2024, 2023, and 2022, depreciation expense of $27.2 million, $22.7 million, $16.7 million was recorded, respectively. The Company did not incur any material impairment charges during the years ended December 31, 2024, 2023, and 2022. ​ As of December 31, 2024 and 2023, the Company’s consolidated balance sheets included $9.1 million and $8.4 million, respectively, of capitalized cloud-based implementation costs. Accumulated amortization associated with these assets was $5.3 million and $2.5 million as of December 31, 2024 and 2023, respectively. The net book value of these capitalized cloud-based implementation was $3.7 million and $5.9 million, for the years ended December 31, 2024 and 2023, respectively and are recorded in current assets and other assets within the Company's consolidated balance sheets depending on the anticipated amortization period. During the years ended December 31, 2024, 2023, and 2022, the Company recorded amortization expense of $2.8 million, $1.4 million and $0.8 million, respectively. ​ Accrued Compensation ​ The Company’s accrued compensation consisted of the following: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ ​ 2024 2023 ​ ​ (in thousands) ​ Accrued paid time off ​ $ 3,826 ​ $ 3,121 ​ Accrued commissions ​ 14,224 ​ 10,522 ​ Accrued bonuses ​ 32,236 ​ 24,651 ​ Other accrued compensation ​ 11,828 ​ 7,563 ​ Total accrued compensation ​ $ 62,114 ​ $ 45,857 ​ ​ Other Accrued Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ 2024 2023 ​ ​ (in thousands) Reserves for refunds to insurance carriers ​ $ 11,276 ​ $ 23,245 ​ Accrued charges for third-party testing ​ ​ 12,321 ​ ​ 14,823 ​ Testing and laboratory materials from suppliers ​ ​ 7,893 ​ ​ 11,229 ​ Marketing and corporate affairs ​ ​ 16,548 ​ ​ 10,085 ​ Legal, audit and consulting fees ​ ​ 54,208 ​ ​ 43,897 ​ Accrued shipping charges ​ ​ 1,625 ​ ​ 3,646 ​ Sales and income tax payable ​ ​ 4,416 ​ ​ 3,731 ​ Accrued third-party service fees ​ ​ 9,046 ​ ​ 7,111 ​ Clinical trials and studies ​ 10,097 ​ 12,126 ​ Operating lease liabilities, current portion ​ ​ 10,168 ​ ​ 11,621 ​ Property and equipment purchases ​ ​ 7,098 ​ ​ 4,316 ​ Other accrued interest ​ ​ — ​ ​ 1,078 ​ Other accrued expenses ​ 2,197 ​ 2,497 ​ Total other accrued liabilities ​ $ 146,893 ​ $ 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 and if these previously accrued amounts are no longer required based on actual refunds requested, any remaining reserve amounts are released. When the Company releases these previously accrued amounts, they are recognized as product revenues in the statements of operations and comprehensive loss. ​ The following table summarizes the reserve balance and activities for refunds to insurance carriers for the years ended December 31, 2024 and 2023: ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ 2024 2023 ​ ​ (in thousands) Beginning balance ​ $ 23,245 ​ $ 18,948 Additional reserves ​ ​ 2,562 ​ ​ 14,974 Refunds to carriers ​ ​ (4,620) ​ ​ (1,583) Reserves released to revenue ​ ​ (9,911) ​ ​ (9,094) Ending balance ​ $ 11,276 ​ $ 23,245 ​ ​ ​ ​ ​ ​ ​ ​

Leases

Leases	12 Months Ended
	Dec. 31, 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. In July 2024, the Company entered into an amendment of the San Carlos lease to extend the term for 60 months to October 2032. The annual rent will be approximately $9.7 million beginning January 2025, escalating annually and may be increased if the Company elects to utilize additional tenant improvement allowances. 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 was 62 months and expired in July 2023. The Company had the option to extend this lease for five years, however, since the Company sold its business related to cord blood and tissue storage in September 2019, the Company subleased the facility through the end of the lease 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-month 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 As part of the IPR&D asset acquisition in September 2021, the Company inherited a 24-month 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 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ ​ 2024 2023 ​ ​ (in thousands) Operating lease liabilities, current portion included in other accrued liabilities ​ $ 10,168 ​ $ 11,621 Operating lease liabilities, long-term portion ​ ​ 96,588 ​ ​ 67,025 Total operating lease liabilities ​ $ 106,756 ​ $ 78,646 ​ 7.76 The Company continues to recognize lease expense on a straight-line basis. The lease expense includes the amortization of the right-of-assets with the associated interest component estimated by applying the effective interest method. Total lease expense recognized in the statements of operations and comprehensive loss were $15.3 million, $14.5 million, and $13.8 million for the years ended December 31, 2024, 2023, and 2022, respectively. Cash paid for amounts in the measurement of operating lease liabilities totaled $16.8 million, $12.4 million, and $9.4 million for the years ended December 31, 2024, 2023, and 2022, respectively. The present value of the future minimum lease payments under all non-cancellable operating leases as of December 31, 2024 is as follows: ​ ​ ​ ​ ​ ​ ​ Operating Leases ​ ​ (in thousands) Year ending December 31: ​ ​ ​ ​ 2025 ​ $ 17,533 ​ 2026 ​ ​ 17,809 ​ 2027 ​ ​ 17,119 ​ 2028 ​ ​ 17,443 ​ 2029 ​ ​ 17,324 ​ 2030 and thereafter ​ ​ 53,335 ​ Total future minimum lease payments ​ ​ 140,563 ​ Less: imputed interest ​ ​ (33,807) ​ Operating lease liabilities ​ $ 106,756 ​ ​

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies
Commitments and Contingencies	8. Commitments and Contingencies ​ Legal Proceedings ​ The Company is or has been 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. 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 reasonable 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. As of December 31, 2024, the aggregate accrual for legal contingencies that are probable and reasonably estimable is approximately $12.6 million. The Company is unable to predict the ultimate outcome of the matters described below and is unable to make a reasonable estimate of the amount or range of loss, if any, that could result from an unfavorable outcome of any such matter in excess of any amounts accrued. 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 “Infringed Patent”) and awarding damages to the Company for lost profits and past royalties totaling $96.3 million. In February 2025, the Court granted CareDx’s motion for judgment as a matter of law and invalidated both asserted Natera patents, including the Infringed Patent. A final judgment has not yet been entered by the Court; the Company plans to appeal the invalidation of its patents. Separately, in October 2024, an ex-parte 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 stay was lifted, and post-trial proceedings resumed, in November 2024. Defendants’ interim appeals remain stayed pending the Court’s final resolution of the post-trial motions. 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. Judgment has not been entered by the Court. 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 petition 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, as a result of Invitae’s voluntary Chapter 11 petition described above, the Court continued 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. 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 two Natera patents (the “’035 Patent” and the “’454 Patent”) by NeoGenomics’ commercialization of the RaDaR test and seeking 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 and was affirmed on appeal in July 2024 by the Federal Circuit Court of Appeals. NeoGenomics filed a petition with the USPTO to review the validity of the ’454 Patent, which was denied in June 2024. NeoGenomics also filed a petition with the USPTO to review the validity of the ‘035 Patent, which proceeding was terminated in October 2024. Pursuant to the terms of a partial settlement of the case, the District Court entered a permanent injunction against NeoGenomics, and it has withdrawn its RaDaR test from the market. The case remains pending with respect to an updated version of the RaDaR test and the ‘454 Patent, as well as an additional Natera patent (the “596 patent”) that was added to the case in December 2024. Neogenomics has filed an inter partes review 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. The Company is involved in two lawsuits against Guardant Health, Inc. (“Guardant”). In May 2021, 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. In November 2024, after trial, the jury returned a verdict finding the Company liable for false advertising and found damages of $292.5 million. A final judgment has not been entered by the Court; the Company plans to appeal any adverse judgment. In February 2025, Guardant filed suit against the Company and two of its former employees who recently joined the Company in the United States District Court for the Northern District of California, alleging trade secret misappropriation, breach of contract and related tort claims, seeking unspecified damages and injunctive relief. Concurrently with the filing of the complaint, Guardant also moved for a temporary restraining order. 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 alleged, among other things, that the Company failed to disclose certain information regarding its Panorama test. The complaint sought, among other relief, monetary damages, attorneys’ fees, and costs. This matter was 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. In October 2024, a purported class action lawsuit was filed against the Company in the United States District Court for the Northern District of California, by patients alleging various causes of action relating to the Company’s preimplantation genetic test for aneuploidies. They request, among other relief, class certification, injunctive relief, restitution and/or disgorgement, attorneys’ fees, and costs. The Company has filed a motion to dismiss the lawsuit. 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 material contractual commitments as of December 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, Party ​ Total Commitments ​ ​ 2025 ​ ​ 2026 ​ ​ 2027 ​ ​ 2028 ​ ​ 2029 ​ ​ 2030 and thereafter ​ ​ ​ (in thousands) Laboratory instruments supplier ​ $ 27,700 ​ $ 8,800 ​ $ 9,200 ​ $ 9,700 ​ $ — ​ $ — ​ $ — Material suppliers ​ ​ 53,988 ​ ​ 53,931 ​ ​ 57 ​ ​ — ​ ​ — ​ ​ — ​ ​ — Application service providers ​ ​ 4,235 ​ ​ 3,892 ​ ​ 343 ​ ​ — ​ ​ — ​ ​ — ​ ​ — Cloud platform service provider ​ ​ 34,180 ​ ​ 7,120 ​ ​ 9,060 ​ ​ 9,000 ​ ​ 9,000 ​ ​ — ​ ​ — Other ​ ​ 51,159 ​ ​ 40,075 ​ ​ 4,684 ​ ​ 2,041 ​ ​ 1,256 ​ ​ 1,103 ​ ​ 2,000 Total ​ $ 171,262 ​ $ 113,818 ​ $ 23,344 ​ $ 20,741 ​ $ 10,256 ​ $ 1,103 ​ $ 2,000 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ During 2024, the Company acquired clinical samples and data for oncology development in exchange for $7.0 million paid in cash plus an additional $13.0 million included in commitments above, with an additional $50.0 million in potential payments owed to the third party

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2024
Stock-Based Compensation
Stock-Based Compensation	9. Stock-Based Compensation ​ Equity Plans ​ 2015 Equity Incentive Plan ​ General ​ Stock options vest as determined by the compensation committee. In general, they will vest over a four-year period following the date of grant. These awards generally expire earlier if the participant's service terminates earlier. Restricted Shares and Stock Units. of performance-based milestones or a combination of both, as determined by the compensation committee. Further, RSUs may be granted and immediately vested in lieu of certain obligations. The Company also periodically awards phantom stock units, under a separate incentive arrangement, to certain international personnel, which are settled in cash upon vesting and accounted for as liability-based awards with no impact to the shares available for grant. Employee Stock Purchase Plan General Share Reserve. ​ Purchase Price. ​ Offering Periods. ​ Stock-Based Compensation Expense ​ The following table presents stock-based compensation expense recorded for equity classified awards in the statement of operations and comprehensive loss: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ (in thousands) Cost of revenues ​ $ 16,468 ​ $ 11,752 ​ $ 7,905 Research and development ​ 88,705 ​ 66,326 ​ 46,545 Selling, general and administrative ​ 169,255 ​ 113,730 ​ 97,934 Total ​ $ 274,428 ​ $ 191,808 ​ $ 152,384 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Additionally, the stock-based compensation expense for liability classified awards for the years ended December 31, 2024, 2023, and 2022 was $1.3 million, $0.8 million, and $0.6 million, respectively. As of December 31, 2024, approximately $509.4 million of unrecognized compensation expense, adjusted for estimated forfeitures, related to unvested option awards and RSUs will be recognized over a weighted-average period of approximately 1.6 years. ​ Stock Options ​ The following table summarizes option activity during the year ended December 31, 2024: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Weighted- ​ Average ​ ​ ​ ​ ​ ​ Average ​ Remaining ​ Aggregate ​ ​ Number of ​ Exercise ​ Contractual ​ Intrinsic ​ ​ Shares ​ Price ​ Life ​ Value (in thousands, except for contractual life and exercise price) ​ ​ ​ ​ ​ ​ (in years) ​ ​ Balance at December 31, 2023 5,501 ​ $ 23.65 4.36 ​ $ 231,133 ​ Options exercised (1,626) ​ $ 7.98 ​ ​ ​ ​ ​ ​ Balance at December 31, 2024 3,875 ​ $ 30.22 4.45 ​ $ 496,135 ​ Exercisable at December 31, 2024 3,185 ​ $ 23.22 3.80 ​ $ 430,197 ​ Vested and expected to vest at December 31, 2024 3,831 ​ $ 29.86 4.42 ​ $ 492,065 ​ ​ The total intrinsic value of stock options exercised during the years ended December 31, 2024, 2023, and 2022 were $145.6 million, $14.7 million, and $26.9 million, respectively. ​ No options were granted in the year ended December 31, 2024. The weighted-average grant date fair value of options granted during the years ended December 31, 2023 and 2022 were $27.31 and $34.00 per share, respectively. ​ ​ Valuation of Stock Option Grants ​ The Company utilizes Black-Scholes option pricing model when estimating the fair value of stock options. No options were granted in the year ended December 31, 2024. The following valuation assumptions were applied to options. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, ​ 2024 2023 2022 ​ Expected term (years) ​ ​ ​ — ​ ​ 5.20 ​ — 6.11 ​ ​ 5.12 ​ — 10.00 ​ Expected volatility ​ ​ ​ — % 67.75 % — 70.07 % ​ 55.91 % — 62.30 % Expected dividend rate ​ ​ ​ — % ​ ​ ​ — % ​ ​ ​ ​ — % Risk-free interest rate ​ ​ ​ — % 3.41 % — 4.80 % ​ 1.62 % — 4.16 % ​ As of December 31, 2024, there were no options outstanding held by non-employees Restricted Stock Units and Performance-based Awards ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ Average ​ ​ Number of ​ Grant Date ​ ​ Shares ​ Fair Value ​ ​ (in thousands) ​ ​ ​ Balance at December 31, 2023 ​ 9,248 ​ $ 49.50 Granted ​ 5,400 ​ $ 76.90 Vested ​ (3,538) ​ $ 55.90 Cancelled/Forfeited ​ (517) ​ $ 58.23 Balance at December 31, 2024 10,593 ​ $ 61.28 ​ ​ ​ ​ ​ ​ ​ 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 year ended December 31, 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 $34.8 million has been recognized for the year ended December 31, 2024. The Company has recognized $89.8 million in stock-based compensation for performance-based awards for the year ended December 31, 2024 compared to $54.2 million for the year ended December 31, 2023 and $48.2 million for the year ended December 31, 2022.

Debt

Debt	12 Months Ended
	Dec. 31, 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 December 31, 2024 was 5.03%. The Credit Line was subsequently increased from $50.0 million to $150.0 million in 2020. In June 2023, the Credit Line decreased from $150.0 million to $100.0 million. 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 which is classified as cash, cash equivalents, and short-term investments in the consolidated balance sheets. 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 October 2023, the interest rate for the Credit Line was subsequently changed to the 30-day SOFR average, plus 0.5%. As of December 31, 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 the years ended December 31, 2024, 2023, and 2022, the Company recorded interest expense of $4.7 million, $4.9 million, and $1.6 million, respectively. Interest payments totaling $4.7 million, $4.9 million, and $1.6 million had been made on the Credit Line during the years ended December 31, 2024, 2023, and 2022, respectively. As of December 31, 2024 and December 31, 2023, and the total principal amount outstanding including 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 Convertible Notes were 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. On July 19, 2024, the Company elected to exercise its optional redemption right to redeem all $287.5 million aggregate principal amount of its outstanding 2.25% Convertible Notes due 2027 and instructed Wilmington Trust, National Association, as trustee under the Convertible Notes Indenture (the “Indenture Agreement”) governing the Convertible Notes, to issue a redemption notice to registered holders of the Convertible Notes. The date fixed for the redemption of the Convertible Notes was October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes was 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 converted their Convertible Notes in connection with the Company’s election to redeem the Convertible Notes was increased by 0.4284 additional shares pursuant to the Indenture Agreement. 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 ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ 2024 ​ 2023 ​ (in thousands) Long-Term Debt ​ ​ ​ ​ ​ Outstanding Principal $ — ​ $ 287,500 Unamortized debt discount and debt issuance cost ​ — ​ ​ (4,555) Net carrying amount $ — ​ $ 282,945 ​ ​ The following table presents total interest expense recognized related to the Convertible Notes during the years as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ 2024 ​ ​ 2023 ​ ​ 2022 ​ (in thousands) Cash interest expense ​ ​ ​ ​ ​ ​ ​ ​ Contractual interest expense $ 2,157 ​ $ 6,469 ​ $ 6,469 Non-cash interest expense ​ ​ ​ ​ ​ ​ ​ ​ Contractual interest expense ​ 2,875 ​ ​ — ​ ​ — Amortization of debt discount and debt issuance cost ​ 991 ​ ​ 1,292 ​ ​ 1,259 Total interest expense $ 6,023 ​ $ 7,761 ​ $ 7,728 ​

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2024
Stockholders' Equity
Stockholders' Equity	11. Stockholders’ Equity As of December 31, 2024, the Company had 50,000,000 authorized shares of its preferred stock, of which no shares were issued and outstanding outstanding In October 2024, the Company elected to settle its outstanding Convertible Notes through physical settlement with shares of the Company’s 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 Convertible Notes were settled for approximately 7,532,300 shares of the Company’s common stock. 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. In November 2022, the Company completed an underwritten equity offering and sold 13,144,500 shares of its common stock at a price of $35 per share to the public. After offering expenses of $0.5 million, the Company received proceeds of $433.2 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. 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. In November 2022, the remaining consideration was modified, resulting in a $10.0 million milestone payment primarily made in the form of the Company’s common stock in December 2022 and a remaining $15.0 million milestone payment made in March 2023 primarily in the Company’s common stock.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Taxes
Income Taxes	12. Income Taxes ​ The Company's effective tax rates for the years ended December 31, 2024, 2023, and 2022 differ from the U.S. federal statutory rate as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ ​ (in thousands, except percentages) ​ U.S. federal taxes (benefit) at statutory rate ​ $ (39,844) ​ 21.00 % ​ $ (91,251) ​ 21.00 % ​ $ (114,832) 21.00 % State tax expense ​ ​ (21,613) ​ 11.39 % ​ ​ (13,492) ​ 3.10 % ​ ​ (21,676) ​ 3.96 % Research and development credits ​ ​ (17,621) ​ 9.29 % ​ ​ (10,837) ​ 2.49 % ​ ​ (7,024) ​ 1.28 % Stock-based compensation ​ ​ (62,969) ​ 33.19 % ​ ​ (6,422) ​ 1.48 % ​ ​ 3,949 ​ (0.72) % Foreign tax ​ ​ (25) ​ 0.01 % ​ ​ (106) ​ 0.02 % ​ ​ 332 ​ (0.06) % Nondeductible officers' compensation ​ ​ 31,718 ​ (16.72) % ​ ​ 8,651 ​ (1.99) % ​ ​ 4,883 ​ (0.89) % Acquisition costs ​ ​ — ​ 0.00 % ​ ​ 563 ​ (0.13) % ​ ​ 3,226 ​ (0.59) % Nondeductible meals and other ​ ​ 2,870 ​ (1.51) % ​ ​ (3,397) ​ 0.79 % ​ ​ 1,964 ​ (0.36) % Change in valuation allowance ​ ​ 108,179 ​ (57.02) % ​ ​ 116,562 ​ (26.82) % ​ ​ 130,156 ​ (23.80) % Provision for income taxes ​ $ 695 ​ (0.37) % ​ $ 271 ​ (0.06) % ​ $ 978 ​ (0.18) % ​ During the years ended December 31, 2024, 2023, and 2022, the Company recorded total income tax expense of $0.7 million, $0.3 million and $1.0 million, respectively. ​ The total provision for income taxes includes foreign withholding and state income tax expense. ​ Deferred income taxes reflect the net tax effects of temporary differences between carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes as well as net operating loss and tax credit carryforwards. The components of the net deferred income tax assets are as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ ​ ​ 2024 ​ 2023 ​ ​ ​ ​ ​ ​ (in thousands) ​ Deferred tax assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net operating loss carryforwards ​ ​ ​ ​ $ 395,139 ​ $ 399,287 ​ Research and development tax credit carryforwards ​ ​ ​ ​ ​ 90,759 ​ ​ 67,035 ​ Capitalized research costs ​ ​ ​ ​ ​ 173,991 ​ ​ 95,923 ​ Reserves and accruals ​ ​ ​ ​ ​ 23,928 ​ ​ 34,898 ​ Lease liabilities ​ ​ ​ ​ ​ 26,649 ​ ​ 19,339 ​ Stock-based compensation ​ ​ ​ ​ ​ 47,864 ​ ​ 29,005 ​ Intangible assets ​ ​ ​ ​ ​ 8,846 ​ ​ 3,809 ​ Other ​ ​ ​ ​ ​ 5,583 ​ ​ 5,640 ​ Total deferred tax assets before valuation allowance ​ ​ ​ ​ ​ 772,759 ​ ​ 654,936 ​ Less: valuation allowance ​ ​ ​ ​ ​ (747,090) ​ ​ (639,510) ​ Total deferred tax assets after valuation allowance ​ ​ ​ ​ ​ 25,669 ​ ​ 15,426 ​ Deferred tax liabilities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fixed assets ​ ​ ​ ​ ​ (4,164) ​ ​ (1,524) ​ Right-of-use lease assets ​ ​ ​ ​ ​ (21,505) ​ ​ (13,902) ​ Total deferred tax liabilities ​ ​ ​ ​ ​ (25,669) ​ ​ (15,426) ​ Net deferred tax assets ​ ​ ​ ​ $ — ​ $ — ​ ​ The Company established a full valuation allowance against its net deferred tax assets in 2024 and 2023 due to the uncertainty surrounding realization of these assets. The valuation allowance increased to $747.1 million as of 2024 from $639.5 million as of 2023 due to current year losses and credits claimed. ​ As of December 31, 2024, the Company had federal, state, and foreign net operating loss (“NOLs”) carryforwards of approximately $1.6 billion, $1.1 billion, and $4.1 million, respectively, which begin to expire in 2033, 2025, and 2027, respectively, if not utilized. Approximately $1.3 billion of federal net operating loss included above can be carried forward indefinitely. ​ The Company also had federal research and development credit carryforwards of approximately $85.2 million, which begin to expire in 2027, and state research and development credit carryforwards of approximately $45.6 million, which begin to expire in 2036. Realization is dependent on generating sufficient taxable income prior to expiration of the loss and credit carryforwards. ​ Federal, state and foreign tax laws impose substantial restrictions on the utilization of NOLs and credit carryforwards in the event of an "ownership change" for tax purpose, as defined in Section 382 of the Internal Revenue Code. Accordingly, the Company's ability to utilize these carryforwards may be limited as the result of such ownership change. Such a limitation could result in limitation in the use of the NOLs in future years and possibly a reduction of the NOLs available. ​ A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 2023 ​ 2022 ​ ​ (in thousands) ​ Balance at beginning of year ​ $ 30,912 ​ $ 23,844 ​ $ 17,514 ​ Additions based on tax positions related to the current year ​ ​ 13,648 ​ ​ 7,034 ​ ​ 6,301 ​ Additions (reductions) for tax positions of prior years ​ ​ (9,620) ​ ​ 34 ​ ​ 29 ​ Balance at end of year ​ $ 34,940 ​ $ 30,912 ​ $ 23,844 ​ ​ During the years ended December 31, 2024, 2023, and 2022, the amount of unrecognized tax benefits increased $4.0 million, $7.1 million, and $6.3 million, respectively, due to additional research and development credits generated during the year. As of December 31, 2024, 2023, and 2022, the total amount of unrecognized tax benefits was $34.9 million, $30.9 million, and $23.8 million, respectively. The reversal of the uncertain tax benefits would not affect the Company's effective tax rate to the extent that it continues to maintain a full valuation allowance against its deferred tax assets. ​ The Company is subject to U.S. federal, state, and foreign income taxes. Tax regulations within each jurisdiction are subject to the interpretation of the related tax laws and regulations, and require significant judgment to apply. The Company is subject to U.S. federal, state and local tax examinations by tax authorities for all prior tax years since incorporation. The Company does not anticipate significant changes to its current uncertain tax positions through December 31, 2024. ​ The Company recognizes any interest and/or penalties related to income tax matters as a component of income tax expense. As of December 31, 2024, there were no ​ In 2021, the Organization for Economic Cooperation and Development (the “OECD”) announced an Inclusive Framework on Base Erosion and Profit Shifting including Pillar Two Model Rules defining the global minimum tax. These rules broadly call for the taxation of large multinational corporations at a minimum rate of 15%. We continue to evaluate the enacted and pending legislation to implement these rules in the non-U.S. tax jurisdictions we operate in but do not currently believe the impact to be material.

Net Loss per Share

Net Loss per Share	12 Months Ended
	Dec. 31, 2024
Net Loss per Share
Net Loss per Share	13. Net Loss per Share ​ The following table shows the potentially dilutive common stock equivalents that were excluded from the computations of diluted net loss per share as their effect would be anti-dilutive, as of December 31, 2024, 2023, and 2022: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 2023 2022 ​ (in thousands) ​ Options to purchase common stock ​ 3,875 5,501 5,300 ​ Performance-based awards and restricted stock units ​ 10,593 ​ 9,248 ​ 6,836 ​ Employee stock purchase plan ​ 40 ​ 88 ​ 90 ​ Convertible Note ​ — ​ 7,411 ​ 7,411 ​ Earnouts for development with acquired Canadian entity ​ — ​ — ​ 361 ​ ​ ​ 14,508 22,248 ​ 19,998 ​ ​

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2024
Subsequent Events
Subsequent Events	14. Subsequent Events Subsequent to December 31, 2024, the Company entered into new lease arrangements for additional space in Austin, Texas and San Carlos, California. The new lease arrangements have future commitments aggregating to approximately $12.8 million through 2033.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (190,426)	$ (434,801)	$ (547,799)

Insider Trading Arrangements

Insider Trading Arrangements - shares	3 Months Ended
	Dec. 31, 2024	Sep. 30, 2024
Matthew Rabinowitz
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	​ On December 3, 2024, Matthew Rabinowitz, adopted a Rule 10b5-1 Trading Plan that provides for the sale of 130,000 shares of our common stock pursuant to the terms of the plan between March 4, 2025 and August 23, 2025.	​ On September 13, 2024, Matthew Rabinowitz, our co-founder and executive chairman, adopted a trading arrangement for the sale of securities of the Company’s common stock (a “Rule 10b5-1 Trading Plan”) that provided for the sale of 160,000 shares of our common stock pursuant to the terms of the plan between December 13, 2024 and May 14, 2025.
Name	Matthew Rabinowitz	Matthew Rabinowitz
Title	co-founder and executive chairman	co-founder and executive chairman
Rule 10b5-1 Arrangement Adopted	true	true
Adoption Date	December 3, 2024	September 13, 2024
Aggregate Available	130,000	160,000
Steve Chapman
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	​ On November 26, 2024, Solomon Moshkevich, our president, clinical diagnostics, adopted a Rule 10b5-1 Trading Plan that provides for the sale of up to 66,000 shares of our common stock pursuant to the terms of the plan between March 4, 2025 and November 30, 2026. ​ On December 2, 2024, Steve Chapman, our chief executive officer, amended a Rule 10b5-1 Trading Plan to provide for the potential sale of up to 395,452 shares of our common stock and the exercise of 156,825 stock options and sale of underlying shares of our common stock, pursuant to the terms of the plan between March 5, 2025 and November 30, 2026. A significant portion of the shares subject to the plan would not be sold unless the Company achieves specified performance targets.
Name	Steve Chapman
Title	chief executive officer
Aggregate Available	395,452
Modification Date	December 2, 2024
Rule 10b5-1 Arrangement Modified	true
Jonathan Sheena
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	​ On December 11, 2024, Jonathan Sheena, our co-founder and a member of our board of directors, adopted a Rule 10b5-1 Trading Plan that provides for the sale of 49,911 shares of our common stock pursuant to the terms of the plan between April 4, 2025 and April 29, 2026.
Name	Jonathan Sheena
Title	co-founder and a member of our board of directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	December 11, 2024
Aggregate Available	49,911
Gail Marcus
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	​ On December 11, 2024, Gail Marcus, a member of our board of directors, adopted a Rule 10b5-1 Trading Plan that provides for the sale of 6,618 shares of our common stock and the exercise of 16,299 stock options and sale of underlying shares of our common stock, pursuant to the terms of the plan between March 12, 2025 and December 31, 2025.
Name	Gail Marcus
Title	member of our board of directors
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	December 11, 2024
Solomon Moshkevich
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	​
Name	Solomon Moshkevich
Title	president
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 26, 2024
Aggregate Available	66,000
Sale of common stock arrangement | Gail Marcus
Trading Arrangements, by Individual
Aggregate Available	6,618
Exercise of stock options arrangement | Steve Chapman
Trading Arrangements, by Individual
Aggregate Available	156,825
Exercise of stock options arrangement | Gail Marcus
Trading Arrangements, by Individual
Aggregate Available	16,299

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management Strategy And Governance [Abstract]
Cybersecurity Risk Management Processes For Assessing Identifying And Managing Threats [Text Block]	Risk Management and Strategy In the ordinary course of our business, we collect and store sensitive data, including legally protected personal information, such as test results and other patient health information, credit card and other financial information, insurance information, and personally identifiable information, as well as sensitive intellectual property and other proprietary business information, including that of our customers, payers and collaboration partners. We are highly dependent on information technology networks and systems – our own as well as those of third-party vendors and their subcontractors – to securely process, transmit, and store this sensitive data and business critical information. Although we take measures to protect sensitive information from unauthorized access, use or disclosure, our information technology and infrastructure, and that of our technology and other third-party service providers and their subcontractors, are nevertheless inherently vulnerable to, and from time to time experience, various cybersecurity threats. We continue to invest in the security and resiliency of our networks and to enhance our internal controls and processes, which are designed to help protect our systems and infrastructure, and the information they contain. For more information regarding the risks we face from cybersecurity threats, please see “Item 1A. Risk Factors” included elsewhere in this Annual Report on Form 10-K. Risk Management Processes Our Information Security Execution Team is responsible for the day-to-day execution of our information security strategy and operations, and comprises key stakeholders across the Company’s information services & technology, engineering, legal, privacy, compliance, finance, human resources, and product teams. The Information Security Execution Team coordinates cross functionally to identify, assess, and address immediate and emerging risks from cybersecurity threats, including leading the formation and activities of working groups and response teams to address cybersecurity matters that arise from time to time. We maintain a cybersecurity incident response plan that addresses critical aspects of incident management, including detection, impact analysis, containment, mitigation, remediation, recovery, and long-term strategies for remediation and prevention of future incidents. In carrying out our incident response plan, our Information Security Execution Team also assesses incidents, or multiple related incidents, by reference to a set of specified criteria and, if one or more of such criteria are met, reports such incidents to management. Our cybersecurity program is aligned with industry standards and best practices, such as the National Institute of Standards and Technology, or NIST, Cybersecurity Framework. We use various tools and methodologies to monitor and manage cybersecurity risks. We also monitor and evaluate our cybersecurity posture and performance on an ongoing basis through regular vulnerability scans, penetration tests and threat intelligence feeds. Our Information Security Execution Team conducts annual tabletop exercises to ensure preparedness for information security, including cybersecurity, incidents. In addition, we promote a company culture of awareness and discipline in cybersecurity matters through annual employee training and education, including periodic phishing simulations. We engage with a range of external experts, including cybersecurity assessors, consultants, and auditors, in evaluating and attesting to our risk management systems, including an annual Systems and Organization Controls 2, or SOC 2, audit with respect to the security, availability, confidentiality, and process integrity trust services criteria, or TSC. Our collaboration with these third-party service providers includes regular audits, threat assessments, and consultation on cybersecurity strategy and enhancements. Recognizing the risks associated with these and other third-party service providers, we also conduct risk assessments on selected systems and third-party service providers on an ongoing basis.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	we collect and store sensitive data, including legally protected personal information, such as test results and other patient health information, credit card and other financial information, insurance information, and personally identifiable information, as well as sensitive intellectual property and other proprietary business information, including that of our customers, payers and collaboration partners. We are highly dependent on information technology networks and systems – our own as well as those of third-party vendors and their subcontractors – to securely process, transmit, and store this sensitive data and business critical information.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight And Identification Processes [Flag]	true
Cybersecurity Risk Board Of Directors Oversight [Text Block]	Governance Board Oversight ​ Cybersecurity is an important area of focus for our board of directors. Our audit committee is responsible for carrying out, on behalf of our board of directors, oversight of information security, including cybersecurity, risks. Our audit committee is composed of directors with diverse expertise relevant to such committee’s responsibilities, and includes two directors who have expertise or certifications in cybersecurity. Our management team provides updates on cybersecurity matters to our audit committee on a quarterly basis, with more frequent or interim communications as warranted. In addition to the oversight by our audit committee, our board of directors receives an annual report on cybersecurity matters from our Chief Technology Officer, or CTO. Our Chief Compliance & Privacy Officer, or CCPO, and CTO also attend regular meetings of our board of directors, and engage in discussions on an ad hoc basis relating to cybersecurity and information security matters. Management We maintain an Information Security Leadership Committee, or ISLC, that is accountable for enterprise-level information security risk strategy, identification, prioritization, and mitigation, including establishing objectives and priorities. The ISLC comprises company executives that, collectively, represent experience and expertise in information technology, enterprise security and risk management, cybersecurity, engineering, technology, privacy, data security, and healthcare compliance. Members of this committee include our CTO, CCPO, Chief Information Officer, Chief Information Security Officer, and Chief Accounting Officer. The ISLC meets on at least a quarterly basis to review matters including updates on existing and emerging cybersecurity risks and threats including prioritization, mitigation, and remediation; the status of projects to strengthen our information security systems; assessments of our information security program and operations; and prioritized information security incidents, if any. The ISLC oversees the Information Security Execution Team.
Cybersecurity Risk Board Committee Or Subcommittee Responsible for Oversight [Text Block]	audit committee
Cybersecurity Risk Process For Informing Board Committee Or Subcommittee Responsible For Oversight [Text Block]	​ Cybersecurity is an important area of focus for our board of directors. Our audit committee is responsible for carrying out, on behalf of our board of directors, oversight of information security, including cybersecurity, risks. Our audit committee is composed of directors with diverse expertise relevant to such committee’s responsibilities, and includes two directors who have expertise or certifications in cybersecurity. Our management team provides updates on cybersecurity matters to our audit committee on a quarterly basis, with more frequent or interim communications as warranted. In addition to the oversight by our audit committee, our board of directors receives an annual report on cybersecurity matters from our Chief Technology Officer, or CTO. Our Chief Compliance & Privacy Officer, or CCPO, and CTO also attend regular meetings of our board of directors, and engage in discussions on an ad hoc basis relating to cybersecurity and information security matters.
Cybersecurity Risk Role Of Management [Text Block]	We maintain an Information Security Leadership Committee, or ISLC, that is accountable for enterprise-level information security risk strategy, identification, prioritization, and mitigation, including establishing objectives and priorities. The ISLC comprises company executives that, collectively, represent experience and expertise in information technology, enterprise security and risk management, cybersecurity, engineering, technology, privacy, data security, and healthcare compliance. Members of this committee include our CTO, CCPO, Chief Information Officer, Chief Information Security Officer, and Chief Accounting Officer. The ISLC meets on at least a quarterly basis to review matters including updates on existing and emerging cybersecurity risks and threats including prioritization, mitigation, and remediation; the status of projects to strengthen our information security systems; assessments of our information security program and operations; and prioritized information security incidents, if any. The ISLC oversees the Information Security Execution Team.
Cybersecurity Risk Management Positions Or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions Or Committees Responsible [Text Block]	Information Security Leadership Committee, or ISLC, that is accountable for enterprise-level information security risk strategy, identification, prioritization, and mitigation, including establishing objectives and priorities.
Cybersecurity Risk Management Expertise Of Management Responsible [Text Block]	The ISLC comprises company executives that, collectively, represent experience and expertise in information technology, enterprise security and risk management, cybersecurity, engineering, technology, privacy, data security, and healthcare compliance
Cybersecurity Risk Process For Informing Management Or Committees Responsible [Text Block]	The ISLC meets on at least a quarterly basis to review matters including updates on existing and emerging cybersecurity risks and threats including prioritization, mitigation, and remediation; the status of projects to strengthen our information security systems; assessments of our information security program and operations; and prioritized information security incidents
Cybersecurity Risk Management Positions Or Committees Responsible Report To Board [Flag]	true

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Summary of Significant Accounting Policies
Basis of Presentation	Basis of Presentation ​ The accompanying consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”).
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 $190.4 million for the year ended December 31, 2024 and an accumulated deficit of $2.6 billion as of December 31, 2024. As of December 31, 2024, the Company had $945.6 million in cash, cash equivalents, and restricted cash, $22.7 million in marketable securities, and $80.4 million of outstanding balance on the Credit Line (as defined in Note 10, Debt) including accrued interest. The Company is required to maintain a minimum of at least $150.0 million in its UBS accounts as collateral for its Credit Line which is classified as cash, cash equivalents, and short-term investments in the consolidated balance sheets. As of December 31, 2024, the Company had $20.0 million remaining and available on its Credit Line. ​ 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 or slow its investment in 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 (the “Convertible Notes”) due 2027. The redemption was completed on October 11, 2024 (the “Redemption Date”). The redemption price for the Convertible Notes equaled 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. On the Redemption Date, $287.4 million of Convertible Notes were redeemed for approximately 7.5 million shares of the Company’s common stock under the terms of the redemption notice. The remaining Convertible Notes not redeemed under the redemption notice were converted in exchange for cash at face value plus accrued interest totaling $0.1 million. As such, the Company’s redemption of its Convertible Notes did not 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. In November 2022, the Company completed an underwritten equity offering and sold 13,144,500 shares of its common stock at a price of $35 per share to the public. After estimated offering expenses of $0.5 million, the Company received proceeds of approximately $433.2 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. The total upfront acquisition consideration amounted 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. Further, additional consideration aggregating up to approximately $35.0 million was estimated to be paid via issuance of an estimated 269,547 additional Natera common shares, 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 Natera 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 February 27, 2025.
Principles of Consolidation	Principles of Consolidation ​ The accompanying consolidated financial statements include all the accounts of the Company and its subsidiaries. All intercompany balances and transactions have been eliminated.
Use of Estimates	Use of Estimates ​ ​
Cash, Cash Equivalents, and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash ​ Cash, cash equivalents, and restricted cash consist of cash, liquid demand deposits, and money market funds whose fund policies require the weighted average maturity of the fund's securities holdings not to exceed 90 days. Restricted cash as of December 31, 2024 and 2023 was immaterial. Cash equivalents do not include U.S. Treasuries.
Investments	Investments ​ ​ Available-for-sale debt securities. Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments
Accounts Receivable, net of allowance	Accounts Receivable, net of allowance Trade accounts receivable and other receivables. Balance Sheet Components With respect to revenue recognized related to genetic test services provided to patient customers whereby consideration is expected to be received from insurance or patient payors, the Company recognizes a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. 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. After applying the ASC 606 constraint, the Company assessed for credit losses under ASC 326 and determined an incremental credit loss was not needed given the quality of the insurance payors from whom such receivables are expected to be collectible and the relatively short duration over which the majority of receivables are collected. Accordingly, the Company currently does not have an incremental credit loss reserve nor allowance for doubtful accounts against accounts receivable for insurance and patient payors due to the average selling price calculations which incorporate these risks as net receivables are recorded.
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 are consumed at the point biologic samples are collected and as the Company provides genetic testing services, and therefore, the Company does not maintain any work-in-process or 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. ​ ​ The following is a roll-forward of the inventory reserve for the years ended December 31, 2024 and 2023. ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ 872 ​ $ 748 Write-offs ​ ​ (454) ​ ​ (2,175) Net additions to reserve ​ ​ 141 ​ ​ 2,299 Ending balance ​ $ 559 ​ $ 872
Property and Equipment	Property and Equipment ​ Property and equipment, including purchased and internally developed software, are recorded at cost less accumulated depreciation and amortization. Depreciation and amortization are calculated using the straight-line method over the estimated useful lives of the assets, which are generally three to five years determined by the classification of the property and equipment class in accordance with the Company’s fixed asset policy. Leasehold improvements are amortized using the straight-line method over the estimated useful lives of the assets or the remaining term of the lease, whichever is shorter. The Company periodically reviews the useful lives assigned to property and equipment placed in service in accordance with the Company’s fixed asset policy and changes the estimates of useful lives to reflect the results of such reviews. ​ Capitalized Software Held for Internal Use ​ The Company capitalizes salaries and related costs of employees and consultants who devote time to the development of internal-use software development projects. Capitalization begins during the application development stage, once the preliminary project stage has been completed, which includes successful validation and approval from management. If a project constitutes an enhancement to previously developed software, the Company assesses whether the enhancement is significant and creates additional functionality to the software, thus qualifying the work incurred for capitalization. Once the project is available for general release, the asset is placed in service and the Company estimates the useful life of the asset and begins amortization. The Company periodically assesses whether triggering events are present to review internal-use software for impairment. Changes in estimates related to internal-use software would increase or decrease operating expenses or amortization recorded during the reporting period. ​ The Company amortizes its internal-use software over the estimated useful lives of three years. The net book value of capitalized software held for internal use was $17.1 million and $8.7 million as of December 31, 2024 and 2023, respectively. Amortization expense for amounts previously capitalized for the years ended December 31, 2024, 2023, and 2022, was $3.5 million, $2.4 million, and $0.2 million, respectively. ​ Impairment of Long-lived Assets ​ The Company evaluates its long-lived assets for indicators of possible impairment when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. The Company then compares the carrying amounts of the assets with the future net undiscounted cash flows expected to be generated by such asset. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value determined using discounted estimates of future cash flows. The Company did not incur any material impairment charges during the years ended December 31, 2024, 2023, and 2022.
Capitalized Software Held for Internal Use	Capitalized Software Held for Internal Use ​ The Company capitalizes salaries and related costs of employees and consultants who devote time to the development of internal-use software development projects. Capitalization begins during the application development stage, once the preliminary project stage has been completed, which includes successful validation and approval from management. If a project constitutes an enhancement to previously developed software, the Company assesses whether the enhancement is significant and creates additional functionality to the software, thus qualifying the work incurred for capitalization. Once the project is available for general release, the asset is placed in service and the Company estimates the useful life of the asset and begins amortization. The Company periodically assesses whether triggering events are present to review internal-use software for impairment. Changes in estimates related to internal-use software would increase or decrease operating expenses or amortization recorded during the reporting period. ​ The Company amortizes its internal-use software over the estimated useful lives of three years. The net book value of capitalized software held for internal use was $17.1 million and $8.7 million as of December 31, 2024 and 2023, respectively. Amortization expense for amounts previously capitalized for the years ended December 31, 2024, 2023, and 2022, was $3.5 million, $2.4 million, and $0.2 million, respectively.
Impairment of Long-lived Assets	Impairment of Long-lived Assets ​ The Company evaluates its long-lived assets for indicators of possible impairment when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. The Company then compares the carrying amounts of the assets with the future net undiscounted cash flows expected to be generated by such asset. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value determined using discounted estimates of future cash flows. The Company did not incur any material impairment charges during the years ended December 31, 2024, 2023, and 2022.
Operating lease right-of-use assets	Operating Lease Right-of-Use Assets ​ The Company determines if an arrangement is or contains a lease at inception and classify each lease as operating or financing. Operating lease right-of-use assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments made during the lease term, net of any tenant improvement allowance. Operating lease right-of-use assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. In determining the present value of committed lease payments, the Company uses its incremental borrowing rate based on the information available at the lease commencement date, which includes significant assumptions made including the Company’s estimated credit rating, annual percentage yields from corporate debt financings of companies of similar size and credit rating over a loan term approximating the remaining term of each lease, and government bond yields for terms approximating the remaining term of each lease in countries where the leased assets are located. Certain leases include payments of operating expenses that are dependent on the landlord’s estimate, and these variable payments are therefore excluded from the lease payments used to determine the operating lease right-of-use asset and lease liability. Lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise any such options. Operating lease right-of-use assets are adjusted for prepaid lease payments, lease incentives and initial direct costs incurred. Lease expense is recognized on a straight-line basis over the expected lease term. ​ The Company elected to not apply the recognition requirements of Topic 842 to short-term leases with terms of 12 months or less. For short-term leases, lease payments are recognized as operating expenses on a straight-line basis over the lease term.
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. During the year ended December 31, 2024, the Company recorded $1.0 million in amortization expense. 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. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ (3,085) ​ $ (16,362) Net unrealized gain (loss) on available-for-sale securities, net of tax and foreign currency translation adjustment ​ ​ 2,741 ​ ​ 13,277 Ending balance ​ $ (344) ​ $ (3,085) ​ ​ ​ ​ ​ ​ ​ ​ The change in net unrealized loss on available-for-sale securities is due to the impact of changes in interest rates on the value of fixed-rate investments and not due to any credit deterioration. Further, due to the short-term nature of these investments, the Company has the ability and intention to hold any such investments until maturity and does not expect to realize any material investment losses. As such, 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,
Cost of Product Revenues	Cost of Product Revenues ​ The components of our cost of product revenues are material and service costs, impairment charges associated with testing equipment, personnel costs, including stock-based compensation expense, equipment and infrastructure expenses associated with testing samples, electronic medical records, order and delivery systems, shipping charges to transport samples, costs incurred from third party test processing fees, and allocated overhead such as rent, information technology costs, equipment depreciation and utilities. Costs associated with Whole Exome Sequencing (“WES”) are also included, as well as labor costs, relating to our Signatera CLIA offering. Costs associated with performing tests are recorded when the test is accessioned. Costs associated with collection kits are recorded upon shipment to the clinics.
Cost of Licensing and Other Revenues	Cost of Licensing and Other Revenues ​ The components of our cost of licensing and other revenues are material costs associated with test kits sold to clients using Constellation, the Company’s cloud software product clients, development and support services relating to our strategic partnership agreements, and other costs.
Research and Development	Research and Development ​ The Company records research and development costs in the period incurred. Research and development costs consist of personnel costs, including stock-based compensation expense, contract services, cost of materials utilized in performing tests, costs of clinical trials, cost of clinical samples and related clinical data, asset acquisition of in-process research and development, and allocated facilities and related overhead expenses.
Advertising Costs	Advertising Costs ​ The Company expenses advertising costs as incurred. The Company incurred advertising costs of $2.3 million, $1.1 million, and $1.8 million for the years ended December 31, 2024, 2023, and 2022, respectively.
Product Shipment Costs	Product Shipment Costs ​ The Company expenses product shipment costs, which include biological samples for processing, in cost of product revenues in the accompanying statements of operations. Shipping and handling costs for the years ended December 31, 2024, 2023, and 2022 were $43.5 million, $42.2 million, and $36.0 million, respectively.
Income Taxes	Income Taxes ​ Income taxes are recorded in accordance with Financial Accounting Standards Board ASC Topic 740, Income Taxes Income Taxes
Defined Contribution Plan Costs	Defined Contribution Plan Costs ​ The Company has a defined contribution plan (the “Defined Contribution Plan”) for its employees which complies with section 401(k) of the Internal Revenue Code. The Company provides a discretionary match to all participants who make 401(k) contributions pursuant to the Defined Contribution Plan. The discretionary match provided to participants is equivalent to 50% of a participant’s pre-tax contributions up to a maximum of 6% of eligible compensation per pay period. Total consolidated contribution expense under these plans was $10.7 million, $8.6 million and $9.1 million for the years ended December 31, 2024, 2023 and 2022, respectively.
Stock-Based Compensation	Stock-Based Compensation ​ Stock-based compensation related to stock options, restricted stock units (“RSUs”), performance-based awards (“PSUs”), market-based awards, and stock purchase rights under an Employee Stock Purchase Plan (“ESPP”) granted to the Company’s employees is measured at the grant date based on the fair value of the award. The fair value is recognized as expense over the requisite service period, which is generally the vesting period of the respective awards. If awards have both a service condition and performance or market condition, then a graded attribution method is used to recognize expense. No compensation cost is recognized when the requisite service has not been met and the awards are therefore forfeited. ​ Employee stock-based compensation expense is calculated based on awards ultimately expected to vest and has been reduced for estimated forfeitures. Forfeitures are estimated at the time of grant and revised, if necessary, in subsequent periods, if actual forfeitures differ from those estimates. Non-employee stock-based compensation expense is not adjusted for estimated forfeitures up until the occurrence of the actual forfeiture of the associated awards. ​ ​ ​ For stock options with market conditions, the Company derives the requisite service period using the Monte Carlo simulation model. For stock options and RSUs that vest upon meeting performance conditions or market conditions in combination with performance conditions, the Company derives the requisite service period from the grant date to the date it is probable that the vesting conditions will be met. ​ ​
Net loss per share	Net Loss Per Share ​
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 Transactions	Related Party Transactions ​ 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 which was allocated $2.2 million for preferred shares and $1.8 million for warrants. In August 2024, the Company participated in a subsequent round of the series B financing and purchased an additional $2.7 million of series B preferred shares at the same valuation as the initial round of financing in December 2021. The Company does not hold a seat on MyOme’s board of directors and does not participate or direct the day to day activities of MyOme. Because MyOme is a privately-held company without readily determinable fair values, the Company elected to account for its preferred Series B share investment in MyOme using the measurement alternative, which is cost, less any impairment, adjusted for changes in fair value resulting from observable transactions for identical or similar investments of the same issuer as of the respective transaction dates. When indicators exist and the estimated fair value of the investment is below its carrying amount, the Company would adjust the investment to fair value. The change in carrying value, resulting from the remeasurements, would be recognized in interest and other income, net on the consolidated statements of operations. During the years ended December 31, 2024, 2023, and 2022, no upward nor downward adjustments have been recorded. 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 22.6% 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 is exercisable in whole or in part, commencing in February 2024, and can be converted to MyOme’s common stock upon the occurrence of MyOme’s initial public offering or a liquidation event (as such terms are defined in MyOme's certificate of incorporation). Additionally, upon the achievement of certain product commercialization milestones, the Company is eligible to receive an additional warrant exercisable for 2,080,565 shares of MyOme’s series B preferred stock with an exercise price of $0.01 per share. During September 2024, the Company achieved certain product commercialization milestones such that the warrant for 2,080,565 shares of MyOme’s series B preferred stock was due from MyOme to the Company. These warrants were granted and issued by MyOme to the Company during the fourth quarter of 2024, and are exercisable in whole or in part commencing in December 2024. However, the Company needs to perform ongoing collaboration in exchange for the warrant consideration. Accordingly, the warrants have been included within other assets and allocated between short-term and long-term liabilities on the consolidated balance sheets. The Company is amortizing the liability as a reduction of selling and marketing expense upon commercialization and sale of the products contemplated under the Collaboration Agreement over the life of the contract. For the year ended December 31, 2024, the amortization of the non-cash liability was $0.4 million. The warrants issued to the Company in 2021 and 2024 are accounted for as derivative instruments and recorded within other assets on the consolidated balance sheets at fair value. The warrants were valued using the Black-Scholes valuation model as of each reporting period, including the date of issuance. No material changes to fair value were identified during the years ended December 31, 2024, 2023 and 2022. 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. For the year ended December 31, 2024, the royalties to MyOme were not material. As of December 31, 2024 and December 31, 2023, the Company’s carrying amount of preferred shares in MyOme was $4.9 million and $2.2 million, respectively, on its consolidated balance sheets. The fair market value of the warrants as of December 31, 2024 and 2023 was $11.2 million and $1.8 million, respectively, on the consolidated balance sheets.
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 credit 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. 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 years ended December 31, 2024, 2023, and 2022, there were no customers exceeding 10% of total revenues on an individual basis. As of December 31, 2024 and 2023, there were no customers with an outstanding balance exceeding 10% of net accounts receivable. ​ For the years ended December 2024, 2023, and 2022, approximately 12.1%, 12.8%, and 11.2%, respectively, of total revenue were paid by Medicare on behalf of multiple customers. For the years ended December 2024 and 2023, approximately 11.5% and 10.2% respectively, of accounts receivable 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. Recently Adopted Accounting Pronouncements In November 2023, ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, was issued which requires disclosure of incremental segment information on an interim and annual basis that are regularly provided to the chief operating decision maker (the “CODM”) and included within each reported measure of segment profit or loss. The Company has adopted this ASU as of December 31, 2024. The Company currently operates as a single reporting segment entity with the Chief Executive Officer as the CODM. The CODM relies on the financial statements as presented within the annual report Form 10-K to evaluate the Company’s financial performance and make key operating decisions. The key area of focus by the CODM for allocation of resources is the cash used in operations. These financial statements provide a comprehensive view of the Company’s overall financial condition, including information on expenses, assets and liabilities. The significant expense categories are consistent with those presented on the face of the statements of operations and comprehensive loss. The CODM does not receive or use any other segmented or disaggregated financial or any significant expense information for decision making purposes. Additionally, gross margin is regularly provided to the CODM and is derived based on the consolidated statements of operations and comprehensive loss as follows: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands except percentages) Revenue ​ $ 1,696,911 ​ $ 1,082,571 ​ $ 820,222 Cost of product revenues ​ ​ 672,304 ​ ​ 588,564 ​ ​ 453,632 Cost of licensing and other revenues ​ ​ 1,449 ​ ​ 1,267 ​ ​ 2,624 Gross margin ​ $ 1,023,158 ​ $ 492,740 ​ $ 363,966 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Gross margin percentage ​ ​ 60.3% ​ ​ 45.5% ​ ​ 44.4% ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 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 December 2023, ASU 2023-09, Income Taxes - Improvements to Income Tax Disclosures In November 2024, Income Statement—Reporting Comprehensive Income—Expense Disaggregation Disclosures (Subtopic 220-40)

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2024
Summary of Significant Accounting Policies
Roll-forward of inventory reserve	​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ 872 ​ $ 748 Write-offs ​ ​ (454) ​ ​ (2,175) Net additions to reserve ​ ​ 141 ​ ​ 2,299 Ending balance ​ $ 559 ​ $ 872
Schedule of Accumulated Other Comprehensive Income (Loss)	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ (3,085) ​ $ (16,362) Net unrealized gain (loss) on available-for-sale securities, net of tax and foreign currency translation adjustment ​ ​ 2,741 ​ ​ 13,277 Ending balance ​ $ (344) ​ $ (3,085) ​ ​ ​ ​ ​ ​ ​
Schedule of recently adopted accounting pronouncements	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands except percentages) Revenue ​ $ 1,696,911 ​ $ 1,082,571 ​ $ 820,222 Cost of product revenues ​ ​ 672,304 ​ ​ 588,564 ​ ​ 453,632 Cost of licensing and other revenues ​ ​ 1,449 ​ ​ 1,267 ​ ​ 2,624 Gross margin ​ $ 1,023,158 ​ $ 492,740 ​ $ 363,966 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Gross margin percentage ​ ​ 60.3% ​ ​ 45.5% ​ ​ 44.4% ​ ​ ​ ​ ​ ​ ​ ​ ​ ​

Revenue Recognition (Tables)

Revenue Recognition (Tables)	12 Months Ended
	Dec. 31, 2024
Revenue Recognition
Schedule of disaggregation of revenues by payer types	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands) Insurance carriers ​ $ 1,571,817 ​ $ 954,155 ​ $ 690,754 Laboratory partners ​ ​ 97,210 ​ ​ 98,891 ​ ​ 94,910 Patients ​ ​ 27,884 ​ ​ 29,525 ​ ​ 34,558 Total revenues ​ $ 1,696,911 ​ $ 1,082,571 ​ $ 820,222
Schedule of total revenue by geographic area	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, ​ ​ 2024 2023 2022 ​ ​ (in thousands) United States ​ $ 1,657,745 $ 1,047,636 $ 785,849 Americas, excluding U.S. ​ ​ 6,620 ​ 4,908 ​ 3,705 Europe, Middle East, India, Africa ​ ​ 23,884 ​ 22,811 ​ 16,640 Asia Pacific and Other ​ ​ 8,662 ​ 7,216 ​ 14,028 Total ​ $ 1,696,911 $ 1,082,571 ​ $ 820,222
Schedule of beginning and ending balances of accounts receivable and deferred revenues	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ Balance at ​ ​ December 31, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Assets: ​ ​ ​ ​ ​ ​ Accounts receivable, net ​ $ 314,165 ​ $ 278,289 Liabilities: ​ ​ ​ ​ ​ ​ Deferred revenue, current portion ​ $ 19,754 ​ $ 16,612 Deferred revenue, long-term portion (1) ​ ​ 16,838 ​ ​ 19,128 Total deferred revenues ​ $ 36,592 ​ $ 35,740
Schedule of changes in the balance of deferred revenues	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Balance at ​ Balance at ​ ​ December 31, ​ December 31, ​ ​ 2024 ​ 2023 ​ ​ (in thousands) Beginning balance ​ $ 35,740 ​ $ 30,778 Increase in deferred revenues ​ ​ 35,440 ​ ​ 35,573 Reclasses from deferred revenues to other short-term liabilities ​ ​ — ​ ​ (522) Revenue recognized during the period that was included in ​ ​ (13,693) ​ ​ (10,564) Revenue recognized from performance obligations satisfied ​ ​ (20,895) ​ ​ (19,525) Ending balance ​ $ 36,592 ​ $ 35,740

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2024
Fair Value Measurements
Summary of financial assets and liabilities measured on recurring basis	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 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) ​ $ 945,587 ​ $ — ​ $ — ​ $ 945,587 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 ​ U.S. Treasury securities ​ ​ — ​ ​ — ​ ​ — ​ ​ — ​ ​ 200,418 ​ ​ — ​ ​ — ​ ​ 200,418 ​ Municipal securities ​ ​ — ​ ​ 22,689 ​ ​ — ​ ​ 22,689 ​ ​ — ​ ​ 36,464 ​ ​ — ​ ​ 36,464 ​ Total financial assets ​ $ 945,587 ​ $ 22,689 ​ $ — ​ $ 968,276 ​ $ 842,513 ​ $ 36,464 ​ $ — ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​

Financial Instruments (Tables)

Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2024
Financial Instruments
Schedule of available-for-sale securities	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 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) ​ $ 945,587 ​ $ — ​ $ — ​ $ 945,587 ​ $ 642,095 ​ $ — ​ $ — ​ $ 642,095 ​ U.S. Treasury securities (1) ​ — ​ — ​ — ​ — ​ 201,522 ​ 14 ​ (1,118) ​ 200,418 ​ Municipal securities (1) ​ ​ 23,019 ​ ​ — ​ ​ (330) ​ ​ 22,689 ​ ​ 38,091 ​ ​ — ​ ​ (1,627) ​ ​ 36,464 ​ Total ​ $ 968,606 ​ $ — ​ $ (330) ​ $ 968,276 ​ $ 881,708 ​ $ 14 ​ $ (2,745) ​ $ 878,977 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Classified as: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash, cash equivalents and restricted cash (2) ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 945,587 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 642,095 ​ Short-term investments ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 22,689 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ 236,882 ​ Total ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 968,276 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ $ 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) Municipal securities ​ $ — ​ $ — ​ $ 17,688 ​ $ (330) ​ $ 17,688 ​ $ (330) Total ​ $ — ​ $ — ​ $ 17,688 ​ $ (330) ​ $ 17,688 ​ $ (330)
Summarized portfolio of available-for-sale securities by contractual maturity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, 2024 ​ ​ ​ Amortized Cost ​ Fair Value ​ ​ ​ (in thousands) ​ Less than or equal to one year ​ $ 23,019 ​ $ 22,689 ​ Greater than one year but less than five years ​ ​ — ​ ​ — ​ Total ​ $ 23,019 ​ $ 22,689 ​ ​

Balance Sheet Components (Table

Balance Sheet Components (Tables)	12 Months Ended
	Dec. 31, 2024
Balance Sheet Components
Schedule of allowances for doubtful accounts	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ (in thousands) Beginning balance ​ $ 6,481 ​ $ 3,830 ​ $ 2,429 Provision for doubtful accounts ​ ​ 1,279 ​ ​ 2,645 ​ ​ 1,770 (Write-offs) / Recoveries ​ ​ (501) ​ ​ 6 ​ ​ (369) Total ​ $ 7,259 ​ $ 6,481 ​ $ 3,830
Schedule of property and equipment	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ December 31, ​ ​ Useful Life 2024 2023 ​ ​ ​ ​ ​ (in thousands) ​ Machinery and equipment 3-5 years $ 117,076 ​ $ 85,626 ​ Computer equipment 3 years ​ 3,178 ​ 1,850 ​ Purchased and capitalized software held for internal use ​ 3 years ​ ​ 13,178 ​ ​ 11,636 ​ Leasehold improvements Lesser of useful life or lease term ​ 48,569 ​ 38,999 ​ Construction-in-process ​ ​ ​ 58,461 ​ 29,392 ​ ​ ​ ​ ​ 240,462 ​ 167,503 ​ Less: Accumulated depreciation and amortization ​ ​ ​ (78,416) ​ (56,293) ​ Total Property and Equipment, net ​ ​ ​ $ 162,046 ​ $ 111,210 ​
Schedule of accrued compensation	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ ​ 2024 2023 ​ ​ (in thousands) ​ Accrued paid time off ​ $ 3,826 ​ $ 3,121 ​ Accrued commissions ​ 14,224 ​ 10,522 ​ Accrued bonuses ​ 32,236 ​ 24,651 ​ Other accrued compensation ​ 11,828 ​ 7,563 ​ Total accrued compensation ​ $ 62,114 ​ $ 45,857 ​
Schedule of other accrued liabilities	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ 2024 2023 ​ ​ (in thousands) Reserves for refunds to insurance carriers ​ $ 11,276 ​ $ 23,245 ​ Accrued charges for third-party testing ​ ​ 12,321 ​ ​ 14,823 ​ Testing and laboratory materials from suppliers ​ ​ 7,893 ​ ​ 11,229 ​ Marketing and corporate affairs ​ ​ 16,548 ​ ​ 10,085 ​ Legal, audit and consulting fees ​ ​ 54,208 ​ ​ 43,897 ​ Accrued shipping charges ​ ​ 1,625 ​ ​ 3,646 ​ Sales and income tax payable ​ ​ 4,416 ​ ​ 3,731 ​ Accrued third-party service fees ​ ​ 9,046 ​ ​ 7,111 ​ Clinical trials and studies ​ 10,097 ​ 12,126 ​ Operating lease liabilities, current portion ​ ​ 10,168 ​ ​ 11,621 ​ Property and equipment purchases ​ ​ 7,098 ​ ​ 4,316 ​ Other accrued interest ​ ​ — ​ ​ 1,078 ​ Other accrued expenses ​ 2,197 ​ 2,497 ​ Total other accrued liabilities ​ $ 146,893 ​ $ 149,405 ​
Schedule of insurance carrier reserve balance	​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ 2024 2023 ​ ​ (in thousands) Beginning balance ​ $ 23,245 ​ $ 18,948 Additional reserves ​ ​ 2,562 ​ ​ 14,974 Refunds to carriers ​ ​ (4,620) ​ ​ (1,583) Reserves released to revenue ​ ​ (9,911) ​ ​ (9,094) Ending balance ​ $ 11,276 ​ $ 23,245 ​ ​ ​ ​ ​ ​ ​ ​

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases.
Schedule of lease liabilities	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, December 31, ​ ​ 2024 2023 ​ ​ (in thousands) Operating lease liabilities, current portion included in other accrued liabilities ​ $ 10,168 ​ $ 11,621 Operating lease liabilities, long-term portion ​ ​ 96,588 ​ ​ 67,025 Total operating lease liabilities ​ $ 106,756 ​ $ 78,646
Schedule of annual minimum lease payments	​ ​ ​ ​ ​ ​ ​ Operating Leases ​ ​ (in thousands) Year ending December 31: ​ ​ ​ ​ 2025 ​ $ 17,533 ​ 2026 ​ ​ 17,809 ​ 2027 ​ ​ 17,119 ​ 2028 ​ ​ 17,443 ​ 2029 ​ ​ 17,324 ​ 2030 and thereafter ​ ​ 53,335 ​ Total future minimum lease payments ​ ​ 140,563 ​ Less: imputed interest ​ ​ (33,807) ​ Operating lease liabilities ​ $ 106,756 ​ ​

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies
Schedule of material contractual commitments	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, Party ​ Total Commitments ​ ​ 2025 ​ ​ 2026 ​ ​ 2027 ​ ​ 2028 ​ ​ 2029 ​ ​ 2030 and thereafter ​ ​ ​ (in thousands) Laboratory instruments supplier ​ $ 27,700 ​ $ 8,800 ​ $ 9,200 ​ $ 9,700 ​ $ — ​ $ — ​ $ — Material suppliers ​ ​ 53,988 ​ ​ 53,931 ​ ​ 57 ​ ​ — ​ ​ — ​ ​ — ​ ​ — Application service providers ​ ​ 4,235 ​ ​ 3,892 ​ ​ 343 ​ ​ — ​ ​ — ​ ​ — ​ ​ — Cloud platform service provider ​ ​ 34,180 ​ ​ 7,120 ​ ​ 9,060 ​ ​ 9,000 ​ ​ 9,000 ​ ​ — ​ ​ — Other ​ ​ 51,159 ​ ​ 40,075 ​ ​ 4,684 ​ ​ 2,041 ​ ​ 1,256 ​ ​ 1,103 ​ ​ 2,000 Total ​ $ 171,262 ​ $ 113,818 ​ $ 23,344 ​ $ 20,741 ​ $ 10,256 ​ $ 1,103 ​ $ 2,000 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Summary of stock-based compensation expenses	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year Ended December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ (in thousands) Cost of revenues ​ $ 16,468 ​ $ 11,752 ​ $ 7,905 Research and development ​ 88,705 ​ 66,326 ​ 46,545 Selling, general and administrative ​ 169,255 ​ 113,730 ​ 97,934 Total ​ $ 274,428 ​ $ 191,808 ​ $ 152,384 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​
Summary of offering activity	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ ​ Weighted- ​ Average ​ ​ ​ ​ ​ ​ Average ​ Remaining ​ Aggregate ​ ​ Number of ​ Exercise ​ Contractual ​ Intrinsic ​ ​ Shares ​ Price ​ Life ​ Value (in thousands, except for contractual life and exercise price) ​ ​ ​ ​ ​ ​ (in years) ​ ​ Balance at December 31, 2023 5,501 ​ $ 23.65 4.36 ​ $ 231,133 ​ Options exercised (1,626) ​ $ 7.98 ​ ​ ​ ​ ​ ​ Balance at December 31, 2024 3,875 ​ $ 30.22 4.45 ​ $ 496,135 ​ Exercisable at December 31, 2024 3,185 ​ $ 23.22 3.80 ​ $ 430,197 ​ Vested and expected to vest at December 31, 2024 3,831 ​ $ 29.86 4.42 ​ $ 492,065 ​
RSU and performance-based awards	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ ​ ​ ​ Average ​ ​ Number of ​ Grant Date ​ ​ Shares ​ Fair Value ​ ​ (in thousands) ​ ​ ​ Balance at December 31, 2023 ​ 9,248 ​ $ 49.50 Granted ​ 5,400 ​ $ 76.90 Vested ​ (3,538) ​ $ 55.90 Cancelled/Forfeited ​ (517) ​ $ 58.23 Balance at December 31, 2024 10,593 ​ $ 61.28 ​ ​ ​ ​ ​ ​
Employee Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of assumptions used in valuation of fair value	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Year ended December 31, ​ 2024 2023 2022 ​ Expected term (years) ​ ​ ​ — ​ ​ 5.20 ​ — 6.11 ​ ​ 5.12 ​ — 10.00 ​ Expected volatility ​ ​ ​ — % 67.75 % — 70.07 % ​ 55.91 % — 62.30 % Expected dividend rate ​ ​ ​ — % ​ ​ ​ — % ​ ​ ​ ​ — % Risk-free interest rate ​ ​ ​ — % 3.41 % — 4.80 % ​ 1.62 % — 4.16 %

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2024
Debt
Schedule of outstanding Convertible Notes	​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ 2024 ​ 2023 ​ (in thousands) Long-Term Debt ​ ​ ​ ​ ​ Outstanding Principal $ — ​ $ 287,500 Unamortized debt discount and debt issuance cost ​ — ​ ​ (4,555) Net carrying amount $ — ​ $ 282,945
Summary of interest expense	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ 2024 ​ ​ 2023 ​ ​ 2022 ​ (in thousands) Cash interest expense ​ ​ ​ ​ ​ ​ ​ ​ Contractual interest expense $ 2,157 ​ $ 6,469 ​ $ 6,469 Non-cash interest expense ​ ​ ​ ​ ​ ​ ​ ​ Contractual interest expense ​ 2,875 ​ ​ — ​ ​ — Amortization of debt discount and debt issuance cost ​ 991 ​ ​ 1,292 ​ ​ 1,259 Total interest expense $ 6,023 ​ $ 7,761 ​ $ 7,728 ​

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Taxes
Schedule of effective tax rates differing from U.S. federal statutory rate	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 ​ 2023 ​ 2022 ​ ​ ​ (in thousands, except percentages) ​ U.S. federal taxes (benefit) at statutory rate ​ $ (39,844) ​ 21.00 % ​ $ (91,251) ​ 21.00 % ​ $ (114,832) 21.00 % State tax expense ​ ​ (21,613) ​ 11.39 % ​ ​ (13,492) ​ 3.10 % ​ ​ (21,676) ​ 3.96 % Research and development credits ​ ​ (17,621) ​ 9.29 % ​ ​ (10,837) ​ 2.49 % ​ ​ (7,024) ​ 1.28 % Stock-based compensation ​ ​ (62,969) ​ 33.19 % ​ ​ (6,422) ​ 1.48 % ​ ​ 3,949 ​ (0.72) % Foreign tax ​ ​ (25) ​ 0.01 % ​ ​ (106) ​ 0.02 % ​ ​ 332 ​ (0.06) % Nondeductible officers' compensation ​ ​ 31,718 ​ (16.72) % ​ ​ 8,651 ​ (1.99) % ​ ​ 4,883 ​ (0.89) % Acquisition costs ​ ​ — ​ 0.00 % ​ ​ 563 ​ (0.13) % ​ ​ 3,226 ​ (0.59) % Nondeductible meals and other ​ ​ 2,870 ​ (1.51) % ​ ​ (3,397) ​ 0.79 % ​ ​ 1,964 ​ (0.36) % Change in valuation allowance ​ ​ 108,179 ​ (57.02) % ​ ​ 116,562 ​ (26.82) % ​ ​ 130,156 ​ (23.80) % Provision for income taxes ​ $ 695 ​ (0.37) % ​ $ 271 ​ (0.06) % ​ $ 978 ​ (0.18) %
Schedule of tax effects of temporary differences that give rise to significant portions of the deferred tax assets	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ ​ ​ 2024 ​ 2023 ​ ​ ​ ​ ​ ​ (in thousands) ​ Deferred tax assets: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Net operating loss carryforwards ​ ​ ​ ​ $ 395,139 ​ $ 399,287 ​ Research and development tax credit carryforwards ​ ​ ​ ​ ​ 90,759 ​ ​ 67,035 ​ Capitalized research costs ​ ​ ​ ​ ​ 173,991 ​ ​ 95,923 ​ Reserves and accruals ​ ​ ​ ​ ​ 23,928 ​ ​ 34,898 ​ Lease liabilities ​ ​ ​ ​ ​ 26,649 ​ ​ 19,339 ​ Stock-based compensation ​ ​ ​ ​ ​ 47,864 ​ ​ 29,005 ​ Intangible assets ​ ​ ​ ​ ​ 8,846 ​ ​ 3,809 ​ Other ​ ​ ​ ​ ​ 5,583 ​ ​ 5,640 ​ Total deferred tax assets before valuation allowance ​ ​ ​ ​ ​ 772,759 ​ ​ 654,936 ​ Less: valuation allowance ​ ​ ​ ​ ​ (747,090) ​ ​ (639,510) ​ Total deferred tax assets after valuation allowance ​ ​ ​ ​ ​ 25,669 ​ ​ 15,426 ​ Deferred tax liabilities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Fixed assets ​ ​ ​ ​ ​ (4,164) ​ ​ (1,524) ​ Right-of-use lease assets ​ ​ ​ ​ ​ (21,505) ​ ​ (13,902) ​ Total deferred tax liabilities ​ ​ ​ ​ ​ (25,669) ​ ​ (15,426) ​ Net deferred tax assets ​ ​ ​ ​ $ — ​ $ — ​
Schedule of reconciliation of the beginning and ending amount of gross unrecognized tax benefits	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 2023 ​ 2022 ​ ​ (in thousands) ​ Balance at beginning of year ​ $ 30,912 ​ $ 23,844 ​ $ 17,514 ​ Additions based on tax positions related to the current year ​ ​ 13,648 ​ ​ 7,034 ​ ​ 6,301 ​ Additions (reductions) for tax positions of prior years ​ ​ (9,620) ​ ​ 34 ​ ​ 29 ​ Balance at end of year ​ $ 34,940 ​ $ 30,912 ​ $ 23,844 ​

Net Loss per Share (Tables)

Net Loss per Share (Tables)	12 Months Ended
	Dec. 31, 2024
Net Loss per Share
Total outstanding potentially dilutive shares	​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ December 31, ​ ​ 2024 2023 2022 ​ (in thousands) ​ Options to purchase common stock ​ 3,875 5,501 5,300 ​ Performance-based awards and restricted stock units ​ 10,593 ​ 9,248 ​ 6,836 ​ Employee stock purchase plan ​ 40 ​ 88 ​ 90 ​ Convertible Note ​ — ​ 7,411 ​ 7,411 ​ Earnouts for development with acquired Canadian entity ​ — ​ — ​ 361 ​ ​ ​ 14,508 22,248 ​ 19,998 ​ ​

Description of Business (Detail

Description of Business (Details)	12 Months Ended
	Dec. 31, 2024 segment
Description of Business
Number of operating segments	1

Summary of Significant Accoun_4

Summary of Significant Accounting Policies (Details)			1 Months Ended			12 Months Ended
	Oct. 11, 2024 USD ($)	Jul. 19, 2024 USD ($)	Sep. 30, 2023 USD ($) $ / shares shares	Nov. 30, 2022 USD ($) $ / shares shares	Apr. 30, 2020 USD ($)	Dec. 31, 2024 USD ($) shares	Dec. 31, 2023 USD ($) shares	Dec. 31, 2022 USD ($)	Oct. 31, 2024 shares	Dec. 31, 2021 USD ($)
Policies
Net Income (Loss)						$ (190,426,000)	$ (434,801,000)	$ (547,799,000)
Accumulated deficit						2,567,862,000	2,377,436,000
Cash, cash equivalents and restricted cash						945,587,000	642,095,000	466,091,000		$ 84,614,000
Marketable securities						22,689,000	236,882,000
Short-term Credit Line, outstanding balance						80,362,000	$ 80,402,000
Borrowings under credit facility								$ 30,000,000
Collateral amount						150,000,000
Remaining borrowing capacity						$ 20,000,000
Common stock, shares issued | shares			4,550,000	13,144,500		132,646,000	119,581,000		7,532,300
Stock issued (in dollars per share) | $ / shares			$ 55	$ 35
Payment of offering expenses			$ 400,000	$ 500,000
Proceeds from issuance of common stock			$ 235,800,000	433,200,000
Convertible Notes
Policies
Outstanding principal balance		$ 287,500,000			$ 287,500,000
Per annum interest rate (as a percent)	2.25%	2.25%			2.25%
Percentage of principal amount converted	100%	100%			100%
Convertible Notes Payable	$ 287,400,000
Convertible to shares of common stock	7,500,000				7,411,704
Proceeds from notes payable	$ 100,000
Line Of Credit-UBS
Policies
Borrowings under credit facility				$ 30,000,000
Collateral amount						$ 150,000,000
Remaining borrowing capacity						$ 20,000,000
Equity offering
Policies
Common stock, shares issued | shares			4,550,000

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Inventory Reserve (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Summary of Significant Accounting Policies
Beginning balance	$ 872	$ 748
Write-offs	(454)	(2,175)
Net additions to reserve	141	2,299
Ending balance	$ 559	$ 872

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Other Assets (Details) - USD ($) $ in Millions		1 Months Ended				3 Months Ended	12 Months Ended
	Sep. 10, 2021	Jan. 31, 2024	Mar. 31, 2023	Dec. 31, 2022	Nov. 30, 2022	Mar. 31, 2023	Dec. 31, 2024
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				$ 10	$ 15
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
Amortized expense							$ 1

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - AOCIL (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	$ (3,085)	$ (16,362)
Ending balance	(344)	(3,085)
Net unrealized gain (loss) 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 income (loss)	$ 2,741	$ 13,277

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Related Party (Details) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	12 Months Ended
	Feb. 29, 2024	Dec. 31, 2024	Sep. 30, 2024	Aug. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 06, 2021
Preferred stock shares
Related Party Transaction [Line Items]
Investment in equity securities without readily determinable fair value							$ 2.2
Warrants to purchase stock
Related Party Transaction [Line Items]
Investment in equity securities without readily determinable fair value							1.8
MyOme, Inc.
Related Party Transaction [Line Items]
Investment in equity securities without readily determinable fair value				$ 2.7			$ 4
Warrants term	10 years
Warrants convertible into number of stock shares	3,058,485		2,080,565
Warrants exercise price (in dollars per share)	$ 0.25
Warrants impairment		$ 0
Carrying amount of investments		4.9			$ 2.2
Carrying value of warrants and warrant receivable		11.2			1.8
Amortization of non-cash liability		0.4
MyOme, Inc. | Series B preferred stock
Related Party Transaction [Line Items]
Warrants convertible into number of stock shares	2,080,565
Warrants exercise price (in dollars per share)	$ 0.01
Equity securities without readily determinable fair value, upward price adjustment amount		0			0	$ 0
Equity securities without readily determinable fair value, downward price adjustment amount		$ 0			$ 0	$ 0
Executive chairman | MyOme, Inc.
Related Party Transaction [Line Items]
Ownership percentage		22.60%

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Risks and Uncertainties (Details) - customer	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Sales | Customer
Risk and Uncertainties
Number of customers exceeding 10% of benchmark	0	0	0
Sales | Customer | Medicare
Risk and Uncertainties
Concentration risk (as a percent)	12.10%	12.80%	11.20%
Accounts receivable | Credit
Risk and Uncertainties
Number of customers exceeding 10% of benchmark	0	0
Accounts receivable | Credit | Medicare
Risk and Uncertainties
Concentration risk (as a percent)	11.50%	10.20%

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Costs (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Capitalized software	$ 17.1	$ 8.7
Advertising costs	$ 2.3	1.1	$ 1.8
Defined contribution plan, employer discretionary matching contribution, percent of match	50%
Defined contribution plan, participant's pre-tax contributions, percent of eligible compensation per pay period	6%
Defined contribution plan, contribution expense	$ 10.7	8.6	9.1
Software held for internal use
Estimated useful life (in years)	3 years
Capitalized software		2.4
Amortized expense	$ 3.5		0.2
Shipping and handling costs
Cost of revenues	$ 43.5	$ 42.2	$ 36

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Recently Adopted Accounting Pronouncements (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenue	$ 1,696,911	$ 1,082,571	$ 820,222
Single reportable segment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenue	1,696,911	1,082,571	820,222
Gross margin	$ 1,023,158	$ 492,740	$ 363,966
Gross margin percentage	60.30%	45.50%	44.40%
Product
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenue	$ 1,685,074	$ 1,068,522	$ 797,307
Cost of revenues	672,304	588,564	453,632
Product | Single reportable segment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cost of revenues	672,304	588,564	453,632
Licensing and other
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenue	11,837	14,049	22,915
Cost of revenues	1,449	1,267	2,624
Licensing and other | Single reportable segment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cost of revenues	$ 1,449	$ 1,267	$ 2,624

Revenue Recognition (Details)

Revenue Recognition (Details) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) item $ / shares	Dec. 31, 2023 USD ($) $ / shares	Dec. 31, 2022 USD ($) $ / shares	Dec. 31, 2021 USD ($)	Aug. 31, 2019 USD ($)	Jun. 30, 2019 USD ($)
Revenue recognized	$ 20,900
Allowances on accounts receivable	7,259	$ 6,481	$ 3,830	$ 2,429
Other assets	36,720	15,403
Deferred revenue	$ 36,592	35,740	30,778
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	$ 10,500
(Increased) decreased net loss per share | $ / shares	$ 0.08
Tests delivered in prior periods that were fully collected
Increased (decreased) revenues	$ 151,200	5,300	19,500
(Increased) decreased net loss	$ 151,200	$ 5,300	$ 19,500
(Increased) decreased net loss per share | $ / shares	$ 1.21	$ 0.05	$ 0.20
Amounts not refunded to insurance carriers
Increased (decreased) revenues	$ 4,200	$ 13,100	$ 5,800
(Increased) decreased net loss	$ 4,200	$ 13,100	$ 5,800
(Increased) decreased net loss per share | $ / shares	$ 0.03	$ 0.11	$ 0.06
BGI Genomics
Revenue recognized	$ 44,000		$ 0
Revenue, remaining performance obligation	6,000
Transaction price	50,000
Deferred revenue	17,300
Prepaid royalties	$ 20,000
BGI Genomics | License and related development services
Revenue recognized		$ 100	8,000
Number of performance obligations | item	2
Revenue, remaining performance obligation	$ 24,000
BGI Genomics | Sequencing services
Other assets	4,100					$ 6,000
BGI Genomics | Sequencing products
Other assets						4,000
Prepaid expenses and other current assets	800
Equipment and services received	800	5,100
BGI Genomics | Sequencing products and services
Other assets	3,300					$ 10,000
BGI Genomics | Oncology assay interpretation services
Revenue recognized	1,600	1,500
Revenue, remaining performance obligation	20,000
BGI Genomics | Royalty
Deferred revenue	1,400	1,200
Foundation Medicine ("FMI")
Revenue recognized	$ 24,300
Agreement term	5 years
Automatic renewals, successive period thereafter	1 year
Revenue, remaining performance obligation	$ 7,700
Transaction price					$ 32,000
Deferred revenue	1,700
Prepaid royalties	5,000
Foundation Medicine ("FMI") | Oncology assay interpretation services
Revenue recognized	1,500	1,000	400
Revenue, remaining performance obligation	5,000
Foundation Medicine ("FMI") | Oncology products
Revenue recognized		$ 200	$ 3,500
Revenue, remaining performance obligation	$ 19,300

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Total revenues	$ 1,696,911	$ 1,082,571	$ 820,222
United States
Disaggregation of Revenue [Line Items]
Total revenues	1,657,745	1,047,636	785,849
Americas, excluding U.S.
Disaggregation of Revenue [Line Items]
Total revenues	6,620	4,908	3,705
Europe, Middle East, India, and Africa
Disaggregation of Revenue [Line Items]
Total revenues	23,884	22,811	16,640
Asia Pacific and Other
Disaggregation of Revenue [Line Items]
Total revenues	8,662	7,216	14,028
Insurance carriers
Disaggregation of Revenue [Line Items]
Total revenues	1,571,817	954,155	690,754
Laboratory partners
Disaggregation of Revenue [Line Items]
Total revenues	97,210	98,891	94,910
Patients
Disaggregation of Revenue [Line Items]
Total revenues	27,884	29,525	34,558
Licensing and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 11,837	$ 14,049	$ 22,915

Revenue Recognition - Accounts

Revenue Recognition - Accounts Receivable and Deferred Revenue (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Assets
Accounts receivable, net	$ 314,165	$ 278,289
Liabilities:
Deferred revenue, current portion	19,754	16,612
Deferred revenue, long-term portion	16,838	19,128
Total deferred revenues	$ 36,592	$ 35,740	$ 30,778

Revenue Recognition - Changes i

Revenue Recognition - Changes in Balance of Deferred Revenues (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Revenue Recognition
Beginning balance	$ 35,740	$ 30,778
Increase in deferred revenues	35,440	35,573
Reclasses from deferred revenues to other short-term liabilities		(522)
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	(13,693)	(10,564)
Revenue recognized from performance obligations satisfied within the same period	(20,895)	(19,525)
Ending Balance	$ 36,592	$ 35,740

Revenue Recognition - Deferred

Revenue Recognition - Deferred Revenues (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	$ 13,693	$ 10,564
Revenue recognized	20,900
Deferred revenue, current portion	19,754	16,612
Deferred revenue, Long-term	16,838	19,128
Deferred revenue	36,592	$ 35,740	$ 30,778
BGI Genomics
Revenue recognized	44,000		$ 0
Deferred revenue, current portion	500
Deferred revenue, Long-term	16,800
Deferred revenue	17,300
Foundation Medicine ("FMI")
Revenue recognized	24,300
Deferred revenue, current portion	1,700
Deferred revenue	1,700
BGI Genomics and Foundation Medicine
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	2,900
Deferred revenue	17,600
Genetic testing services
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	$ 10,800

Fair Value Measurements (Detail

Fair Value Measurements (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Oct. 31, 2023	Dec. 31, 2024	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		$ 0	$ 491,800
Recurring | Available-for-sale securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		968,276	878,977
Recurring | Liquid demand deposits
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		945,587	642,095
Recurring | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets			200,418
Recurring | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		22,689	36,464
Recurring | Level 1 | Available-for-sale securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		945,587	842,513
Recurring | Level 1 | Liquid demand deposits
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		945,587	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			200,418
Recurring | Level 2 | Available-for-sale securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		22,689	36,464
Recurring | Level 2 | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total financial assets		$ 22,689	$ 36,464

Financial Instruments (Details)

Financial Instruments (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) position item	Dec. 31, 2023 USD ($) item	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Cash, cash equivalents and restricted cash	$ 945,587	$ 642,095	$ 466,091	$ 84,614
Proceeds from investments sold	$ 24,800		248,500
Gross realized gains (losses)			$ (900)
Number of investments sold | item	1	0
Number of investments, unrealized loss position | position	6
Credit loss reserve	$ 0	$ 0
Number of investments, unrealized loss position less than 12 months | position	0
12 Months or Longer, Fair value	$ 17,688
Fair value	17,688
12 Months or Longer, Unrealized loss	(330)
Unrealized loss	(330)
Amortized Cost
Less than or equal to one year	23,019
Total	23,019
Fair Value
Less than or equal to one year	22,689
Total	22,689
Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	968,606	881,708
Gross Unrealized Gain		14
Gross Unrealized Loss	(330)	(2,745)
Estimated Fair Value	968,276	878,977
Liquid demand deposits
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	945,587	642,095
Estimated Fair Value	945,587	642,095
U.S. Treasury securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost		201,522
Gross Unrealized Gain		14
Gross Unrealized Loss		(1,118)
Estimated Fair Value		200,418
Municipal securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	23,019	38,091
Gross Unrealized Loss	(330)	(1,627)
Estimated Fair Value	22,689	36,464
12 Months or Longer, Fair value	17,688
Fair value	17,688
12 Months or Longer, Unrealized loss	(330)
Unrealized loss	(330)
Cash equivalents | Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Estimated Fair Value	945,587	642,095
Short-term investments | Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Estimated Fair Value	$ 22,689	$ 236,882

Balance Sheet Components - Allo

Balance Sheet Components - Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Allowance for doubtful accounts
Beginning balance	$ 6,481	$ 3,830	$ 2,429
Provision for doubtful accounts	1,279	2,645	1,770
(Write-offs) / Recoveries	(501)	6	(369)
Total	$ 7,259	$ 6,481	$ 3,830

Balance Sheet Components - Prop

Balance Sheet Components - Property and Equipment, net (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property and Equipment, net
Property and equipment, gross	$ 240,462	$ 167,503
Less: Accumulated depreciation and amortization	(78,416)	(56,293)
Total Property and Equipment, net	162,046	111,210
Depreciation expense	27,200	22,700	$ 16,700
Cloud-based implementation costs	9,100	8,400
Cloud-based implementation costs, accumulated amortization	5,300	2,500
Cloud-based implementation costs, net book value	3,700	5,900
Cloud-based implementation costs, amortization expense	2,800	1,400	$ 800
Equipment pledged	150,000
Machinery and equipment
Property and Equipment, net
Property and equipment, gross	117,076	85,626
Computer equipment
Property and Equipment, net
Property and equipment, gross	$ 3,178	1,850
Useful Life	3 years
Software held for internal use
Property and Equipment, net
Property and equipment, gross	$ 13,178	11,636
Useful Life	3 years
Leasehold improvements
Property and Equipment, net
Property and equipment, gross	$ 48,569	38,999
Construction-in-process
Property and Equipment, net
Property and equipment, gross	$ 58,461	$ 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 - Accr

Balance Sheet Components - Accrued Compensation (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Balance Sheet Components
Accrued paid time off	$ 3,826	$ 3,121
Accrued commissions	14,224	10,522
Accrued bonuses	32,236	24,651
Other accrued compensation	11,828	7,563
Total accrued compensation	$ 62,114	$ 45,857

Balance Sheet Components - Othe

Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Balance Sheet Components
Reserves for refunds to insurance carriers	$ 11,276	$ 23,245	$ 18,948
Accrued charges for third-party testing	12,321	14,823
Testing and laboratory materials from suppliers	7,893	11,229
Marketing and corporate affairs	16,548	10,085
Legal, audit and consulting fees	54,208	43,897
Accrued shipping charges	1,625	3,646
Sales and income tax payable	4,416	3,731
Accrued third-party service fees	9,046	7,111
Clinical trials and studies	10,097	12,126
Operating lease liabilities, current portion	10,168	11,621
Property and equipment purchases	7,098	4,316
Other accrued interest		1,078
Other accrued expenses	2,197	2,497
Total other accrued liabilities	$ 146,893	$ 149,405
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Total other accrued liabilities	Total other accrued liabilities
Accrued settlement liability	$ 12,600

Balance Sheet Components - Rese

Balance Sheet Components - Reserve Balance and Activities for Refunds (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Balance Sheet Components
Beginning balance	$ 23,245	$ 18,948
Additional reserves	2,562	14,974
Refunds to carriers	(4,620)	(1,583)
Reserves released to revenue	(9,911)	(9,094)
Ending balance	$ 11,276	$ 23,245

Leases (Details)

Leases (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) ft² location lease	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Lessee, Lease, Description [Line Items]
Operating lease liabilities, current portion included in other accrued liabilities	$ 10,168	$ 11,621
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Other Accrued Liability, Current	Other Accrued Liability, Current
Operating lease liabilities, long-term portion	$ 96,588	$ 67,025
Operating lease liabilities	106,756	78,646
Noncash activities related to right-of-use assets	$ 38,800	2,100
Weighted average remaining lease term	7 years 9 months 3 days
Weighted average discount rate (as a percent)	7.20%
Lease expense	$ 15,300	14,500	$ 13,800
Operating lease payments	$ 16,800	$ 12,400	$ 9,400
Minimum
Lessee, Lease, Description [Line Items]
Term of lease	1 year
Maximum
Lessee, Lease, Description [Line Items]
Term of lease	5 years
Austin TX, Long-term Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	94,000
Number of office space locations | lease	2
Term of lease	132 months
First Expansion Premises
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	32,500
Second Expansion Premises
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	65,222
Corporate Headquarters Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	136,000
Number of office space locations | location	2
Annual lease payment	$ 9,700
Renewal term of lease	60 months
"First Space" Sublease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	88,000
"Second Space" Sublease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	48,000
Corporate Headquarters Lease Amendment
Lessee, Lease, Description [Line Items]
Renewal term of lease	48 months
Lease expense	$ 9,300
Tukwila, WA Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	10,000
Term of lease	62 months
Renewal term of lease	5 years
South San Francisco, CA Lease
Lessee, Lease, Description [Line Items]
Lease space (area) | ft²	11,395
Term of lease	36 months
Renewal term of lease	3 years
Lease expense	$ 900
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

Leases - Payments (Details)

Leases - Payments (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Leases.
2025	$ 17,533
2026	17,809
2027	17,119
2028	17,443
2029	17,324
2030 and thereafter	53,335
Total future minimum lease payments	140,563
Less: imputed interest	(33,807)
Operating lease liabilities	$ 106,756	$ 78,646

Commitments and Contingencies_2

Commitments and Contingencies (Details) $ in Thousands

1 Months Ended

3 Months Ended

12 Months Ended

Feb. 27, 2025 employee

Nov. 30, 2024 USD ($)

Jan. 31, 2024 USD ($)

Jul. 31, 2023 patent

Jun. 30, 2023 USD ($) patent

Dec. 31, 2022 lawsuit

Mar. 31, 2022 USD ($)

Nov. 30, 2021 patent

Sep. 30, 2021 patent

May 31, 2021 lawsuit

Jan. 31, 2021 patent

Oct. 31, 2020 patent

Jun. 30, 2020 patent

Mar. 31, 2020 lawsuit patent

Mar. 31, 2024 USD ($) patent

Dec. 31, 2024 USD ($)

Feb. 28, 2022 lawsuit

Other commitments

Accrued settlement liability

$ 12,600

Contractual commitments

171,262

Clinical samples and data for oncology development

Other commitments

Contractual commitments

13,000

Acquired clinical samples and data for oncology development

7,000

Potential payments to third party vendor

$ 50,000

CareDX Patent Case

Other commitments

Number of patent litigations | lawsuit

2

Loss contingency, patents allegedly infringed, number | patent

3

3

Gain contingency, patents allegedly infringed, number | patent

1

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

3

Amount awarded from other party

$ 19,350

Ravgen Patent Case

Other commitments

Loss contingency, patents allegedly infringed, number | patent

2

Amount awarded to other party

$ 57,000

Genosity Inc. Patent Case

Other commitments

Gain contingency, patents allegedly infringed, number | patent

1

Inivata Patent Case

Other commitments

Number of patent litigations | lawsuit

2

Inivitae Patent Case

Other commitments

Loss contingency, patents allegedly infringed, number | patent

3

NeoGenomics Patent Case

Other commitments

Gain contingency, patents allegedly infringed, number | patent

2

Guardant Case

Other commitments

Number of lawsuits | lawsuit

2

Amount awarded to other party

$ 292,500

Guardant Case | Subsequent event

Other commitments

Pending claim, number of employees | employee

2

Class action

Other commitments

Number of lawsuits | lawsuit

2

Commitments and Contingencies -

Commitments and Contingencies - Contractual commitments (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Recorded Unconditional Purchase Obligation [Line Items]
Total	$ 171,262
2025	113,818
2026	23,344
2027	20,741
2028	10,256
2029	1,103
2030 and thereafter	2,000
Laboratory instruments supplier
Recorded Unconditional Purchase Obligation [Line Items]
Total	27,700
2025	8,800
2026	9,200
2027	9,700
Material suppliers
Recorded Unconditional Purchase Obligation [Line Items]
Total	53,988
2025	53,931
2026	57
Application service providers
Recorded Unconditional Purchase Obligation [Line Items]
Total	4,235
2025	3,892
2026	343
Cloud platform service provider
Recorded Unconditional Purchase Obligation [Line Items]
Total	34,180
2025	7,120
2026	9,060
2027	9,000
2028	9,000
Other material suppliers
Recorded Unconditional Purchase Obligation [Line Items]
Total	51,159
2025	40,075
2026	4,684
2027	2,041
2028	1,256
2029	1,103
2030 and thereafter	$ 2,000

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details)	3 Months Ended	12 Months Ended
	Jun. 30, 2024 shares	Dec. 31, 2024 USD ($) period shares	Dec. 31, 2023 USD ($) shares	Dec. 31, 2022 USD ($)
Stock Based Compensation
Stock-based compensation expense | $		$ 274,428,000	$ 191,808,000	$ 152,384,000
2015 Plan
Stock Based Compensation
Additional shares reserved for issuance	6,000,000
Plan extension term	10 years
Employee stock purchase plan
Stock Based Compensation
Shares reserved for issuance		4,289,349
Additional shares reserved for issuance		880,000
Shares reserved for issuance as a proportion of common stock outstanding (as a percent)		1%
Price in relation to fair market value of common stock on the date of grant, lower range limit (as a percent)		85%
Maximum number of shares a participant may receive during the period (in shares)		5,000
Maximum amount of award or purchase during a calendar year | $		$ 25,000
Maximum offering period, term		27 months
Number of expected offering periods each year | period		2
Offering period, expected term		6 months
Maximum employee contribution of employee's cash compensation (as a percent)		15%
Performance-based awards
Stock Based Compensation
Stock-based compensation expense | $		$ 89,800,000	$ 54,200,000	48,200,000
Shares granted		800,000
Options to purchase common stock
Stock Based Compensation
Options outstanding (in shares)		3,875,000	5,501,000
Restricted stock units
Stock Based Compensation
Number of shares vested		3,538
Shares granted		5,400
Non-employee stock options
Stock Based Compensation
Options outstanding (in shares)		0
Liability classified awards
Stock Based Compensation
Stock-based compensation expense | $		$ 1,300,000	$ 800,000	$ 600,000

Stock-Based Compensation - Comp

Stock-Based Compensation - Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Stock based compensation expense
Stock-based compensation expense	$ 274,428	$ 191,808	$ 152,384
Cost of revenues
Stock based compensation expense
Stock-based compensation expense	16,468	11,752	7,905
Research and development
Stock based compensation expense
Stock-based compensation expense	88,705	66,326	46,545
Selling, general and administrative
Stock based compensation expense
Stock-based compensation expense	169,255	113,730	97,934
Options to purchase common stock
Stock based compensation expense
Unrecognized compensation expense	$ 509,400
Unrecognized compensation expense, weighted average period of recognition	1 year 7 months 6 days
Liability classified awards
Stock based compensation expense
Stock-based compensation expense	$ 1,300	$ 800	$ 600

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Options to purchase common stock
Number of shares Outstanding
Outstanding, beginning balance (in shares)	5,501
Options exercised (in shares)	(1,626)
Outstanding, end balance (in shares)	3,875	5,501
Exercisable (in shares)	3,185
Vested and expected to vest (in shares)	3,831
Weighted-Average Exercise Price
Outstanding, beginning balance (in dollars per share)	$ 23.65
Exercised (in dollars per share)	7.98
Outstanding, end balance (in dollars per share)	30.22	$ 23.65
Exercisable (in dollars per share)	23.22
Vested and expected to vest (in dollars per share)	$ 29.86
Additional disclosures
Weighted average contractual term, options outstanding	4 years 5 months 12 days	4 years 4 months 9 days
Exercisable (in years)	3 years 9 months 18 days
Vested and expected to vest (in years)	4 years 5 months 1 day
Aggregate intrinsic value, options outstanding	$ 496,135	$ 231,133
Aggregate intrinsic value, options exercisable	430,197
Aggregate intrinsic value, vested and expected to vest	492,065
Aggregate intrinsic value, options exercised	145,600	14,700	$ 26,900
Fair value, options vested	$ 41,700	$ 57,500	$ 49,000
Weighted-average grant date fair value, options granted		$ 27.31	$ 34
Non-employee stock options
Number of shares Outstanding
Outstanding, end balance (in shares)	0

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Units (Details) - Restricted stock units	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Shares
Balance (in shares) | shares	9,248
Granted (in shares) | shares	5,400
Vested (in shares) | shares	(3,538)
Canceled/Forfeited (in shares) | shares	(517)
Balance (in shares) | shares	10,593
Weighted Average Grant Date Fair Value
Balance (in dollars per share) | $ / shares	$ 49.50
Granted (in dollars per share) | $ / shares	76.90
Vested (in dollars per share) | $ / shares	55.90
Canceled/Forfeited (in dollars per share) | $ / shares	58.23
Balance (in dollars per share) | $ / shares	$ 61.28

Stock-Based Compensation - Perf

Stock-Based Compensation - Performance-based Awards (Details) - USD ($) $ in Thousands, shares in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 274,428	$ 191,808	$ 152,384
Performance-based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	0.8
Aggregate value	$ 55,000
Aggregate value recognized	$ 34,800
Target (percentage)	200%
Expected compensation expense recognition over requisite service period	$ 110,000
Stock-based compensation expense	$ 89,800	$ 54,200	$ 48,200

Stock-Based Compensation - Assu

Stock-Based Compensation - Assumptions (Details) - Employee Stock Option [Member]	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Valuation of Stock Option Grants to Employees
Risk free interest rate, minimum	3.41%	1.62%
Risk free interest rate, maximum	4.80%	4.16%
Expected volatility, minimum	67.75%	55.91%
Expected volatility, maximum	70.07%	62.30%
Minimum
Valuation of Stock Option Grants to Employees
Expected term (years)	5 years 2 months 12 days	5 years 1 month 13 days
Maximum
Valuation of Stock Option Grants to Employees
Expected term (years)	6 years 1 month 9 days	10 years

Debt (Details)

Debt (Details)			1 Months Ended			12 Months Ended
	Oct. 11, 2024 USD ($)	Jul. 19, 2024 USD ($)	Oct. 31, 2023	Nov. 30, 2022 USD ($) $ / shares shares	Apr. 30, 2020 USD ($) $ / shares	Dec. 31, 2024 USD ($) D $ / shares shares	Dec. 31, 2023 USD ($) $ / shares shares	Dec. 31, 2022 USD ($)	Oct. 31, 2024 shares	Sep. 30, 2023 $ / shares shares	Jun. 30, 2023 USD ($)	Dec. 31, 2021 USD ($)	Sep. 30, 2015 USD ($)
Debt Instrument [Line Items]
Remaining borrowing capacity						$ 20,000,000
Borrowings under credit facility								$ 30,000,000
Collateral amount						$ 150,000,000
Common Stock, Par or Stated Value Per Share | $ / shares						$ 0.0001	$ 0.0001
Common stock, shares issued | shares				13,144,500		132,646,000	119,581,000		7,532,300	4,550,000
Stock issued (in dollars per share) | $ / shares				$ 35						$ 55
Convertible, if converted common shares aggregate value						$ 286,730,000
Carrying value							$ 282,945,000
Accrued Interest							1,078,000
Amortization of debt discount and issuance cost						991,000	1,292,000	1,259,000
Interest expense						10,685,000	12,638,000	9,319,000
Convertible Notes
Debt Instrument [Line Items]
Principal amount		$ 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%			2.25%
Interest expense						$ 6,023,000	7,761,000	7,728,000
Common Stock, Par or Stated Value Per Share | $ / shares					$ 0.0001
Debt instrument, term						7 years
Effective interest rate (as a percent)						2.72%
Principal amount per convertible note					$ 1,000	$ 1,000
Threshold business days | D						5
Conversion price (in dollars per share) | $ / shares					$ 38.79
Initial conversion rate					25.7785
Conversion rate increase		0.4284
Convertible to shares of common stock	7,500,000				7,411,704
Percentage of principal amount converted	100%	100%			100%
Debt, repayment amount					$ 79,200,000
Commencing after September 30, 2020 | Convertible Notes
Debt Instrument [Line Items]
Threshold trading days | D						30
Percentage of conversion price						130%
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					20
Percentage of conversion price					130%
Redeemable for cash on or after May 2024 | Convertible Notes
Debt Instrument [Line Items]
Threshold trading days					30
Percentage of principal amount converted					100%
Level 2 | Convertible Notes
Debt Instrument [Line Items]
Fair value of long-term debt						$ 0	491,800,000
Minimum | Commencing after September 30, 2020 | Convertible Notes
Debt Instrument [Line Items]
Threshold trading days | D						20
Line Of Credit-UBS
Debt Instrument [Line Items]
Maximum borrowing capacity											$ 100,000,000	$ 150,000,000	$ 50,000,000
Outstanding balance						$ 80,400,000	80,400,000
Credit facility drawn down						(80,000,000)
Remaining borrowing capacity						20,000,000
Borrowings under credit facility				$ 30,000,000
Collateral amount						150,000,000
Interest expense						4,700,000	4,900,000	1,600,000
Interest paid						$ 4,700,000	$ 4,900,000	$ 1,600,000
Effective interest rate (as a percent)						5.03%
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%

Debt - Discount and Issuance Co

Debt - Discount and Issuance Costs (Details) - Convertible Notes	12 Months Ended
	Dec. 31, 2024
Effective interest rate (as a percent)	2.72%
Debt instrument, term	7 years

Debt - Convertible Notes Balanc

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

Debt - Interest Expense Recogni

Debt - Interest Expense Recognized Related to Convertible Notes (Details) - Convertible Notes - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash interest expense
Contractual interest expense	$ 2,157	$ 6,469	$ 6,469
Non-cash interest expense
Contractual interest expense	2,875
Amortization of debt discount and debt issuance cost	991	1,292	1,259
Total interest expense	$ 6,023	$ 7,761	$ 7,728

Stockholders' Equity (Details)

Stockholders' Equity (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended				3 Months Ended	12 Months Ended
	Sep. 10, 2021	Sep. 30, 2023	Mar. 31, 2023	Dec. 31, 2022	Nov. 30, 2022	Mar. 31, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Oct. 31, 2024	Dec. 31, 2021
Stock issued (in dollars per share)		$ 55			$ 35
Payment of offering expenses		$ 400			$ 500
Proceeds from issuance of common stock		$ 235,800			$ 433,200
Research and development							$ 404,138	$ 320,678	$ 316,415
Preferred stock, shares authorized							50,000,000
Preferred stock, shares issued							0
Preferred stock, shares outstanding							0
Common stock, shares authorized							750,000,000	750,000,000
Common stock, par value (in dollars per share)							$ 0.0001	$ 0.0001
Common stock, shares issued		4,550,000			13,144,500		132,646,000	119,581,000		7,532,300
Common stock, shares outstanding							132,646,000	119,581,000
In-process research and development acquisition
Asset acquisition, consideration	$ 35,600		$ 15,000	$ 10,000
Issuance of common stock	276,346
Value of common stock issued	$ 30,900				$ 10,000	$ 15,000
Cash consideration	3,900
Net liabilities assumed	200
Acquisition related costs	600
Value of additional shares potentially issuable	$ 35,000
Number of additional shares potentially issuable	269,547
Common stock
Common stock, shares issued				111,255,000			132,646,000	119,581,000	111,255,000		95,140,000

Income Taxes - Effective Tax Ra

Income Taxes - Effective Tax Rates (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Effective tax rates differing from U.S. federal statutory rate
U.S. Federal taxes (benefit) at statutory rate	$ (39,844)	$ (91,251)	$ (114,832)
State tax expense	(21,613)	(13,492)	(21,676)
Research and development credits	(17,621)	(10,837)	(7,024)
Stock-based compensation	(62,969)	(6,422)	3,949
Foreign tax	(25)	(106)	332
Nondeductible officers' compensation	31,718	8,651	4,883
Acquisition costs		563	3,226
Nondeductible meals and other	2,870	(3,397)	1,964
Change in valuation allowance	108,179	116,562	130,156
Provision for income taxes	$ 695	$ 271	$ 978
U.S. Federal taxes (benefit) at statutory rate (as a percent)	21%	21%	21%
State tax expense (as a percent)	11.39%	3.10%	3.96%
Research and development credits (as a percent)	9.29%	2.49%	1.28%
Stock-based compensation (as a percent)	33.19%	1.48%	(0.72%)
Foreign tax differential (as a percent)	0.01%	0.02%	(0.06%)
Nondeductible officers' compensation (as a percent)	(16.72%)	(1.99%)	(0.89%)
Acquisition costs (as a percent)	0%	(0.13%)	(0.59%)
Other (as a percent)	(1.51%)	0.79%	(0.36%)
Change in valuation allowance (as a percent)	(57.02%)	(26.82%)	(23.80%)
Provision for income taxes (as a percent)	(0.37%)	(0.06%)	(0.18%)
Income tax expense	$ 695	$ 271	$ 978

Income Taxes - Deferred Income

Income Taxes - Deferred Income Taxes (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Income Taxes
Valuation allowance	$ 747,090	$ 639,510
Deferred tax assets
Net operating loss carryforwards	395,139	399,287
Research and development tax credit carryforwards	90,759	67,035
Capitalized research costs	173,991	95,923
Reserves and accruals	23,928	34,898
Lease liabilities	26,649	19,339
Stock based compensation	47,864	29,005
Intangible assets	8,846	3,809
Other	5,583	5,640
Total deferred tax assets before valuation allowance	772,759	654,936
Less: valuation allowance	(747,090)	(639,510)
Total deferred tax assets after valuation allowance	25,669	15,426
Deferred tax liabilities
Fixed assets	(4,164)	(1,524)
Right-of-use lease assets	(21,505)	(13,902)
Total deferred tax liabilities	(25,669)	(15,426)
Net deferred tax assets

Income Taxes - Net Operating Lo

Income Taxes - Net Operating Loss Carryforwards (Details) $ in Millions	Dec. 31, 2024 USD ($)
Federal
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 1,600
State
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	1,100
Foreign
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 4.1

Income Taxes - Tax Credit Carry

Income Taxes - Tax Credit Carryforwards (Details) $ in Millions	Dec. 31, 2024 USD ($)
Federal | Research and development tax credit carryforward
Tax Credit Carryforward [Line Items]
Tax credit carryforward	$ 85.2
Federal | Tax credit that can be carried forward indefinitely
Tax Credit Carryforward [Line Items]
Tax credit carryforward	1,300
State | Research and development tax credit carryforward
Tax Credit Carryforward [Line Items]
Tax credit carryforward	$ 45.6

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Taxes [Line Items]
Interest and penalties accrued	$ 0
Reconciliation of the beginning and ending amount of gross unrecognized tax benefits
Balance at beginning of year	30,912	$ 23,844	$ 17,514
Additions based on tax positions related to the current year	13,648	7,034	6,301
Additions (reductions) for tax positions of prior years	(9,620)
Additions for tax positions of prior years		34	29
Balance at end of year	34,940	30,912	23,844
Research and development tax credit carryforward
Income Taxes [Line Items]
Unrecognized tax benefits increase	$ 4,000	$ 7,100	$ 6,300

Net Loss per Share - Potentiall

Net Loss per Share - Potentially Dilutive Shares (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	14,508	22,248	19,998
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	3,875	5,501	5,300
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	10,593	9,248	6,836
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	40	88	90
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
Earnouts for development with acquired Canadian entity
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation			361

Subsequent Events (Details)

Subsequent Events (Details) - USD ($) $ in Thousands	Jan. 01, 2025	Dec. 31, 2024
Subsequent Event [Line Items]
Future lease commitments		$ 140,563
Subsequent event | Austin, Texas and San Carlos, California leases
Subsequent Event [Line Items]
Future lease commitments	$ 12,800