Natera (NTRA) 10-Q4 Nov 212021 Q3 Quarterly reportFinancial data

Company Profile

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
Document and Entity Information - shares	Sep. 30, 2021	Nov. 01, 2021
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2021
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	249-9090
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	NTRA
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		94,594,816
Entity Central Index Key	0001604821
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3
Amendment Flag	false

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 95,103	$ 48,668
Restricted cash	228	187
Short-term investments	928,596	688,606
Accounts receivable, net of allowance of $2,965 in 2021 and $3,080 in 2020	110,416	78,565
Inventory	28,022	20,031
Prepaid expenses and other current assets, net	28,858	26,606
Total current assets	1,191,223	862,663
Property and equipment, net	59,293	33,348
Operating lease right-of-use assets	47,656	21,399
Other assets	13,202	14,743
Total assets	1,311,374	932,153
Current liabilities:
Accounts payable	8,181	8,096
Accrued compensation	35,331	30,371
Other accrued liabilities	96,486	60,407
Deferred revenue, current portion	9,667	50,125
Short-term debt financing	50,049	50,054
Total current liabilities	199,714	199,053
Long-term debt financing	280,085	202,493
Deferred revenue, long-term portion	22,706	22,805
Operating lease liabilities, long-term portion	48,388	21,246
Other long-term liabilities	1,464	320
Total liabilities	552,357	445,917
Commitments and contingencies (Note 8)
Stockholders' equity:
Common stock, $0.0001 par value: 750,000 shares authorized at both September 30, 2021 and December 31, 2020, respectively; 94,538 and 86,223 shares issued and outstanding at September 30, 2021 and December 31, 2020, respectively	10	9
Additional paid in capital	2,011,788	1,411,286
Accumulated deficit	(1,254,272)	(929,318)
Accumulated other comprehensive gain	1,491	4,259
Total stockholders' equity	759,017	486,236
Total liabilities and stockholders' equity	$ 1,311,374	$ 932,153

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) shares in Thousands, $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Condensed Consolidated Balance Sheets
Allowances on accounts receivable	$ 2,965	$ 3,080
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized	750,000	750,000
Common stock, shares issued	94,538	86,223
Common stock, shares outstanding	94,538	86,223

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenues
Total revenues	$ 158,116,000	$ 98,143,000	$ 452,458,000	$ 278,627,000
Cost and expenses
Research and development	98,457,000	26,421,000	192,397,000	67,651,000
Selling, general and administrative	128,485,000	75,678,000	364,273,000	209,547,000
Total cost and expenses	308,313,000	153,920,000	780,966,000	420,936,000
Loss from operations	(150,197,000)	(55,777,000)	(328,508,000)	(142,309,000)
Interest expense	(2,078,000)	(4,270,000)	(6,226,000)	(10,772,000)
Interest and other income, net	1,274,000	1,749,000	4,230,000	5,661,000
Loss on debt extinguishment				(5,848,000)
Loss before income taxes	(151,001,000)	(58,298,000)	(330,504,000)	(153,268,000)
Income tax expense	(272,000)	(25,000)	(648,000)	(63,000)
Net loss	(151,273,000)	(58,323,000)	(331,152,000)	(153,331,000)
Unrealized gain (loss) on available-for-sale securities, net of tax	(950,000)	(600,000)	(2,768,000)	4,251,000
Comprehensive loss	$ (152,223,000)	$ (58,923,000)	$ (333,920,000)	$ (149,080,000)
Net loss per share (Note 12):
Basic and diluted (in dollars per share)	$ (1.63)	$ (0.72)	$ (3.72)	$ (1.93)
Weighted-average number of shares used in computing basic and diluted net loss per share:
Basic and diluted (in shares)	92,558	80,908	89,130	79,430
Product
Revenues
Total revenues	$ 150,651,000	$ 93,286,000	$ 406,265,000	$ 260,746,000
Cost and expenses
Cost of revenues	76,838,000	46,873,000	211,387,000	131,124,000
Licensing and other
Revenues
Total revenues	7,465,000	4,857,000	46,193,000	17,881,000
Cost and expenses
Cost of revenues	$ 4,533,000	$ 4,948,000	$ 12,909,000	$ 12,614,000

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Thousands, $ in Thousands	Common stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit	Total
Balance at Dec. 31, 2019	$ 8	$ 976,955	$ 919	$ (699,171)	$ 278,711
Balance (in shares) at Dec. 31, 2019	78,005
Issuance of common stock upon exercise of stock options		15,782			15,782
Issuance of common stock upon exercise of stock options (in shares)	1,534
Issuance of common stock under employee stock purchase plan		3,062			3,062
Issuance of common stock under employee stock purchase plan (in shares)	97
Equity component of Convertible Notes, net		82,873			82,873
Issuance of common stock for public offering, net	$ 1	270,649			270,650
Issuance of common stock for public offering, net (in shares)	4,792
Vesting of restricted stock units (in shares)	853
Stock based compensation		34,406			34,406
Unrealized (loss) gain on available-for-sale securities			4,251		4,251
Cumulative-effect adjustment upon adoption				(404)	(404)
Net loss				(153,331)	(153,331)
Balance at Sep. 30, 2020	$ 9	1,383,727	5,170	(852,906)	536,000
Balance (in shares) at Sep. 30, 2020	85,281
Balance at Jun. 30, 2020	$ 8	1,093,072	5,770	(794,583)	304,267
Balance (in shares) at Jun. 30, 2020	79,717
Issuance of common stock upon exercise of stock options		4,974			4,974
Issuance of common stock upon exercise of stock options (in shares)	498
Issuance of common stock for public offering, net	$ 1	270,649			270,650
Issuance of common stock for public offering, net (in shares)	4,792
Vesting of restricted stock units (in shares)	274
Stock based compensation		15,032			15,032
Unrealized (loss) gain on available-for-sale securities			(600)		(600)
Net loss				(58,323)	(58,323)
Balance at Sep. 30, 2020	$ 9	1,383,727	5,170	(852,906)	536,000
Balance (in shares) at Sep. 30, 2020	85,281
Balance at Dec. 31, 2020	$ 9	1,411,286	4,259	(929,318)	$ 486,236
Balance (in shares) at Dec. 31, 2020	86,223				86,223
Issuance of common stock upon exercise of stock options		10,774			$ 10,774
Issuance of common stock upon exercise of stock options (in shares)	1,051
Issuance of common stock under employee stock purchase plan		6,085			6,085
Issuance of common stock under employee stock purchase plan (in shares)	106
Issuance of common stock for public offering, net	$ 1	550,821			550,822
Issuance of common stock for public offering, net (in shares)	5,175
Issuance of common stock for IPR&D acquisition		30,901			30,901
Issuance of common stock for IPR&D acquisition (in shares)	276
Vesting of restricted stock units (in shares)	1,707
Stock based compensation		84,797			84,797
Unrealized (loss) gain on available-for-sale securities			(2,768)		(2,768)
Cumulative-effect adjustment upon adoption		(82,876)		6,198	(76,678)
Net loss				(331,152)	(331,152)
Balance at Sep. 30, 2021	$ 10	2,011,788	1,491	(1,254,272)	$ 759,017
Balance (in shares) at Sep. 30, 2021	94,538				94,538
Balance at Jun. 30, 2021	$ 9	1,399,659	2,441	(1,102,999)	$ 299,110
Balance (in shares) at Jun. 30, 2021	88,498
Issuance of common stock upon exercise of stock options		3,945			3,945
Issuance of common stock upon exercise of stock options (in shares)	268
Issuance of common stock for public offering, net	$ 1	550,821			550,822
Issuance of common stock for public offering, net (in shares)	5,176
Issuance of common stock for IPR&D acquisition		30,901			30,901
Issuance of common stock for IPR&D acquisition (in shares)	276
Vesting of restricted stock units		3			3
Vesting of restricted stock units (in shares)	320
Stock based compensation		26,459			26,459
Unrealized (loss) gain on available-for-sale securities			(950)		(950)
Net loss				(151,273)	(151,273)
Balance at Sep. 30, 2021	$ 10	$ 2,011,788	$ 1,491	$ (1,254,272)	$ 759,017
Balance (in shares) at Sep. 30, 2021	94,538				94,538

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating activities
Net loss	$ (331,152)	$ (153,331)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	8,259	6,215
Expensed in-process research and development	35,604
Premium amortization and discount accretion on investment securities	5,707	3,333
(Gain) loss on investments	(58)
Stock-based compensation	84,797	34,406
Non-cash lease expense	8,106	5,819
Amortization of debt discount and issuance cost	917	149
Inventory reserve adjustments	726	(180)
Other non-cash benefits (charges)	133	(135)
Provision for credit losses	380	1,445
Loss on Debt Extinguishment		5,848
Accretion of Convertible Note		4,514
Changes in operating assets and liabilities
Accounts receivable	(32,232)	(17,940)
Inventory	(8,717)	(7,803)
Prepaid expenses and other current assets	(7,851)	(7,288)
Other assets	(550)	97
Accounts payable	183	(1,613)
Accrued compensation	4,960	6,362
Other accrued liabilities	34,845	16,362
Deferred revenue	(40,557)	(5,470)
Cash used in operating activities	(236,500)	(109,210)
Investing activities
Purchases of investments	(674,372)	(479,037)
Proceeds from sale of investments	77,563	11,500
Proceeds from maturity of investments	348,410	247,315
Purchases of property and equipment, net	(32,027)	(12,073)
Cash paid for acquisition of an asset	(4,271)
Cash used in investing activities	(284,697)	(232,295)
Financing activities
Proceeds from exercise of stock options	10,774	15,782
Proceeds from issuance of common stock under employee stock purchase plan	6,085	3,062
Proceeds from Convertible Note, net of issuance costs		278,316
Loan payment		(78,757)
Proceeds from public offering, net of issuance costs	550,814	270,650
Cash provided by financing activities	567,673	489,053
Net increase in cash, cash equivalents and restricted cash	46,476	147,548
Cash, cash equivalents and restricted cash, beginning of period	48,855	61,981
Cash, cash equivalents and restricted cash, end of period	95,331	209,529
Supplemental disclosure of cash flow information:
Cash paid for interest	3,690	3,137
Non-cash investing and financing activities:
Purchases of property and equipment in accounts payable and accruals	$ 4,957	$ 2,814

Description of Business

Description of Business	9 Months Ended
Description of Business	Sep. 30, 2021
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 best-in-class accuracy and coverage. The Company’s technology has been proven clinically and commercially in the women’s health space, in which it 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. The Company is now translating its success in women’s health and applying its core technology to the oncology market, in which it is commercializing a personalized blood-based DNA test to detect molecular residual disease and monitor disease recurrence, as well as to the organ health market, initially with a test to assess kidney transplants for rejection. The Company operates laboratories certified under the Clinical Laboratory Improvement Amendments ("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 also has two subsidiaries, one of which operates in the state of Texas and the other in Canada. The Company's product offerings include its Panorama Non-Invasive Prenatal Test ("NIPT") that screens for chromosomal abnormalities of a fetus as well as in twin pregnancies, typically with a blood draw from the mother; Vistara, a single-gene mutations screening test performed to identify single-gene disorders; Horizon Carrier Screening ("HCS") to determine carrier status for a large number of severe genetic diseases that could be passed on to the carrier’s children; Spectrum Pre-implantation Genetics (“Spectrum”) to evaluate embryos to identify chromosomal anomalies or inherited genetic conditions to improve the chances of a healthy pregnancy during an in vitro fertilization ("IVF") cycle; Anora Miscarriage Test (“Anora”) to rapidly and extensively analyze fetal chromosomes to understand the cause of miscarriage; Non-Invasive Paternity Testing ("PAT"), which is exclusively marketed and sold by a licensee from whom the Company receives a royalty; Signatera, which detects circulating tumor DNA in patients previously diagnosed with cancer to assess molecular residual disease and monitor for recurrence; and Prospera, to assess organ transplant rejection. 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 tests based on the Company’s technology. Through the third quarter of 2019, the Company offered Evercord for the collection and storage of newborn cord blood and cord tissue units, which was sold in the third quarter of 2019 to a third-party buyer.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
Summary of Significant Accounting Policies	Sep. 30, 2021
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the three and nine months ended September 30, 2021, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2020 has been derived from audited financial statements at that date, these financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2020 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 26, 2021. Liquidity Matters The Company has incurred net losses since its inception and anticipates net losses and negative operating cash flows for the near future. The Company had a net loss of $331.2 million for the nine months ended September 30, 2021 and an accumulated deficit of $1.3 billion as of September 30, 2021. As of September 30, 2021, the Company had $95.3 million in cash, cash equivalents, and restricted cash, $928.6 million in marketable securities, $50.0 million of outstanding balance of the Credit Line (as defined in Note 10, Debt The Company continues to develop and commercialize 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 at all, or in amounts or on terms acceptable to the Company. If the Company is unable to obtain additional financing, it may be required to delay the development and commercialization of its products and significantly scale back its business and operations. In May 2021, the Company entered into a development and option agreement with a third party that requires the third party to use its best efforts to perform an agreed upon development plan and provides the Company with an exclusive option to purchase the third party’s assets. The Company paid the third party $10 million in the second quarter of 2021 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 (“IPR&D”) in exchange for an equity consideration payment. The third party was a biotechnology company focused on oncology. The total 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. Further, there are an estimated 269,547 of additional shares, consistent with the registration statement filed with the SEC on September 10, 2021, that are potentially issuable to legacy shareholders of this third party upon the achievement of defined milestones which will be revalued at each reporting date. These milestones are assessed as probable as of September 30, 2021. As a result, this was accounted as contingent compensation expense recognized over the performance period at fair market value. The Company concluded the acquired IPR&D has no alternative-future use and accordingly expensed on the day of the transaction close as research and development expense which is reflected in our condensed consolidated statement of operations. In April 2019, the Company completed an underwritten equity offering and sold 6,052,631 shares of its common stock at a price of $19 per share to the public. Before offering expenses of $0.6 million, the Company received proceeds of $108.1 million net of the underwriting discount. In October 2019, the Company completed another underwritten equity offering and sold 6,571,428 shares of its common stock at a price of $35 per share to the public. Before offering expenses of $0.4 million, the Company received proceeds of $216.2 million net of the underwriting discount. In September 2020, the Company completed an additional underwritten equity offering and sold 4,791,665 shares of its common stock at a price of $60.00 per share to the public. Before offering expenses of $0.3 million, the Company received proceeds of $271.0 million net of the underwriting discount. In July 2021, the Company completed an underwritten equity offering and sold 5,175,000 shares of its common stock at a price of $113 per share to the public. Before offering expenses of $0.4 million, the Company received proceeds of $551.2 million net of the underwriting discount. 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 November 4, 2021. Principles of Consolidation The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. The Company established a subsidiary that operates in the state of Texas to support the Company’s laboratory and operational functions. The Company established a subsidiary that operates in Canada following the acquisition of the IPR&D asset, which includes a lease for the laboratory space located in Canada. All intercompany balances and transactions have been eliminated. Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles (GAAP) in the United States requires management to make estimates and assumptions about future events that affect the amounts of assets and liabilities reported, disclosures about contingent assets and liabilities, and reported amounts of revenues and expenses. Significant items subject to such estimates include the allowance for doubtful accounts calculated based on the average selling price expected to be received from insurance payors, the operating right-of-use assets and the associated lease liabilities, deferred revenues associated with unsatisfied performance obligations, accrued liability for potential refund requests, the valuation of the Convertible Notes, stock-based compensation, the fair value of options, income tax uncertainties, and the expected consideration to be received from contracts with customers. These estimates and assumptions are based on management's best estimates and judgment. Management regularly evaluates its estimates and assumptions using historical experience and other factors, including contractual terms and statutory limits; however, actual results could differ from these estimates and could have an adverse effect on the Company's financial statements. Credit Losses Trade accounts receivable and other receivables. The following is a roll-forward of the allowances for credit losses related to trade accounts receivable and other receivables for the nine months ended September 30, 2021: Nine Months Ended September 30, 2021 (in thousands) Beginning balance $ 4,220 Provision for credit losses 380 Write-offs (495) Total $ 4,105 Available-for-sale debt securities. Investments Investments consist primarily of debt securities such as U.S. Treasuries, U.S. agency and municipal bonds. Management determines the appropriate classification of securities at the time of purchase and re-evaluates such determination at each balance sheet date. The Company generally classifies its entire investment portfolio as available-for-sale. The Company views its available-for-sale portfolio as available for use in current operations. Accordingly, the Company classifies all investments as short-term, irrespective of maturity date. Available-for-sale securities are carried at fair value, with unrealized gains and losses reported in accumulated other comprehensive income (loss), which is a separate component of stockholders’ equity. Risk and Uncertainties The Company is subject to risks and uncertainties as a result of the COVID-19 pandemic. The extent of the impact of the COVID-19 pandemic on the Company's business is highly uncertain and difficult to predict, and the full extent and duration of the impact of the COVID-19 pandemic on its business, its operations, and the global economy as a whole is not yet known. While the Company’s test volumes and overall average selling prices for its tests increased during the nine months ended September 30, 2021 compared to the nine months ended September 30, 2020, the Company cannot predict the potential nature, magnitude and duration of the effects of the COVID-19 pandemic on the macroeconomic environment or its business. Financial instruments that potentially subject the Company to credit risk consist of 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. The Company performs evaluations of financial conditions for insurance carriers, patients, clinics and laboratory partners and generally does not require collateral to support credit sales. For the nine months ended September 30, 2021, and 2020, there were no customers exceeding 10% of total revenues on an individual basis. As of September 30, 2021 and December 31, 2020, there were no customers with an outstanding balance exceeding 10% of net accounts receivable. 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. Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Beginning balance $ 2,441 $ 5,770 $ 4,259 $ 919 Net unrealized gain (loss) on available-for-sale securities, net of tax (950) (600) (2,768) 4,251 Ending balance $ 1,491 $ 5,170 $ 1,491 $ 5,170 Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date. Unless otherwise discussed below, the Company believes that the impact of accounting standards updates recently issued that are not yet effective will not have a material impact on its financial position or results of operations upon adoption. Recently Adopted Accounting Pronouncements Fair Value Measurement In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement Goodwill - Internal-Use Software Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350 ‑ 40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract Credit Losses In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses: Measurement of Credit Losses on Financial Instruments amortized costs. The Company adopted ASU 2016-13, as amended, effective January 1, 2020 using the modified retrospective method and recorded a cumulative-effect adjustment of $0.4 million in retained earnings as of January 1, 2020. Collaborative Arrangements Collaborative Arrangements (Topic 808): Clarifying the Interaction between Topic 808 and Topic 606 Income Taxes Simplifying the Accounting for Income Taxes (Topic 740) Codification Improvements Debt In August 2020, ASU 2020-06, Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) respectively. As such, net loss from continuing operations attributable to the Company per common share for the three and nine months ended September 30, 2021 was $0.03 and $0.08 lower due to the effect of adoption of ASU 2020-06, respectively. December 31, ASU 2020-06 January 1, 2020 Adoption Adjustment 2021 (in thousands) Liabilities Outstanding Principal $ 287,500 $ — $ 287,500 Unamortized debt discount and issuance cost (85,007) 76,674 (8,333) Net carrying amount $ 202,493 $ 76,674 $ 279,167 Equity Additional paid-in-capital $ (1,411,286) $ 82,872 $ (1,328,414) Accumulated deficit (929,318) 6,198 (923,120) New Accounting Pronouncements Not Yet Adopted In March 2020, ASU 2020-04, Reference Rate Reform (Topic 848)

Revenue Recognition

Revenue Recognition	9 Months Ended
Revenue Recognition	Sep. 30, 2021
Revenue Recognition
Revenue Recognition	3. Revenue Recognition The Company recognizes revenues when, or as, performance obligations in the contracts are satisfied, in the amount reflecting the expected consideration to be received from the goods or services transferred to the customers. Product Revenues Product revenues are derived from contracts with insurance carriers, laboratory partners and patients in connection with sales primarily related to prenatal genetic tests. The Company enters into contracts with insurance carriers with primarily payment terms related to tests provided to the patients who have health insurance coverage. Insurance carriers are considered as third-party payers on behalf of the patients, and the patients are considered as the customers who receive genetic test services. Tests may be billed to insurance carriers, patients, or a combination of insurance carriers and patients. Further, the Company sells tests to a number of domestic and international laboratory partners and identifies the laboratory partners as customers provided that there is a test services agreement between the two parties. 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 insurance carriers, laboratory partners and patients and identifies the performance obligations in those contracts, which are the delivery of the test results. The total consideration which the Company expects to collect in exchange for the Company’s products is an estimate and may be fixed or variable. Consideration includes reimbursement from both patients and insurance carriers, adjusted for variable consideration related to disallowed cases, discounts, refunds and doubtful accounts, and is estimated using the expected value approach. For insurance carriers with similar reimbursement characteristics, the Company uses a portfolio of relevant historical data to estimate variable consideration and total collections for the Company’s products. The Company constrains the estimated variable consideration when it assesses it is probable that a significant reversal in the amount of cumulative revenue recognized may occur in future periods. The consideration expected from laboratory partners usually includes a fixed amount, but it can be variable depending on the volume of tests performed, and the Company determines the variable consideration using the expected value approach. For insurance carriers, 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 for insurance carriers and patients, a certain percentage of revenues is further constrained for estimated refunds. 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. Tests billed to insurance carriers and directly to patients usually take an average of nine two Product revenue is recognized in an amount equal to the total consideration (as described above) at a point in time when the test results are delivered. The Company reserves certain amounts in other accrued liabilities on the balance sheet in anticipation of requests for refunds of payments previously made by insurance carriers, which are accounted for as reductions in product revenues in the statement of operations and comprehensive loss. During the three months ended September 30, 2021 and 2020, $1.6 million and $1.1 million, respectively, were released from amounts previously held in reserves in other accrued liabilities, and recognized as product revenue. During the nine months ended September 30, 2021 and 2020, $4.6 million and $2.7 million, respectively, were released from amounts previously held in reserves in other accrued liabilities, and recognized as product revenue. The release of amounts reserved were recognized as product revenue within that period. 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 IVD kits. The Company also recognizes revenues from the Signatera research use only (“RUO”) offering and from its agreements with Qiagen LLC, (“Qiagen”), BGI Genomics Co., Ltd. (“BGI Genomics”), and Foundation Medicine, Inc. (“Foundation Medicine”). 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. Signatera 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 (“WES”) services and the testing of patient samples to detect cancer mutations using its Signatera test. Each test is billable to customers 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. The Company allocates the contract price to each test using the stand-alone selling price for each service and recognizes the test processing revenue as individual test results are delivered to customers. Qiagen BGI Genomics 2019, which was received in January 2021. Also, 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 for equipment and services to be received in future periods aggregating to $10.0 million were recorded in long-term advances on the Company’s Condensed Consolidated Balance Sheet. The Company is responsible for granting a license to specified intellectual property and performing certain development activities to customize its genetic testing assays for oncology and NIPT for use with BGI Genomics’ sequencing instruments and proprietary technology platform. Revenue associated with these performance obligations is recognized over time using the input method, based on costs incurred to perform the development services, since the level of costs incurred over time best reflect the transfer of development services. Revenue associated with the assay interpretation services will be recognized upon delivery of these services. Funds received in advance are recorded as deferred revenue and will be recognized as the related services are delivered. The initial transaction price was primarily comprised of license and milestone fees. The Company constrains the estimated variable consideration when it assesses it is probable that a significant reversal in the amount of cumulative revenue recognized may occur in future periods. Certain milestone and license fees were constrained and not included in the transaction price due to the uncertainties of research and development. The Company re-evaluates the transaction price, including the estimated variable consideration included in the transaction price and all constrained amounts, in each reporting period and as uncertain events are resolved or other changes in circumstances occur. The allocation of the transaction price was performed based on standalone selling prices, which are based on estimated amounts that the Company would charge for a performance obligation if it were sold separately. In accordance with ASC 340-40, any incremental costs incurred to obtain a contract with a customer are required to be capitalized and amortized over the period in which the goods and services are transferred to the customer. The Company has elected to apply a practical expedient under ASC 340-40 to recognize the incremental costs of obtaining a contract as an expense when incurred provided that the amortization period of such costs, if capitalized, is one year or less. The incremental costs incurred in connection with the BGI Genomics arrangement is not material on an accumulated basis and therefore will not be capitalized on the balance sheet but will be expensed as incurred. 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 Foundation Medicine Agreement has an initial term of five years, expiring in August 2024, with automatic renewals thereafter for successive one-year terms, unless the Foundation Medicine Agreement is earlier terminated in accordance with its terms. Natera 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 provides for approximately $13.3 million in upfront licensing fees and prepaid revenues payable to the Company, and up to approximately $32.0 million in minimum annual payments and payments tied to the Company’s achievement of certain developmental, regulatory, and commercial milestones. As of December 31, 2019, the Company received $16.3 million of these amounts, of which $3.0 million was for achieving certain milestones, and $13.3 million was for licensing fees and prepaid revenue. There was an additional milestone met in May 2021. The Company accrued a $1.0 million milestone payment against accounts receivable and short-term deferred revenue. This milestone was paid in early July 2021 Pursuant to the Foundation Medicine Agreement, the Company will provide development services in conjunction with granting the use of the Company’s intellectual property. Following completion of those development services, the Company is currently providing RUO assay testing services over the term of the agreement. The Company has concluded that the license is not a distinct performance obligation as it is highly interrelated and interdependent with the related development services. Therefore, license and related development services represent a single performance obligation. The Company is responsible for providing the technology license and certain development services that are required to customize its proprietary Signatera test to work with Foundation Medicine’s FoundationOne CDx. The intellectual property has been licensed to Foundation Medicine for the customized test. In addition, the Company is responsible for delivering clinical study plans in order to demonstrate efficacy of the customized test which has commenced in the second quarter of 2021. Revenues associated with each of the performance obligations are recognized over time using the input method, based on costs incurred to perform the development services, since the level of costs incurred over time best reflect the transfer of development services. Revenue associated with the assay testing services will be recognized upon delivery of these services. Funds received in advance are recorded as deferred revenue and will be recognized as the related services are delivered. The initial transaction price was primarily comprised of license and milestone fees. The Company constrains the estimated variable consideration when it assesses it is probable that a significant reversal in the amount of cumulative revenue recognized may occur in future periods. Certain milestone fees were constrained and not included in the transaction price due to the uncertainties of research and development. The Company re-evaluates the transaction price, including the estimated variable consideration included in the transaction price and all constrained amounts, in each reporting period and as uncertain events are resolved or other changes in circumstances occur. The allocation of the transaction price was performed based on standalone selling prices, which are based on estimated amounts that the Company would charge for a performance obligation if it were sold separately. In accordance with ASC 340-40, any incremental costs incurred to obtain a contract with a customer are required to be capitalized and amortized over the period in which the goods and services are transferred to the customer. The Company has elected to apply a practical expedient under ASC 340-40 to recognize the incremental costs of obtaining a contract as an expense when incurred provided that the amortization period of such costs, if capitalized, is one year or less. Disaggregation of Revenues The Company measures its performance results primarily based on revenues recognized from the three categories described below. The following table shows disaggregation of revenues by payer types: Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) Insurance carriers $ 132,423 $ 78,004 $ 351,218 $ 216,305 Laboratory and other partners 17,441 13,701 77,575 42,426 Patients 8,252 6,438 23,665 19,896 Total revenues $ 158,116 $ 98,143 $ 452,458 $ 278,627 The following table presents total revenues by geographic area based on the location of the Company’s payers: Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) United States $ 148,033 $ 93,511 $ 427,804 $ 260,999 Americas, excluding U.S. 1,247 1,081 3,052 2,584 Europe, Middle East, India, Africa 5,598 3,524 14,322 10,584 Asia Pacific and Other 3,238 27 7,280 4,460 Total revenues $ 158,116 $ 98,143 $ 452,458 $ 278,627 Balance at Balance at September 30, December 31, (in thousands) 2021 2020 Assets: Accounts receivable $ 110,416 $ 78,565 Liabilities: Deferred revenue, current portion $ 9,667 $ 50,125 Deferred revenue, long-term portion 22,706 22,805 Total deferred revenues $ 32,373 $ 72,930 Deferred Revenues (in thousands) Balance at December 31, 2020 $ 72,930 Increase in deferred revenues 4,703 Refunds of revenues previously deferred (10,000) Revenue recognized during the period that was included in (32,864) Revenue recognized from performance obligations satisfied (2,396) Balance at September 30, 2021 $ 32,373

Fair Value Measurements

Fair Value Measurements	9 Months Ended
Fair Value Measurements	Sep. 30, 2021
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. 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 September 30, 2021 December 31, 2020 Level I Level II Level III Total Level I Level II Level III Total (in thousands) Financial Assets: Money market deposits $ 55,703 $ — $ — $ 55,703 $ 28,990 $ — $ — $ 28,990 U.S. Treasury securities 787,875 — — 787,875 597,744 — — 597,744 Corporate bonds and notes — 52,721 — 52,721 — 12,328 — 12,328 Municipal securities — 88,000 — 88,000 — 78,534 — 78,534 Total financial assets $ 843,578 $ 140,721 $ — $ 984,299 $ 626,734 $ 90,862 $ — $ 717,596 Fair Value of Long-Term Debt: As of September 30, 2021, the estimated fair value of the Convertible Notes, which are not presented at fair value on the Condensed Consolidated Balance Sheets as of September 30, 2021, was $863.3 million and was based upon observable, Level 2 inputs, including pricing information from recent trades of the Convertible Notes (see Note 10, Debt

Financial Instruments

Financial Instruments	9 Months Ended
Financial Instruments	Sep. 30, 2021
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 equivalents and investments, all of which are classified as available-for-sale securities, consisted of the following: September 30, 2021 December 31, 2020 Amortized Gross Gross Estimated Fair Value Amortized Gross Gross Estimated Fair Value (in thousands) Money market deposits $ 55,703 $ — $ — $ 55,703 $ 28,990 $ — $ — $ 28,990 U.S. Treasury securities (1) 786,404 1,821 (350) 787,875 594,252 3,512 (20) 597,744 Corporate bonds and notes (1) 52,868 — (147) 52,721 12,331 2 (5) 12,328 Municipal securities 87,824 378 (202) 88,000 77,764 796 (26) 78,534 Total $ 982,799 $ 2,199 $ (699) $ 984,299 $ 713,337 $ 4,310 $ (51) $ 717,596 Classified as: Cash equivalents (2) $ 55,703 $ 28,990 Short-term investments 928,596 688,606 Total $ 984,299 $ 717,596 (1) Per the Company’s investment policy, all debt securities are classified as short-term investments irrespective of holding period. (2) Cash equivalents includes cash sweep accounts and U.S. Treasury money market mutual 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 there is currently no other than temporary impairment of its investments and will continue to recognize unrealized gains and losses in other comprehensive income (loss). During the nine months ended September 30, 2021 and 2020, the Company sold $77.6 million and $11.5 million of investments, respectively. During the nine months ended September 30, 2021, the amount of gross realized gains and realized losses upon sales of investments were insignificant. 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 September 30, 2021, the Company had 43 investments in an unrealized loss position in its portfolio. An allowance for credit losses was not necessary for the third quarter of 2021 since the investments are low risk, investment grade securities. The Company has assessed the unrealized loss position for available-for-sale debt securities for which an allowance for credit losses has not been recorded. The fair value for investment securities at an unrealized loss position as of September 30, 2021 was $522.0 million. The aggregate amount of unrealized losses of these securities was $0.7 million, and the impact of the securities in a continuous loss position to the condensed consolidated statements of operations and comprehensive loss were not material as of September 30, 2021. September 30, 2021 Amortized Fair (in thousands) Less than or equal to one year $ 403,211 $ 403,784 Greater than one year but less than five years 523,885 524,812 Total $ 927,096 $ 928,596

Balance Sheet Components

Balance Sheet Components	9 Months Ended
Balance Sheet Components	Sep. 30, 2021
Balance Sheet Components
Balance Sheet Components	6. Balance Sheet Components Property and Equipment, net The Company’s property and equipment consisted of the following: September 30, December 31, Useful Life 2021 2020 (in thousands) Machinery and equipment 3-5 years $ 64,583 $ 51,001 Furniture and fixtures 3 years 1,393 1,376 Computer equipment 3 years 2,772 2,428 Capitalized software held for internal use 3 years 8,776 7,417 Leasehold improvements Lesser of useful life or lease term 15,351 14,810 Construction-in-process 24,732 6,370 117,607 83,402 Less: Accumulated depreciation and amortization (58,314) (50,054) Total Property and Equipment, net $ 59,293 $ 33,348 All of the Company’s long-lived assets are located in the United States. During the nine months ended September 30, 2021, the increase in net property and equipment was due to purchases of new equipment for the Company’s laboratories located in Texas and California to expand testing capabilities, offset by depreciation expense of $8.3 million recorded in the nine months ended September 30, 2021. The Company did not incur an impairment charge during the nine months ended September 30, 2021. Accrued Compensation The Company’s accrued compensation consisted of the following: September 30, December 31, 2021 2020 (in thousands) Accrued paid time off $ 2,472 $ 2,260 Accrued commissions 10,950 12,686 Accrued bonuses 12,275 9,635 Other accrued compensation 9,634 5,790 Total accrued compensation $ 35,331 $ 30,371 Other Accrued Liabilities The Company’s other accrued liabilities consisted of the following: September 30, December 31, 2021 2020 (in thousands) Reserves for refunds to insurance carriers $ 15,879 $ 17,366 Accrued charges for third-party testing 17,690 5,141 Testing and laboratory materials from suppliers 6,513 2,720 Marketing and corporate affairs 6,152 3,325 Legal, audit and consulting fees 15,215 4,189 Accrued shipping charges 399 1,604 Sales tax payable 1,758 1,723 Accrued third-party service fees 3,363 2,355 Clinical trials and studies 6,282 2,353 Operating lease liabilities, current portion 6,922 7,300 Fixed asset purchases 4,957 1,691 Other accrued interest 2,695 1,078 Other accrued expenses 8,661 9,562 Total other accrued liabilities $ 96,486 $ 60,407 Reserves for refunds to insurance carriers include overpayments from and amounts to be refunded to insurance carriers, and additional amounts that the Company estimates for potential refund requests during the period. When the Company releases these previously accrued amounts, they are recognized as product revenues in the statements of operations and comprehensive loss. The following table summarizes the reserve balance and activities for refunds to insurance carriers for the nine months ended September 30, 2021: September 30, September 30, 2021 2020 (in thousands) Beginning balance $ 17,366 $ 9,410 Additional reserves 11,776 11,912 Refunds to carriers (8,664) (5,244) Reserves released to revenue (4,599) (2,756) Ending balance $ 15,879 $ 13,322

Leases

Leases	9 Months Ended
Leases	Sep. 30, 2021
Leases
Leases	7. Leases Operating Leases 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 will be $9.3 million commencing in October 2023. 36-month three September 30, 2021 (in thousands) Operating lease liabilities, current portion included in other accrued liabilities $ 6,922 Operating lease liabilities, long-term portion 48,388 Total operating lease liabilities $ 55,310 3.66 The present value of the future annual minimum lease payments under all non-cancellable operating leases as of September 30, 2021 are as follows: Operating Leases (in thousands) Year ending December 31: 2021 (remaining 3 months) $ 2,689 2022 10,909 2023 11,456 2024 11,993 2025 12,216 2026 and thereafter 20,026 69,289 Less: imputed interest (13,979) Operating lease liabilities $ 55,310

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
Commitments and Contingencies	Sep. 30, 2021
Commitments and Contingencies
Commitments and Contingencies	8. Commitments and Contingencies Legal Proceedings From time to time, the Company is involved in disputes, litigation, and other regulatory or administrative actions, including those with respect to intellectual property, employment, testing, billing, reimbursement and other matters. Such actions may include allegations of negligence, products/professional liability or other legal claims, and could involve claims for substantial compensatory and/or punitive damages or claims for indeterminate amounts of damages. The Company is aggressively defending and/or prosecuting its current litigation matters, but cannot provide any assurance as to the ultimate outcome or that an adverse resolution would not have a material adverse effect on its financial condition and results of operations. There are many uncertainties associated with any litigation and these actions or other third party claims against the Company, including by governmental entities, or by the Company against third parties, may cause the Company to incur costly litigation and/or substantial settlement charges. In addition, the resolution of any intellectual property litigation may require the Company to make royalty payments, which could adversely affect gross margins in future periods. If this were to occur, the Company's business, financial condition, results of operations, and cash flows could be adversely affected. The Company assesses legal contingencies to determine the degree of probability and range of possible loss for potential accrual in its financial statements. When evaluating legal contingencies, the Company may be unable to provide a meaningful estimate due to a number of factors, including the procedural status of the matter in question, the presence of complex or novel legal theories, and/or the ongoing discovery and development of information important to the matters. In addition, damage amounts claimed in litigation or other matters may be unsupported, exaggerated or unrelated to possible outcomes, and as such are not meaningful indicators of its potential liability. During the periods presented, the Company has not recorded any accrual for loss contingencies associated with such legal proceedings or other matters, determined that an unfavorable outcome is probable or reasonably possible, or determined that the amount or range of any possible loss is reasonably estimable. 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 suit, CareDx alleged, in a complaint filed jointly with the Board of Trustees of the Leland Stanford Junior University (“Stanford”) in March 2019 and amended in March 2020, that the Company infringed three patents. The complaint sought unspecified damages and injunctive relief. On September 28, 2021, the Court granted the Company’s motion for summary judgment, finding all three patents invalid. CareDx and Stanford have filed a notice of appeal to the United States Court of Appeals for the Federal Circuit. In the second suit, filed by the Company in January 2020, the Company alleged infringement by CareDx of two of the Company’s patents, seeking unspecified damages and injunctive relief. The case is currently pending. The Company has filed suit against ArcherDX, Inc. (“ArcherDX”) in the United States District Court for the District of Delaware, alleging, in complaints filed in January, April, and August of 2020, which cases were consolidated in September 2020, that certain ArcherDX DNA oncology products infringe five of the Company’s patents. In June 2020, ArcherDX filed a motion to dismiss aspects of the Company’s case, including to invalidate several of the Company’s asserted patents. That motion was denied in its entirety in October 2020. In January 2021, the Company filed a second amended complaint naming an additional Archer DX entity, ArcherDx LLC, and Invitae Corp. as defendants. The Company is seeking unspecified monetary damages and injunctive relief. A jury trial is set for May 16, 2022. 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. The complaint seeks monetary damages and injunctive relief. Trial is set for December 13, 2021. The Company filed suit against Progenity, Inc. (“Progenity”) in June 2020 in the United States District Court for the Western District of Texas and in the United States District Court for the Northern District of Texas, in each case alleging that Progenity’s NIPT test infringes six of the Company’s patents. The complaints sought treble damages and injunctive relief. In July 2020, Progenity filed suit against the Company in the United States District Court for the Southern District of California, seeking declaratory judgment of non-infringement of the Company’s asserted patents. Progenity also petitioned the Patent Trial and Appeal Board (“PTAB”) of the United States Patent and Trademark Office for inter partes 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 oncology products infringe one of the Company’s patents and seeking unspecified monetary damages and injunctive relief. In March 2021, the Company filed a motion to dismiss certain of Genosity’s affirmative defenses and a counterclaim. In January 2021, the Company filed suit against Inivata, Inc. and Inivata Ltd. (collectively “Inivata”) in the United States District Court for the District of Delaware. The complaint, amended by the Company in May 2021, alleges that various Inivata oncology products infringe two of the Company’s patents and seeks unspecified monetary damages and injunctive relief. In June 2021, Inivata filed a motion to dismiss the Company’s amended complaint. In May 2021, Invitae Corp. (“Invitae”) filed a complaint against the Company alleging infringement of one patent and seeking monetary damages and injunctive relief. In June 2021, the Company filed a motion to dismiss Invitae’s complaint in its entirety. Other Litigation Matters. In August 2019, a suit was filed against the Company in the Circuit Court of Cook County, Illinois by a patient alleging claims relating to a discordant test result and seeking monetary damages. The suit was dismissed in June 2021. The Company is also the subject of a lawsuit filed by CareDx against the Company in April 2019 in the United States District Court for the District of Delaware, alleging false advertising, trademark disparagement, unfair competition, and unfair or deceptive trade practices based on statements describing studies that concern the Company’s technology and CareDx’s technology (“CareDx’s Advertising Case”). The complaint seeks unspecified damages and injunctive relief. In May 2019, the Company filed a motion to dismiss the entirety of CareDx’s Advertising Case for failure to state a claim, following which in February 2020, CareDx filed an amended complaint withdrawing its trademark disparagement claim. Also in February 2020, 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. The parties cross-moved for partial summary judgment, which was denied in April 2021. The Company is involved in litigation against Guardant, Inc. (“Guardant”). On or about May 27, 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. On or about May 28, 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. In the California action, the Company has answered Guardant’s complaint and has asserted its claims as counterclaims, seeking unspecified damages and injunctive relief. On August 3, 2021, Guardant moved to dismiss the Company’s counterclaims. 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 amount of 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. Contractual Commitments The following table sets forth the material contractual commitments as of September 30, 2021 with a remaining term of at least one year: Party Commitments Expiry Date (in thousands) Material suppliers $ 14,717 June 2026 Application service providers 30,331 March 2026 Earnouts for asset development with third party* 35,000 September 2023 Other material suppliers 10,581 Various Total $ 90,630 * The earnouts for asset development with the third party consists of three milestones which are upon the satisfaction of certain contractual conditions.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
Stock-Based Compensation	Sep. 30, 2021
Stock-Based Compensation
Stock-Based Compensation	9. Stock-Based Compensation 2015 Equity Incentive Plan General Share Reserve The initial number of shares of the Company’s common stock available for issuance under the 2015 Plan was 3,451,495 shares. ● 3,500,000 shares; ● 4% of the shares of common stock outstanding on the last business day of the prior fiscal year; or ● the number of shares determined by the Company’s board of directors. Stock options vest as determined by the compensation committee. In general, they will vest over a four-year period following the date of grant. Stock options expire at the time determined by the compensation committee but in no event more than ten years after they are granted. These awards generally expire earlier if the participant's service terminates earlier. Restricted Shares and Stock Units. Performance-based Awards Period Granted Options Granted RSUs Granted Options Vested RSUs Vested Milestone Valuation Method (in thousands) Q1 2019 200 300 201 300 (1) Monte-Carlo Simulation Q2 2019 — 188 — 81 (2) Fair Market Value Q3 2019 — 50 — 50 (1) Monte-Carlo Simulation Q1 2020 150 300 113 225 (1) Monte-Carlo Simulation Q1 2020 — 436 — 406 (3) Fair Market Value Q1 2020 129 — 129 — (3) Black-Scholes-Merton Q2 2020 — 21 — 21 (3) Fair Market Value Q3 2020 10 — 10 — (4) Black-Scholes-Merton Q3 2020 — 27 — 17 (3) Fair Market Value Q4 2020 — 32 — 6 (1) Monte-Carlo Simulation Q4 2020 — 22 — 2 (5) Fair Market Value Q1 2021 150 125 — — (1) Monte-Carlo Simulation Q1 2021 — 279 — 10 (3) Fair Market Value Q2 2021 163 — — — (1) Monte-Carlo Simulation Q2 2021 29 — — — (3) Black-Scholes-Merton Q2 2021 — 7 — — (3) Fair Market Value ________________________________ (1) The awards will vest based on the achievement of certain values of the Company’s common stock at multiple thresholds within certain periods and are contingent upon the completion of requisite service through the date of such vesting. (2) The vesting of the awards will be triggered after the end of the achievement milestone, as measured by the Company. (3) The awards will vest based on achievement of a revenue target and are contingent upon the completion of requisite service through the date of such vesting. (4) The awards vest based on achievement of a reimbursement target. (5) The awards will vest based on achievement of certain revenue and recruiting targets. The Company has recognized $9.6 million and $39.5 million in stock-based compensation for performance-based awards for the three and nine months ended September 30, 2021, respectively. The Company has recognized $6.6 million and $11.8 million in stock-based compensation for performance-based awards for the three and nine months ended September 30, 2020, respectively. September 30, 2021 Risk-free interest rate 0.80 % — 1.42 % Expected dividend yield 0.00 % Expected volatility 60 % Expected term (years) 7.25 — 10.00 Employee Stock Purchase Plan During the period ended September 30, 2021, there have not been any changes to the Company’s 2015 Natera, Inc. Employee Stock Purchase Plan (the “ESPP”) as disclosed in Form 10-K for the fiscal year ended December 31, 2020. The Company has made 2,940,084 shares available for issuance under the Plan as of September 30, 2021, a number that is automatically increased by the least of (i) 1% of the total number of shares of common stock actually issued and outstanding on the last business day of the prior fiscal year, (ii) 880,000 shares of common stock (subject to certain adjustments pursuant to Subsection (c) below), or (iii) a number of shares of common stock determined by the Company’s board of directors. The first offering period of 2021 started on November 1, 2020 and ended on April 30, 2021 , and 106,435 shares were purchased for proceeds of $6.1 million. The second offering period of 2021 began on May 1, 2021 and will end on October 31, 2021. As of September 30, 2021, no shares have been purchased in the second offering period. Stock Options and Restricted Stock Units The following table summarizes option activity for the nine months ended September 30, 2021: Outstanding Options Weighted- Weighted- Average Shares Average Remaining Aggregate Available for Number of Exercise Contractual Intrinsic (in thousands, except for contractual life and exercise price) Grant Shares Price Life Value (in years) Balance at December 31, 2020 3,197 6,707 $ 11.19 6.04 $ 592,468 Additional shares authorized 3,446 — Options granted (391) 391 $ 104.02 Options exercised — (1,051) $ 10.26 Options forfeited/cancelled 35 (35) $ 13.78 RSUs granted (1,528) — RSUs forfeited/cancelled 227 — Balance at September 30, 2021 4,986 6,012 $ 17.37 5.63 $ 566,871 Exercisable at September 30, 2021 4,785 $ 9.99 4.98 $ 485,498 Vested and expected to vest at September 30, 2021 5,936 $ 17.00 5.60 $ 561,788 The following table summarizes RSU activity for the nine months ended September 30, 2021: Weighted- Average Grant Date (in thousands, except for grant date fair value) Shares Fair Value Balance at December 31, 2020 4,188 $ 34.02 Granted 1,528 $ 104.48 Vested (1,707) $ 25.83 Cancelled/forfeited (227) $ 49.39 Balance at September 30, 2021 3,782 $ 64.78 Stock-Based Compensation Expense Stock based compensation is related to stock options and RSUs granted to the Company’s employees and 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 on a straight-line basis. No compensation cost is recognized when the requisite service has not been met and the awards are therefore forfeited. Employee stock-based compensation expense was 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 was not adjusted for estimated forfeitures up until the occurrence of the actual forfeiture of the associated awards. The following tables present the effect of employee and non-employee stock-based compensation expense on selected statements of operations line items for the three and nine months ended September 30, 2021 and 2020. Three months ended September 30, 2021 2020 Employee Non-Employee Total Employee Non-Employee Total (in thousands) Cost of revenues $ 1,262 $ — $ 1,262 $ 458 $ — $ 458 Research and development 6,242 410 6,652 3,081 17 3,098 Selling, general and administrative 18,478 67 18,544 11,404 72 11,476 Total $ 25,982 $ 477 $ 26,459 $ 14,943 $ 89 $ 15,032 Nine months ended September 30, 2021 2020 Employee Non-Employee Total Employee Non-Employee Total (in thousands) Cost of revenues $ 3,246 $ — $ 3,246 $ 1,213 $ — $ 1,213 Research and development 16,168 974 17,142 7,394 459 7,853 Selling, general and administrative 64,231 178 64,409 25,183 157 25,340 Total $ 83,645 $ 1,152 $ 84,797 $ 33,790 $ 616 $ 34,406 Valuation of Stock Option Grants to Employees and Non-employees The Company utilizes the Black-Scholes option pricing model when estimating the fair value of stock options. For the three nine months ended September 30, 2021, the following valuation assumptions were applied on both the employee and non-employee options. In the same period of the prior year, the valuation assumptions as follows were only used for stock options granted to employees. Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Expected term (years) 10.00 5.22 — 10.00 5.11 — 10.00 5.22 — 10.00 Expected volatility 56.31 % 54.18 % — 61.96 % 55.33 % — 63.30 % 49.94 % — 61.96 % Expected dividend rate 0.00 % 0.00 % 0.00 % 0.00 % Risk-free interest rate 1.30 % 0.31 % — 0.65 % 0.81 % — 1.67 % 0.31 % — 1.70 %

Debt

Debt	9 Months Ended
Debt	Sep. 30, 2021
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 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. 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. For the three months ended September 30, 2021 and 2020, the Company recorded interest expense on the Credit Line of $0.2 million for both periods. For the nine months ended September 30, 2021 and 2020, the Company recorded interest expense on the Credit Line of $0.5 million and $0.7 million, respectively. Interest payments on the Credit Line were made within the same periods. As of September 30, 2021, the total principal amount outstanding with accrued interest was $50.0 million. Convertible Notes ● During any fiscal quarter commencing after March 31, 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. 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. September 30, 2021 (in thousands) Long-Term Debt Outstanding Principal $ 287,500 Unamortized debt discount and issuance cost (7,415) Net carrying amount $ 280,085 Three months ended Nine months ended September 30, September 30, 2021 2021 (in thousands) Cash interest expense Contractual interest expense $ 1,617 $ 4,852 Non-cash interest expense Amortization of debt discount and debt issuance cost 308 917 Total interest expense $ 1,925 $ 5,769

Income Taxes

Income Taxes	9 Months Ended
Income Taxes	Sep. 30, 2021
Income Taxes
Income Taxes	11. Income Taxes In response to the COVID-19 pandemic, the Coronavirus Aid, Relief and Economic Security Act (“CARES Act”) was signed into law in March 2020. The CARES Act includes modifications for net operating loss carryovers and carrybacks, limitations of business interest expense, immediate refund of alternative minimum tax (“AMT”) credit carryovers as well as a technical correction to the Tax Cuts and Jobs Act of 2017, for qualified improvement property. As of September 30, 2021, the Company expects that these provisions will not have a material impact as the Company has no net operating losses or AMT credits that would fall under these provisions and does not expect interest expense to be deductible due to current and historical losses. During the three months ended September 30, 2021 and 2020, the Company recorded total income tax expense of approximately $272,000 and $25,000, respectively. During the nine months ended September 30, 2021 and 2020, the Company recorded total income tax expense of approximately $648,000 and $63,000, respectively. For the three and nine months ended September 30, 2021, the income tax expense is primarily attributable to state income tax and foreign income tax expenses resulting from testing to clinics and licenses of cloud-based software and intellectual property that are based in a foreign country. There was no state income tax expense recorded for the three and nine months ended September 30, 2020. Due to the Company’s history of cumulative operating losses, the Company concluded that, after considering all the available objective evidence, it is not more likely than not that all of the Company’s net deferred tax assets will be realized. Accordingly, all of the Company’s deferred tax assets, which includes net operating loss or NOL carryforwards and tax credits related primarily to research and development, continue to be subjected to a valuation allowance as of September 30, 2021. The Company will continue to maintain a full valuation allowance until there is sufficient evidence to support recoverability of its deferred tax assets. As described in Note 10, Debt The Company had $13.6 million and $11.5 million in unrecognized tax benefits as of September 30, 2021 and December 31, 2020, respectively. The reversal of the uncertain tax benefits would not affect the effective tax rate to the extent that the Company continues to maintain a full valuation allowance against its deferred tax assets. Unrecognized tax benefits may change during the next twelve months for items that arise in the ordinary course of business. Interest and/or penalties related to income tax matters are recognized as a component of income tax expense. As of September 30, 2021, there were no accrued interest and penalties related to uncertain tax positions. As part of the IPR&D acquisition, the Company acquired $5.8 million of deferred tax assets which have been fully offset by a valuation allowance as it is not more likely that these assets will be realized as of September 30, 2021. Included in the deferred tax assets is $12.1 million of NOL carryforwards which begin to expire in 2031. Because the IPR&D was expensed immediately after acquisition, the Company treated this asset as IPR&D expense. For tax purposes the write-off of amounts assigned to IPR&D occurs prior to the measurement of deferred taxes. Therefore a deferred tax liability has not been recorded as of the acquisition date and the value of the IPR&D is expected to be treated as a permanent tax difference.

Net Loss per Share

Net Loss per Share	9 Months Ended
Net Loss per Share	Sep. 30, 2021
Net Loss per Share
Net Loss per Share	12. Net Loss per Share Basic net loss per share is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding for the period, excluding shares subject to repurchase and without consideration of potentially dilutive securities. Diluted net loss per share is computed by giving effect to all potentially dilutive common shares outstanding for the period. For purposes of this computation, outstanding common stock options, and restricted stock units are considered to be common share equivalents. Common share equivalents are excluded from the computation in periods in which they have an anti-dilutive effect, unless the consideration of any one of them gives a dilutive effect. The Convertible Notes are convertible as of September 30, 2021. Upon conversion, the Company has the option to pay cash, issue shares of common stock, or any combination thereof for the aggregate amount due upon conversion. If converted, the value of the Convertible Notes based on contractual settlement provisions would exceed its principal amount by $564.6 million as of September 30, 2021. Since the Company is in a net loss position in the periods presented, the shares which would be issued upon conversion of the Convertible Notes are excluded from the net loss per share calculation as it would have an antidilutive effect. As such, the 7.4 million shares underlying the conversion option of the Convertible Notes will not have an impact on the Company’s diluted earnings per share. If converted, the Company does not intend to settle the obligation in cash. The following table provides the basic and diluted net loss per share computations for the nine months ended September 30, 2021 and 2020. Three months ended Nine months ended September 30, September 30, (in thousands, except per share data) 2021 2020 2021 2020 Numerator: Net loss, basic and diluted $ (151,273) $ (58,323) $ (331,152) $ (153,331) Denominator: Weighted-average number of shares used in computing net loss per share, basic and diluted 92,558 80,908 89,130 79,430 Net loss per share, basic and diluted $ (1.63) $ (0.72) $ (3.72) $ (1.93) The following table shows total outstanding potentially dilutive shares excluded from the computation of diluted loss per share as their effect would be anti-dilutive, as of September 30, 2021 and 2020: September 30, 2021 2020 (in thousands) Options to purchase common stock 6,012 7,265 Restricted stock units 3,782 3,901 Employee stock purchase plan 73 122 Convertible Notes 7,411 7,411 Estimated earnout shares for an asset acquisition 270 — Total 17,548 18,699

Subsequent Events

Subsequent Events	9 Months Ended
Subsequent Events	Sep. 30, 2021
Subsequent Events
Subsequent Events	13. Subsequent Events None.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
Summary of Significant Accounting Policies (Policies)	Sep. 30, 2021
Summary of Significant Accounting Policies
Basis of Presentation	Basis of Presentation The accompanying unaudited interim condensed consolidated financial statements have been prepared in conformity with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial information. The unaudited interim condensed consolidated financial information includes only adjustments of a normal recurring nature necessary for a fair presentation of the results of operations, financial position, changes in stockholders’ equity, and cash flows. The results of operations for the three and nine months ended September 30, 2021, are not necessarily indicative of the results for the full year or the results for any future periods. The condensed consolidated balance sheet as of December 31, 2020 has been derived from audited financial statements at that date, these financial statements should be read in conjunction with the audited financial statements, and related notes for the year ended December 31, 2020 included in the Company’s Annual Report on Form 10-K filed with the SEC on February 26, 2021.
Liquidity Matters	Liquidity Matters The Company has incurred net losses since its inception and anticipates net losses and negative operating cash flows for the near future. The Company had a net loss of $331.2 million for the nine months ended September 30, 2021 and an accumulated deficit of $1.3 billion as of September 30, 2021. As of September 30, 2021, the Company had $95.3 million in cash, cash equivalents, and restricted cash, $928.6 million in marketable securities, $50.0 million of outstanding balance of the Credit Line (as defined in Note 10, Debt The Company continues to develop and commercialize 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 at all, or in amounts or on terms acceptable to the Company. If the Company is unable to obtain additional financing, it may be required to delay the development and commercialization of its products and significantly scale back its business and operations. In May 2021, the Company entered into a development and option agreement with a third party that requires the third party to use its best efforts to perform an agreed upon development plan and provides the Company with an exclusive option to purchase the third party’s assets. The Company paid the third party $10 million in the second quarter of 2021 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 (“IPR&D”) in exchange for an equity consideration payment. The third party was a biotechnology company focused on oncology. The total 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. Further, there are an estimated 269,547 of additional shares, consistent with the registration statement filed with the SEC on September 10, 2021, that are potentially issuable to legacy shareholders of this third party upon the achievement of defined milestones which will be revalued at each reporting date. These milestones are assessed as probable as of September 30, 2021. As a result, this was accounted as contingent compensation expense recognized over the performance period at fair market value. The Company concluded the acquired IPR&D has no alternative-future use and accordingly expensed on the day of the transaction close as research and development expense which is reflected in our condensed consolidated statement of operations. In April 2019, the Company completed an underwritten equity offering and sold 6,052,631 shares of its common stock at a price of $19 per share to the public. Before offering expenses of $0.6 million, the Company received proceeds of $108.1 million net of the underwriting discount. In October 2019, the Company completed another underwritten equity offering and sold 6,571,428 shares of its common stock at a price of $35 per share to the public. Before offering expenses of $0.4 million, the Company received proceeds of $216.2 million net of the underwriting discount. In September 2020, the Company completed an additional underwritten equity offering and sold 4,791,665 shares of its common stock at a price of $60.00 per share to the public. Before offering expenses of $0.3 million, the Company received proceeds of $271.0 million net of the underwriting discount. In July 2021, the Company completed an underwritten equity offering and sold 5,175,000 shares of its common stock at a price of $113 per share to the public. Before offering expenses of $0.4 million, the Company received proceeds of $551.2 million net of the underwriting discount. 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 November 4, 2021.
Principles of Consolidation	Principles of Consolidation The accompanying condensed consolidated financial statements include all the accounts of the Company and its subsidiaries. The Company established a subsidiary that operates in the state of Texas to support the Company’s laboratory and operational functions. The Company established a subsidiary that operates in Canada following the acquisition of the IPR&D asset, which includes a lease for the laboratory space located in Canada. All intercompany balances and transactions have been eliminated.
Use of Estimates	Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles (GAAP) in the United States requires management to make estimates and assumptions about future events that affect the amounts of assets and liabilities reported, disclosures about contingent assets and liabilities, and reported amounts of revenues and expenses. Significant items subject to such estimates include the allowance for doubtful accounts calculated based on the average selling price expected to be received from insurance payors, the operating right-of-use assets and the associated lease liabilities, deferred revenues associated with unsatisfied performance obligations, accrued liability for potential refund requests, the valuation of the Convertible Notes, stock-based compensation, the fair value of options, income tax uncertainties, and the expected consideration to be received from contracts with customers. These estimates and assumptions are based on management's best estimates and judgment. Management regularly evaluates its estimates and assumptions using historical experience and other factors, including contractual terms and statutory limits; however, actual results could differ from these estimates and could have an adverse effect on the Company's financial statements.
Credit Losses	Credit Losses Trade accounts receivable and other receivables. The following is a roll-forward of the allowances for credit losses related to trade accounts receivable and other receivables for the nine months ended September 30, 2021: Nine Months Ended September 30, 2021 (in thousands) Beginning balance $ 4,220 Provision for credit losses 380 Write-offs (495) Total $ 4,105 Available-for-sale debt securities.
Investments	Investments Investments consist primarily of debt securities such as U.S. Treasuries, U.S. agency and municipal bonds. Management determines the appropriate classification of securities at the time of purchase and re-evaluates such determination at each balance sheet date. The Company generally classifies its entire investment portfolio as available-for-sale. The Company views its available-for-sale portfolio as available for use in current operations. Accordingly, the Company classifies all investments as short-term, irrespective of maturity date. Available-for-sale securities are carried at fair value, with unrealized gains and losses reported in accumulated other comprehensive income (loss), which is a separate component of stockholders’ equity.
Risk and Uncertainties	Risk and Uncertainties The Company is subject to risks and uncertainties as a result of the COVID-19 pandemic. The extent of the impact of the COVID-19 pandemic on the Company's business is highly uncertain and difficult to predict, and the full extent and duration of the impact of the COVID-19 pandemic on its business, its operations, and the global economy as a whole is not yet known. While the Company’s test volumes and overall average selling prices for its tests increased during the nine months ended September 30, 2021 compared to the nine months ended September 30, 2020, the Company cannot predict the potential nature, magnitude and duration of the effects of the COVID-19 pandemic on the macroeconomic environment or its business. Financial instruments that potentially subject the Company to credit risk consist of 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. The Company performs evaluations of financial conditions for insurance carriers, patients, clinics and laboratory partners and generally does not require collateral to support credit sales. For the nine months ended September 30, 2021, and 2020, there were no customers exceeding 10% of total revenues on an individual basis. As of September 30, 2021 and December 31, 2020, there were no customers with an outstanding balance exceeding 10% of net accounts receivable.
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. Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Beginning balance $ 2,441 $ 5,770 $ 4,259 $ 919 Net unrealized gain (loss) on available-for-sale securities, net of tax (950) (600) (2,768) 4,251 Ending balance $ 1,491 $ 5,170 $ 1,491 $ 5,170
Recent Accounting Pronouncements	Recent Accounting Pronouncements From time to time, new accounting pronouncements are issued by the Financial Accounting Standards Board (“FASB”) under its accounting standard codifications or other standard setting bodies and adopted by the Company as of the specified effective date. Unless otherwise discussed below, the Company believes that the impact of accounting standards updates recently issued that are not yet effective will not have a material impact on its financial position or results of operations upon adoption. Recently Adopted Accounting Pronouncements Fair Value Measurement In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement Goodwill - Internal-Use Software Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350 ‑ 40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract Credit Losses In June 2016, the FASB issued ASU 2016-13, Financial Instruments—Credit Losses: Measurement of Credit Losses on Financial Instruments amortized costs. The Company adopted ASU 2016-13, as amended, effective January 1, 2020 using the modified retrospective method and recorded a cumulative-effect adjustment of $0.4 million in retained earnings as of January 1, 2020. Collaborative Arrangements Collaborative Arrangements (Topic 808): Clarifying the Interaction between Topic 808 and Topic 606 Income Taxes Simplifying the Accounting for Income Taxes (Topic 740) Codification Improvements Debt In August 2020, ASU 2020-06, Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40) respectively. As such, net loss from continuing operations attributable to the Company per common share for the three and nine months ended September 30, 2021 was $0.03 and $0.08 lower due to the effect of adoption of ASU 2020-06, respectively. December 31, ASU 2020-06 January 1, 2020 Adoption Adjustment 2021 (in thousands) Liabilities Outstanding Principal $ 287,500 $ — $ 287,500 Unamortized debt discount and issuance cost (85,007) 76,674 (8,333) Net carrying amount $ 202,493 $ 76,674 $ 279,167 Equity Additional paid-in-capital $ (1,411,286) $ 82,872 $ (1,328,414) Accumulated deficit (929,318) 6,198 (923,120) New Accounting Pronouncements Not Yet Adopted In March 2020, ASU 2020-04, Reference Rate Reform (Topic 848)

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
Summary of Significant Accounting Policies (Tables)	Sep. 30, 2021
Summary Of Significant Accounting Policies [Line Items]
Schedule of allowances for credit losses	Nine Months Ended September 30, 2021 (in thousands) Beginning balance $ 4,220 Provision for credit losses 380 Write-offs (495) Total $ 4,105
Schedule of Accumulated Other Comprehensive Income (Loss)	Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) (in thousands) Beginning balance $ 2,441 $ 5,770 $ 4,259 $ 919 Net unrealized gain (loss) on available-for-sale securities, net of tax (950) (600) (2,768) 4,251 Ending balance $ 1,491 $ 5,170 $ 1,491 $ 5,170
Accounting Standards Update 2020-06
Summary Of Significant Accounting Policies [Line Items]
Schedule of new accounting pronouncements and changes in accounting principle	December 31, ASU 2020-06 January 1, 2020 Adoption Adjustment 2021 (in thousands) Liabilities Outstanding Principal $ 287,500 $ — $ 287,500 Unamortized debt discount and issuance cost (85,007) 76,674 (8,333) Net carrying amount $ 202,493 $ 76,674 $ 279,167 Equity Additional paid-in-capital $ (1,411,286) $ 82,872 $ (1,328,414) Accumulated deficit (929,318) 6,198 (923,120)

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
Revenue Recognition (Tables)	Sep. 30, 2021
Revenue Recognition
Schedule of disaggregation of revenues by payer types	Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) Insurance carriers $ 132,423 $ 78,004 $ 351,218 $ 216,305 Laboratory and other partners 17,441 13,701 77,575 42,426 Patients 8,252 6,438 23,665 19,896 Total revenues $ 158,116 $ 98,143 $ 452,458 $ 278,627
Schedule of total revenue by geographic area	Three months ended Nine months ended September 30, September 30, 2021 2020 2021 2020 (in thousands) United States $ 148,033 $ 93,511 $ 427,804 $ 260,999 Americas, excluding U.S. 1,247 1,081 3,052 2,584 Europe, Middle East, India, Africa 5,598 3,524 14,322 10,584 Asia Pacific and Other 3,238 27 7,280 4,460 Total revenues $ 158,116 $ 98,143 $ 452,458 $ 278,627
Schedule of beginning and ending balances of accounts receivable and deferred revenues	Balance at Balance at September 30, December 31, (in thousands) 2021 2020 Assets: Accounts receivable $ 110,416 $ 78,565 Liabilities: Deferred revenue, current portion $ 9,667 $ 50,125 Deferred revenue, long-term portion 22,706 22,805 Total deferred revenues $ 32,373 $ 72,930
Schedule of changes in the balance of deferred revenues	Deferred Revenues (in thousands) Balance at December 31, 2020 $ 72,930 Increase in deferred revenues 4,703 Refunds of revenues previously deferred (10,000) Revenue recognized during the period that was included in (32,864) Revenue recognized from performance obligations satisfied (2,396) Balance at September 30, 2021 $ 32,373

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
Fair Value Measurements (Tables)	Sep. 30, 2021
Fair Value Measurements
Summary of financial assets and liabilities measured on recurring basis	September 30, 2021 December 31, 2020 Level I Level II Level III Total Level I Level II Level III Total (in thousands) Financial Assets: Money market deposits $ 55,703 $ — $ — $ 55,703 $ 28,990 $ — $ — $ 28,990 U.S. Treasury securities 787,875 — — 787,875 597,744 — — 597,744 Corporate bonds and notes — 52,721 — 52,721 — 12,328 — 12,328 Municipal securities — 88,000 — 88,000 — 78,534 — 78,534 Total financial assets $ 843,578 $ 140,721 $ — $ 984,299 $ 626,734 $ 90,862 $ — $ 717,596

Financial Instruments (Tables)

Financial Instruments (Tables)	9 Months Ended
Financial Instruments (Tables)	Sep. 30, 2021
Financial Instruments
Schedule of available-for-sale securities	September 30, 2021 December 31, 2020 Amortized Gross Gross Estimated Fair Value Amortized Gross Gross Estimated Fair Value (in thousands) Money market deposits $ 55,703 $ — $ — $ 55,703 $ 28,990 $ — $ — $ 28,990 U.S. Treasury securities (1) 786,404 1,821 (350) 787,875 594,252 3,512 (20) 597,744 Corporate bonds and notes (1) 52,868 — (147) 52,721 12,331 2 (5) 12,328 Municipal securities 87,824 378 (202) 88,000 77,764 796 (26) 78,534 Total $ 982,799 $ 2,199 $ (699) $ 984,299 $ 713,337 $ 4,310 $ (51) $ 717,596 Classified as: Cash equivalents (2) $ 55,703 $ 28,990 Short-term investments 928,596 688,606 Total $ 984,299 $ 717,596 (1) Per the Company’s investment policy, all debt securities are classified as short-term investments irrespective of holding period. (2) Cash equivalents includes cash sweep accounts and U.S. Treasury money market mutual funds.
Summarized portfolio of available-for-sale securities by contractual maturity	September 30, 2021 Amortized Fair (in thousands) Less than or equal to one year $ 403,211 $ 403,784 Greater than one year but less than five years 523,885 524,812 Total $ 927,096 $ 928,596

Balance Sheet Components (Table

Balance Sheet Components (Tables)	9 Months Ended
Balance Sheet Components (Tables)	Sep. 30, 2021
Balance Sheet Components
Schedule of property and equipment	September 30, December 31, Useful Life 2021 2020 (in thousands) Machinery and equipment 3-5 years $ 64,583 $ 51,001 Furniture and fixtures 3 years 1,393 1,376 Computer equipment 3 years 2,772 2,428 Capitalized software held for internal use 3 years 8,776 7,417 Leasehold improvements Lesser of useful life or lease term 15,351 14,810 Construction-in-process 24,732 6,370 117,607 83,402 Less: Accumulated depreciation and amortization (58,314) (50,054) Total Property and Equipment, net $ 59,293 $ 33,348
Schedule of accrued compensation	September 30, December 31, 2021 2020 (in thousands) Accrued paid time off $ 2,472 $ 2,260 Accrued commissions 10,950 12,686 Accrued bonuses 12,275 9,635 Other accrued compensation 9,634 5,790 Total accrued compensation $ 35,331 $ 30,371
Schedule of other accrued liabilities	September 30, December 31, 2021 2020 (in thousands) Reserves for refunds to insurance carriers $ 15,879 $ 17,366 Accrued charges for third-party testing 17,690 5,141 Testing and laboratory materials from suppliers 6,513 2,720 Marketing and corporate affairs 6,152 3,325 Legal, audit and consulting fees 15,215 4,189 Accrued shipping charges 399 1,604 Sales tax payable 1,758 1,723 Accrued third-party service fees 3,363 2,355 Clinical trials and studies 6,282 2,353 Operating lease liabilities, current portion 6,922 7,300 Fixed asset purchases 4,957 1,691 Other accrued interest 2,695 1,078 Other accrued expenses 8,661 9,562 Total other accrued liabilities $ 96,486 $ 60,407
Summary of reserve balance and activities for refunds to insurance carriers	September 30, September 30, 2021 2020 (in thousands) Beginning balance $ 17,366 $ 9,410 Additional reserves 11,776 11,912 Refunds to carriers (8,664) (5,244) Reserves released to revenue (4,599) (2,756) Ending balance $ 15,879 $ 13,322

Leases (Tables)

Leases (Tables)	9 Months Ended
Leases (Tables)	Sep. 30, 2021
Leases
Schedule of lease liabilities	September 30, 2021 (in thousands) Operating lease liabilities, current portion included in other accrued liabilities $ 6,922 Operating lease liabilities, long-term portion 48,388 Total operating lease liabilities $ 55,310
Schedule of annual minimum lease payments	Operating Leases (in thousands) Year ending December 31: 2021 (remaining 3 months) $ 2,689 2022 10,909 2023 11,456 2024 11,993 2025 12,216 2026 and thereafter 20,026 69,289 Less: imputed interest (13,979) Operating lease liabilities $ 55,310

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
Commitments and Contingencies (Tables)	Sep. 30, 2021
Commitments and Contingencies
Schedule of material contractual commitments	Party Commitments Expiry Date (in thousands) Material suppliers $ 14,717 June 2026 Application service providers 30,331 March 2026 Earnouts for asset development with third party* 35,000 September 2023 Other material suppliers 10,581 Various Total $ 90,630 * The earnouts for asset development with the third party consists of three milestones which are upon the satisfaction of certain contractual conditions.

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
Stock-Based Compensation (Tables)	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of performance-based awards	Period Granted Options Granted RSUs Granted Options Vested RSUs Vested Milestone Valuation Method (in thousands) Q1 2019 200 300 201 300 (1) Monte-Carlo Simulation Q2 2019 — 188 — 81 (2) Fair Market Value Q3 2019 — 50 — 50 (1) Monte-Carlo Simulation Q1 2020 150 300 113 225 (1) Monte-Carlo Simulation Q1 2020 — 436 — 406 (3) Fair Market Value Q1 2020 129 — 129 — (3) Black-Scholes-Merton Q2 2020 — 21 — 21 (3) Fair Market Value Q3 2020 10 — 10 — (4) Black-Scholes-Merton Q3 2020 — 27 — 17 (3) Fair Market Value Q4 2020 — 32 — 6 (1) Monte-Carlo Simulation Q4 2020 — 22 — 2 (5) Fair Market Value Q1 2021 150 125 — — (1) Monte-Carlo Simulation Q1 2021 — 279 — 10 (3) Fair Market Value Q2 2021 163 — — — (1) Monte-Carlo Simulation Q2 2021 29 — — — (3) Black-Scholes-Merton Q2 2021 — 7 — — (3) Fair Market Value ________________________________ (1) The awards will vest based on the achievement of certain values of the Company’s common stock at multiple thresholds within certain periods and are contingent upon the completion of requisite service through the date of such vesting. (2) The vesting of the awards will be triggered after the end of the achievement milestone, as measured by the Company. (3) The awards will vest based on achievement of a revenue target and are contingent upon the completion of requisite service through the date of such vesting. (4) The awards vest based on achievement of a reimbursement target. (5) The awards will vest based on achievement of certain revenue and recruiting targets.
Summary of stock option activity	Outstanding Options Weighted- Weighted- Average Shares Average Remaining Aggregate Available for Number of Exercise Contractual Intrinsic (in thousands, except for contractual life and exercise price) Grant Shares Price Life Value (in years) Balance at December 31, 2020 3,197 6,707 $ 11.19 6.04 $ 592,468 Additional shares authorized 3,446 — Options granted (391) 391 $ 104.02 Options exercised — (1,051) $ 10.26 Options forfeited/cancelled 35 (35) $ 13.78 RSUs granted (1,528) — RSUs forfeited/cancelled 227 — Balance at September 30, 2021 4,986 6,012 $ 17.37 5.63 $ 566,871 Exercisable at September 30, 2021 4,785 $ 9.99 4.98 $ 485,498 Vested and expected to vest at September 30, 2021 5,936 $ 17.00 5.60 $ 561,788
Restricted stock units	Weighted- Average Grant Date (in thousands, except for grant date fair value) Shares Fair Value Balance at December 31, 2020 4,188 $ 34.02 Granted 1,528 $ 104.48 Vested (1,707) $ 25.83 Cancelled/forfeited (227) $ 49.39 Balance at September 30, 2021 3,782 $ 64.78
Summary of stock-based compensation expenses	Three months ended September 30, 2021 2020 Employee Non-Employee Total Employee Non-Employee Total (in thousands) Cost of revenues $ 1,262 $ — $ 1,262 $ 458 $ — $ 458 Research and development 6,242 410 6,652 3,081 17 3,098 Selling, general and administrative 18,478 67 18,544 11,404 72 11,476 Total $ 25,982 $ 477 $ 26,459 $ 14,943 $ 89 $ 15,032 Nine months ended September 30, 2021 2020 Employee Non-Employee Total Employee Non-Employee Total (in thousands) Cost of revenues $ 3,246 $ — $ 3,246 $ 1,213 $ — $ 1,213 Research and development 16,168 974 17,142 7,394 459 7,853 Selling, general and administrative 64,231 178 64,409 25,183 157 25,340 Total $ 83,645 $ 1,152 $ 84,797 $ 33,790 $ 616 $ 34,406
Performance-based awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of assumptions used in valuation of fair value	September 30, 2021 Risk-free interest rate 0.80 % — 1.42 % Expected dividend yield 0.00 % Expected volatility 60 % Expected term (years) 7.25 — 10.00
Employee stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Schedule of assumptions used in valuation of fair value	Three months ended September 30, Nine months ended September 30, 2021 2020 2021 2020 Expected term (years) 10.00 5.22 — 10.00 5.11 — 10.00 5.22 — 10.00 Expected volatility 56.31 % 54.18 % — 61.96 % 55.33 % — 63.30 % 49.94 % — 61.96 % Expected dividend rate 0.00 % 0.00 % 0.00 % 0.00 % Risk-free interest rate 1.30 % 0.31 % — 0.65 % 0.81 % — 1.67 % 0.31 % — 1.70 %

Debt (Tables)

Debt (Tables)	9 Months Ended
Debt (Tables)	Sep. 30, 2021
Debt
Schedule of outstanding Convertible Notes	September 30, 2021 (in thousands) Long-Term Debt Outstanding Principal $ 287,500 Unamortized debt discount and issuance cost (7,415) Net carrying amount $ 280,085
Summary of interest expense	Three months ended Nine months ended September 30, September 30, 2021 2021 (in thousands) Cash interest expense Contractual interest expense $ 1,617 $ 4,852 Non-cash interest expense Amortization of debt discount and debt issuance cost 308 917 Total interest expense $ 1,925 $ 5,769

Net Loss per Share (Tables)

Net Loss per Share (Tables)	9 Months Ended
Net Loss per Share (Tables)	Sep. 30, 2021
Net Loss per Share
Basic and diluted net loss per share	Three months ended Nine months ended September 30, September 30, (in thousands, except per share data) 2021 2020 2021 2020 Numerator: Net loss, basic and diluted $ (151,273) $ (58,323) $ (331,152) $ (153,331) Denominator: Weighted-average number of shares used in computing net loss per share, basic and diluted 92,558 80,908 89,130 79,430 Net loss per share, basic and diluted $ (1.63) $ (0.72) $ (3.72) $ (1.93)
Total outstanding potentially dilutive shares	September 30, 2021 2020 (in thousands) Options to purchase common stock 6,012 7,265 Restricted stock units 3,782 3,901 Employee stock purchase plan 73 122 Convertible Notes 7,411 7,411 Estimated earnout shares for an asset acquisition 270 — Total 17,548 18,699

Description of Business (Detail

Description of Business (Details)	9 Months Ended
Description of Business (Details)	Sep. 30, 2021subsidiarysegment
Description of Business
Number of operating segments \| segment	1
Number of subsidiaries \| subsidiary	2

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Liquidity Matters (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended						3 Months Ended		9 Months Ended
	Jul. 31, 2021	May 31, 2021	Sep. 30, 2020	Apr. 30, 2020	Oct. 31, 2019	Apr. 30, 2019	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Policies
Net (loss) income							$ (151,273)	$ (58,323)	$ (331,152)	$ (153,331)
Accumulated deficit							1,254,272		1,254,272		$ 929,318
Cash, cash equivalents and restricted cash			$ 209,529				95,331	$ 209,529	95,331	209,529	48,855	$ 61,981
Marketable securities							928,596		928,596		688,606
Short-term Credit Line, outstanding balance							$ 50,049		$ 50,049		$ 50,054
Contractual commitment for development and option agreement		$ 10,000
Payment for third party assets if purchase option is exercised		$ 290,000
Common stock, shares issued							94,538,000		94,538,000		86,223,000
Net proceeds										278,316
Loss on Debt Extinguishment										$ 5,848
Convertible Notes
Policies
Outstanding principal balance				$ 287,500			$ 287,500		$ 287,500
Per annum interest rate (as a percent)				2.25%					2.25%
Net proceeds				$ 278,300
Equity offering
Policies
Common stock, shares issued	5,175,000		4,791,665		6,571,428	6,052,631		4,791,665		4,791,665
Stock issued (in dollars per share)	$ 113		$ 60		$ 35	$ 19		$ 60		$ 60
Payment of offering expenses	$ 400		$ 300		$ 400	$ 600
Proceeds from issuance of common stock	$ 551,200		$ 271,000		$ 216,200	$ 108,100

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Asset acquisition (Details) - In-process research and development acquisition $ in Millions	Sep. 10, 2021USD ($)shares
Asset Acquisition [Line Items]
Asset acquisition, consideration transferred	$ 35.6
Issuance of common stock \| shares	276,346
Fair value of common stock issued	$ 30.9
Cash consideration	3.9
Net liabilities assumed	0.2
Acquisition related costs	$ 0.6
Number of additional shares potentially issuable \| shares	269,547

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Credit Losses (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Summary of Significant Accounting Policies
Beginning balance	$ 4,220
Provision for credit losses	380
Write-offs	(495)
Ending balance	$ 4,105

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Concentration (Details)	9 Months Ended		12 Months Ended
	Sep. 30, 2021customerUSD ($)	Sep. 30, 2020USD ($)	Dec. 31, 2020customer
Sales \| Customer
Risk and Uncertainties
Number of customers exceeding 10% of benchmark \| $	0	0
Accounts receivable \| Credit
Risk and Uncertainties
Number of customers exceeding 10% of benchmark \| customer	0		0

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - AOCIL (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning balance	$ 2,441	$ 5,770	$ 4,259	$ 919
Ending balance	1,491	5,170	1,491	5,170
Net unrealized gain (loss) on available-for-sale securities, net of tax
Accumulated Other Comprehensive Income (Loss) [Line Items]
Increase (decrease) in other comprehensive loss	$ (950)	$ (600)	$ (2,768)	$ 4,251

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Accounting Pronouncements (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021	Mar. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accumulated deficit	$ (1,254,272)	$ (1,254,272)		$ (929,318)
Convertible Notes
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Interest expense	1,925	5,769
Outstanding principle	287,500	287,500	$ 287,500
Net carrying amount	280,085	280,085
Previously reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Interest expense	$ 2,400	$ 7,000
Previously reported \| Convertible Notes
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Outstanding principle				287,500
Unamortized debt discount and issuance cost				(85,007)
Net carrying amount				202,493
Additional paid-in-capital				(1,411,286)
Accumulated deficit				(929,318)
ASU 2016-13
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect adjustment					$ 400
Accounting Standards Update 2020-06 \| Convertible Notes
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Outstanding principle				287,500
Unamortized debt discount and issuance cost				(8,333)
Net carrying amount				279,167
Additional paid-in-capital				(1,328,414)
Accumulated deficit				(923,120)
Accounting Standards Update 2020-06 \| Adoption Adjustment
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Reduction in net loss from continuing operations per share	$ 0.03	$ 0.08
Accounting Standards Update 2020-06 \| Adoption Adjustment \| Convertible Notes
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Unamortized debt discount and issuance cost				76,674
Net carrying amount				76,674
Additional paid-in-capital				82,872
Accumulated deficit				$ 6,198

Revenue Recognition (Details)

Revenue Recognition (Details) - USD ($) $ in Thousands	1 Months Ended		3 Months Ended				9 Months Ended		12 Months Ended
Revenue Recognition (Details) - USD ($) $ in Thousands	Jul. 31, 2021	Feb. 28, 2019	Sep. 30, 2021	Mar. 31, 2021	Sep. 30, 2020	Jun. 30, 2019	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2020	Sep. 30, 2019	Aug. 31, 2019
Refunds of revenues previously deferred							$ 10,000
Deferred revenue, Long-term			$ 22,706				22,706				$ 22,805
Other assets			13,202				13,202				14,743
Deferred revenue			32,373				32,373				72,930
Deferred revenue, current portion			9,667				9,667				50,125
Total revenues			158,116		$ 98,143		452,458	$ 278,627
Deferred revenue, long-term portion			22,706				22,706				$ 22,805
Revenue recognized during the period that was included in deferred revenues at the beginning of the period							32,864
Product
Revenue recognized			1,600		1,100		4,600	2,700
Cost of revenues			76,838		46,873		211,387	131,124
Total revenues			150,651		93,286		$ 406,265	260,746
Product \| Minimum
Billing collection period (in months)							9 months
Product \| Maximum
Billing collection period (in months)							12 months
Licensing and other
Cost of revenues			4,533		4,948		$ 12,909	12,614
Total revenues			7,465		$ 4,857		46,193	$ 17,881
Genetic testing services
Revenue recognized during the period that was included in deferred revenues at the beginning of the period							$ 300
Qiagen
Proceeds from license agreement										$ 5,000
Agreement term							10 years
Revenue, remaining performance obligation										40,000
Revenue recognized during the period that was included in deferred revenues at the beginning of the period							$ 28,600
Qiagen \| Volume, regulatory and commercial milestones
Revenue, remaining performance obligation										$ 10,000
Qiagen \| Other licensing and other revenue
Refunds of revenues previously deferred				$ 10,000
Deferred revenue				$ 28,600
Laboratory distribution partners \| Product \| Minimum
Billing collection period (in months)							2 months
Laboratory distribution partners \| Product \| Maximum
Billing collection period (in months)							3 months
BGI Genomics
Proceeds from license agreement		$ 50,000				$ 35,600
Receivable						$ 2,500
Agreement term		10 years
Deferred revenue, current portion			3,500				$ 3,500
BGI Genomics \| Sequencing services
Other assets												$ 6,000
BGI Genomics \| Sequencing products
Other assets												4,000
BGI Genomics \| Sequencing products and services
Other assets												$ 10,000
Foundation Medicine ("FMI")
Proceeds from license agreement									$ 16,300
Deferred revenue, current portion			3,700				3,700
Foundation Medicine ("FMI") \| Milestone payments
Proceeds from license agreement	$ 1,000
Deferred revenue, current portion			$ 1,000				1,000
Foundation Medicine ("FMI") \| Upfront licensing fees and prepaid revenues
Initial transaction price													$ 13,300
Foundation Medicine ("FMI") \| Developmental, regulatory, and commercial milestones
Initial transaction price													$ 32,000
Foundation Medicine ("FMI") \| Developmental performance milestones
Proceeds from license agreement									3,000
Foundation Medicine ("FMI") \| Licensing fees and prepaid revenue
Proceeds from license agreement									$ 13,300
BGI and FMI \| Genetic testing services
Revenue recognized during the period that was included in deferred revenues at the beginning of the period							$ 4,000

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Total revenues	$ 158,116	$ 98,143	$ 452,458	$ 278,627
United States
Disaggregation of Revenue [Line Items]
Total revenues	148,033	93,511	427,804	260,999
Americas, excluding U.S.
Disaggregation of Revenue [Line Items]
Total revenues	1,247	1,081	3,052	2,584
Europe, Middle East, India, Africa
Disaggregation of Revenue [Line Items]
Total revenues	5,598	3,524	14,322	10,584
Asia Pacific and Other
Disaggregation of Revenue [Line Items]
Total revenues	3,238	27	7,280	4,460
Insurance carriers
Disaggregation of Revenue [Line Items]
Total revenues	132,423	78,004	351,218	216,305
Laboratory partners
Disaggregation of Revenue [Line Items]
Total revenues	17,441	13,701	77,575	42,426
Patients
Disaggregation of Revenue [Line Items]
Total revenues	8,252	6,438	23,665	19,896
Licensing and other
Disaggregation of Revenue [Line Items]
Total revenues	$ 7,465	$ 4,857	$ 46,193	$ 17,881

Revenue Recognition - Accounts

Revenue Recognition - Accounts Receivable and Deferred Revenue (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Assets
Accounts receivable	$ 110,416	$ 78,565
Liabilities:
Deferred revenue, current portion	9,667	50,125
Deferred revenue, long-term portion	22,706	22,805
Total deferred revenues	$ 32,373	$ 72,930

Revenue Recognition - Changes i

Revenue Recognition - Changes in Balance of Deferred Revenues (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2021USD ($)
Revenue Recognition
Balance	$ 72,930
Increase in deferred revenues	4,703
Refunds of revenues previously deferred	(10,000)
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	(32,864)
Revenue recognized from performance obligations satisfied within the same period	(2,396)
Balance	$ 32,373

Revenue Recognition - Deferred

Revenue Recognition - Deferred Revenues (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	$ 32,864
Deferred revenue, current portion	9,667	$ 50,125
Deferred revenue, Long-term	22,706	22,805
Deferred revenue	32,373	$ 72,930
BGI Genomics
Deferred revenue, current portion	3,500
Foundation Medicine ("FMI")
Deferred revenue, current portion	3,700
Qiagen
Revenue recognized during the period that was included in deferred revenues at the beginning of the period	$ 28,600

Fair Value Measurements (Detail

Fair Value Measurements (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Level 2
Liabilities:
Fair value of liability	$ 863,300
Recurring
Financial Assets:
Total financial assets	984,299	$ 717,596
Recurring \| Money market deposits
Financial Assets:
Total financial assets	55,703	28,990
Recurring \| U.S. Treasury securities
Financial Assets:
Total financial assets	787,875	597,744
Recurring \| Corporate bonds and notes
Financial Assets:
Total financial assets	52,721	12,328
Recurring \| Municipal securities
Financial Assets:
Total financial assets	88,000	78,534
Recurring \| Level 1
Financial Assets:
Total financial assets	843,578	626,734
Recurring \| Level 1 \| Money market deposits
Financial Assets:
Total financial assets	55,703	28,990
Recurring \| Level 1 \| U.S. Treasury securities
Financial Assets:
Total financial assets	787,875	597,744
Recurring \| Level 2
Financial Assets:
Total financial assets	140,721	90,862
Recurring \| Level 2 \| Corporate bonds and notes
Financial Assets:
Total financial assets	52,721	12,328
Recurring \| Level 2 \| Municipal securities
Financial Assets:
Total financial assets	$ 88,000	$ 78,534

Financial Instruments (Details)

Financial Instruments (Details) $ in Thousands	9 Months Ended
Financial Instruments (Details) $ in Thousands	Sep. 30, 2021USD ($)position	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Estimated Fair Value	$ 928,596		$ 688,606
Proceeds from investments sold	77,600	$ 11,500
Other than temporary impairment	$ 0
Number of investments, unrealized loss position \| position	43
Amortized Cost
Less than or equal to one year	$ 403,211
Greater than one year but less than five years	523,885
Total	927,096
Fair Value
Less than or equal to one year	403,784
Greater than or equal to one year but less than five years	524,812
Total	928,596
Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	982,799		713,337
Gross Unrealized Gain	2,199		4,310
Gross Unrealized Loss	(699)		(51)
Estimated Fair Value	984,299		717,596
Unrealized loss position	522,000
Money market deposits
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	55,703		28,990
Estimated Fair Value	55,703		28,990
U.S. Treasury securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	786,404		594,252
Gross Unrealized Gain	1,821		3,512
Gross Unrealized Loss	(350)		(20)
Estimated Fair Value	787,875		597,744
Corporate bonds and notes
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	52,868		12,331
Gross Unrealized Gain			2
Gross Unrealized Loss	(147)		(5)
Estimated Fair Value	52,721		12,328
Municipal securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Amortized Cost	87,824		77,764
Gross Unrealized Gain	378		796
Gross Unrealized Loss	(202)		(26)
Estimated Fair Value	88,000		78,534
Cash equivalents \| Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Estimated Fair Value	55,703		28,990
Short-term investments \| Available-for-sale securities
Debt Securities, Available-for-sale, Fair Value to Amortized Cost [Abstract]
Estimated Fair Value	$ 928,596		$ 688,606

Balance Sheet Components - Prop

Balance Sheet Components - Property and Equipment, net (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Property and Equipment, net
Property and equipment, gross	$ 117,607	$ 83,402
Less: Accumulated depreciation and amortization	(58,314)	(50,054)
Total Property and Equipment, net	59,293	33,348
Depreciation expense	8,300
Impairment	0
Machinery and equipment
Property and Equipment, net
Property and equipment, gross	64,583	51,001
Furniture and fixtures
Property and Equipment, net
Property and equipment, gross	$ 1,393	1,376
Useful Life	3 years
Computer equipment
Property and Equipment, net
Property and equipment, gross	$ 2,772	2,428
Useful Life	3 years
Capitalized software held for internal use
Property and Equipment, net
Property and equipment, gross	$ 8,776	7,417
Useful Life	3 years
Leasehold improvements
Property and Equipment, net
Property and equipment, gross	$ 15,351	14,810
Construction-in-process
Property and Equipment, net
Property and equipment, gross	$ 24,732	$ 6,370
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	Sep. 30, 2021	Dec. 31, 2020
Balance Sheet Components
Accrued paid time off	$ 2,472	$ 2,260
Accrued commissions	10,950	12,686
Accrued bonuses	12,275	9,635
Other accrued compensation	9,634	5,790
Total accrued compensation	$ 35,331	$ 30,371

Balance Sheet Components - Othe

Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2020	Dec. 31, 2019
Balance Sheet Components
Reserves for refunds to insurance carriers	$ 15,879	$ 17,366	$ 13,322	$ 9,410
Accrued charges for third-party testing	17,690	5,141
Testing and laboratory materials from suppliers	6,513	2,720
Marketing and corporate affairs	6,152	3,325
Legal, audit and consulting fees	15,215	4,189
Accrued shipping charges	399	1,604
Sales tax payable	1,758	1,723
Accrued third-party service fees	3,363	2,355
Clinical trials and studies	6,282	2,353
Operating lease liabilities, current portion	6,922	7,300
Fixed asset purchases	4,957	1,691
Other accrued interest	2,695	1,078
Other accrued expenses	8,661	9,562
Total other accrued liabilities	$ 96,486	$ 60,407

Balance Sheet Components - Rese

Balance Sheet Components - Reserve Balance and Activities for Refunds (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Balance Sheet Components
Beginning balance	$ 17,366	$ 9,410
Additional reserves	11,776	11,912
Refunds to carriers	(8,664)	(5,244)
Reserves released to revenue	(4,599)	(2,756)
Ending balance	$ 15,879	$ 13,322

Leases (Details)

Leases (Details) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
Leases (Details) $ in Thousands	Sep. 30, 2021USD ($)ft²	Sep. 30, 2021USD ($)ft²	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)ft²item	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)
Lessee, Lease, Description [Line Items]
Operating lease liabilities, current portion included in other accrued liabilities	$ 6,922	$ 6,922		$ 6,922		$ 7,300
Operating lease liabilities, long-term portion	48,388	48,388		48,388		$ 21,246
Operating lease liabilities	$ 55,310	$ 55,310		55,310
Noncash investing activities related to right-of-use assets				$ 31,300
Weighted average remaining lease term	3 years 7 months 28 days	3 years 7 months 28 days		3 years 7 months 28 days
Weighted average discount rate (as a percent)	7.48%	7.48%		7.48%
Lease expense		$ 2,800	$ 1,900	$ 8,100	$ 5,800
Operating lease payments		$ 2,600	$ 2,200	$ 7,600	$ 6,600
Minimum
Lessee, Lease, Description [Line Items]
Term of lease	3 years	3 years		3 years
Maximum
Lessee, Lease, Description [Line Items]
Term of lease	5 years	5 years		5 years
Corporate Headquarters Lease
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	113,000	113,000		113,000
Number of office space locations \| item				2
Term of lease	84 months	84 months		84 months
Renewal term of lease	5 years	5 years		5 years
"First Space" Sublease
Lessee, Lease, Description [Line Items]
Number of office space locations \| ft²				88,000
"Second Space" Sublease
Lessee, Lease, Description [Line Items]
Number of office space locations \| ft²				25,000
Corporate Headquarters Lease Amendment
Lessee, Lease, Description [Line Items]
Annual lease payment				$ 9,300
Term of lease	48 months	48 months		48 months
Austin TX, Long-term Lease
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	94,000	94,000		94,000
Term of lease	132 months	132 months		132 months
Tukwila, WA Lease
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	10,000	10,000		10,000
Term of lease	62 months	62 months		62 months
Renewal term of lease	5 years	5 years		5 years
San Carlos, CA Sublease
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	25,879	25,879		25,879
Term of lease	48 months	48 months		48 months
Sublease receivable	$ 1,900	$ 1,900		$ 1,900
San Carlos, CA Sublease Amendment
Lessee, Lease, Description [Line Items]
Noncash investing activities related to right-of-use assets				$ 29,700
San Carlos, CA Sublease Amendment \| Rentable square feet surrendered in lease amendment
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	25,879	25,879		25,879
South San Francisco, CA Lease
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	11,395	11,395		11,395
Annual lease payment				$ 900
Term of lease	36 months	36 months		36 months
Vancouver, British Columbia, Canada
Lessee, Lease, Description [Line Items]
Office space (area) \| ft²	7,107	7,107		7,107
Annual lease payment	$ 200
Term of lease	24 months	24 months		24 months

Leases - Payments (Details)

Leases - Payments (Details) $ in Thousands	Sep. 30, 2021USD ($)
Leases
2021 (remaining 3 months)	$ 2,689
2022	10,909
2023	11,456
2024	11,993
2025	12,216
2026 and thereafter	20,026
Total	69,289
Less: imputed interest	(13,979)
Operating lease liabilities	$ 55,310

Commitments and Contingencies_2

Commitments and Contingencies (Details) $ in Thousands	Sep. 28, 2021patent	May 31, 2021USD ($)	Jan. 31, 2021patent	Sep. 30, 2020patent	Jun. 30, 2020patent	Mar. 31, 2020patentlawsuit	Sep. 30, 2021USD ($)Milestone
Other commitments
Contractual commitment for development and option agreement \| $		$ 10,000
Payment for third party assets if purchase option is exercised \| $		$ 290,000
Total commitments \| $							$ 90,630
Material suppliers
Other commitments
Total commitments \| $							14,717
Application service providers
Other commitments
Total commitments \| $							30,331
Earnouts for asset development with third party
Other commitments
Total commitments \| $							$ 35,000
Number of milestones to be met \| Milestone							3
Other material suppliers
Other commitments
Total commitments \| $							$ 10,581
CareDX Patent Case
Other commitments
Loss contingency, patents allegedly infringed, number						3
Number of patent litigations \| lawsuit						2
Number of invalid patents	3
Gain contingency, patents allegedly infringed, number						2
ArcherDX Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number				5
Ravgen Patent Case
Other commitments
Loss contingency, patents allegedly infringed, number					2
Progenity Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number					6
Inivita Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number			2
Claims remaining \| Progenity Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number					3
Claims dropped or dismissed \| Progenity Patent Case
Other commitments
Gain contingency, patents allegedly infringed, number					3

Stock-Based Compensation (Detai

Stock-Based Compensation (Details) - USD ($) $ in Thousands	2 Months Ended	3 Months Ended		6 Months Ended	9 Months Ended
Stock-Based Compensation (Details) - USD ($) $ in Thousands	Jun. 30, 2021	Sep. 30, 2021	Sep. 30, 2020	Apr. 30, 2021	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020	Jun. 30, 2015
Performance-based awards
Stock Based Compensation
Stock-based compensation expense		$ 9,600	$ 6,600		$ 39,500	$ 11,800
Employee and non-employee stock options
Stock Based Compensation
Stock-based compensation expense		$ 26,459	$ 15,032		$ 84,797	$ 34,406
Shares granted					1,528,000
Shares available for issuance		4,986,000			4,986,000		3,197,000
Restricted stock units
Stock Based Compensation
Number of shares vested					1,707,000
Shares granted					1,528,000
2015 Employee Stock Purchase Plan
Stock Based Compensation
Shares reserved for issuance		2,940,084			2,940,084			3,451,495
Shares granted	0			106,435
Proceeds from shares purchased				$ 6,100
Shares reserved for issuance as a proportion of common stock outstanding (as a percent)					4.00%
2015 Employee Stock Purchase Plan \| Minimum
Stock Based Compensation
Shares reserved for issuance		880,000			880,000
Additional shares reserved for issuance		3,500,000			3,500,000
Shares reserved for issuance as a proportion of common stock outstanding (as a percent)					1.00%

Stock-Based Compensation - Perf

Stock-Based Compensation - Performance-based Awards (Details) - USD ($) shares in Thousands, $ in Thousands

3 Months Ended

9 Months Ended

Sep. 30, 2021

Jun. 30, 2021

Mar. 31, 2021

Dec. 31, 2020

Sep. 30, 2020

Jun. 30, 2020

Mar. 31, 2020

Sep. 30, 2019

Jun. 30, 2019

Mar. 31, 2019

Sep. 30, 2021

Sep. 30, 2020

Fair Market Value

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Valuation Method

Fair Market Value

Black-Scholes Merton

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Valuation Method

Black-Scholes-Merton

Monte-Carlo

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Valuation Method

Monte-Carlo Simulation

Performance-based awards

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Stock-based compensation expense

$ 9,600

$ 6,600

$ 39,500

$ 11,800

Restricted stock units

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

RSUs Granted (in shares)

1,528

Vested (in shares)

1,707

Restricted stock units | Fair Market Value

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

RSUs Granted (in shares)

279

436

188

Vested (in shares)

406

Restricted stock units | Monte-Carlo

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

RSUs Granted (in shares)

125

300

Vested (in shares)

225

300

Employee and non-employee stock options

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Options Granted (in shares)

391

RSUs Granted (in shares)

1,528

Stock-based compensation expense

$ 26,459

$ 15,032

$ 84,797

$ 34,406

Employee and non-employee stock options | Black-Scholes Merton

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Options Granted (in shares)

129

Options Vested (in shares)

129

Employee and non-employee stock options | Monte-Carlo

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Options Granted (in shares)

163

150

200

Options Vested (in shares)

113

201

Stock-Based Compensation - Assu

Stock-Based Compensation - Assumptions (Details) - shares	3 Months Ended		9 Months Ended
Stock-Based Compensation - Assumptions (Details) - shares	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Performance-based awards
Valuation of Stock Option Grants to Employees
Expected volatility, maximum			60.00%
Risk free interest rate, minimum			0.80%
Risk free interest rate, maximum			1.42%
Performance-based awards \| Minimum
Valuation of Stock Option Grants to Employees
Expected term (years)			7 years 3 months
Performance-based awards \| Maximum
Valuation of Stock Option Grants to Employees
Expected term (years)			10 years
Expected dividend yield			0.00%
Employee and non-employee stock options
Stock Based Compensation
Options granted (in shares)			391,000
Valuation of Stock Option Grants to Employees
Expected volatility, minimum		54.18%	55.33%	49.94%
Expected volatility, maximum	56.31%	61.96%	63.30%	61.96%
Expected dividend yield	0.00%	0.00%	0.00%	0.00%
Risk free interest rate, minimum		0.31%	0.81%	0.31%
Risk free interest rate, maximum	1.30%	0.65%	1.67%	1.70%
Employee and non-employee stock options \| Minimum
Valuation of Stock Option Grants to Employees
Expected term (years)		5 years 2 months 19 days	5 years 1 month 9 days	5 years 2 months 19 days
Employee and non-employee stock options \| Maximum
Valuation of Stock Option Grants to Employees
Expected term (years)	10 years	10 years	10 years	10 years
Non-employee stock options
Stock Based Compensation
Options granted (in shares)			32,053
Options unvested (in shares)	1,459		1,459

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Employee and non-employee stock options
Stock Based Compensation
Shares available for grant, beginning balance	3,197,000
Additional shares authorized	3,446,000
Options granted (in shares)	(391,000)
Options forfeited (in shares)	35,000
RSUs granted (in shares)	(1,528,000)
RSUs forfeited/cancelled (in shares)	227,000
Shares available for grant, end balance	4,986,000	3,197,000
Number of shares
Outstanding, beginning balance (in shares)	6,707,000
Options granted (in shares)	391,000
Options exercised (in shares)	(1,051,000)
Options forfeited (in shares)	(35,000)
Outstanding, end balance (in shares)	6,012,000	6,707,000
Exercisable (in shares)	4,785,000
Vested and expected to vest (in shares)	5,936,000
Weighted-Average Exercise Price
Outstanding, beginning balance (in dollars per share)	$ 11.19
Granted (in dollars per share)	104.02
Exercised (in dollars per share)	10.26
Forfeited (in dollars per share)	13.78
Outstanding, end balance (in dollars per share)	17.37	$ 11.19
Exercisable (in dollars per share)	9.99
Vested and expected to vest (in dollars per share)	$ 17
Additional disclosures
Weighted average contractual term, options outstanding	5 years 7 months 17 days	6 years 14 days
Exercisable (in years)	4 years 11 months 23 days
Vested and expected to vest (in years)	5 years 7 months 6 days
Aggregate intrinsic value, options outstanding	$ 566,871	$ 592,468
Aggregate intrinsic value, options exercisable	485,498
Aggregate intrinsic value, vested and expected to vest	$ 561,788
Non-employee stock options
Stock Based Compensation
Options granted (in shares)	(32,053)
Number of shares
Options granted (in shares)	32,053
Additional disclosures
Options unvested (in shares)	1,459
Restricted stock units
Stock Based Compensation
RSUs granted (in shares)	(1,528,000)
RSUs forfeited/cancelled (in shares)	227,000

Stock-Based Compensation - Rest

Stock-Based Compensation - Restricted Stock Units (Details) - Restricted stock units shares in Thousands	9 Months Ended
	Sep. 30, 2021$ / sharesshares
Shares
Balance (in shares) \| shares	4,188
Granted (in shares) \| shares	1,528
Vested (in shares) \| shares	(1,707)
Canceled/Forfeited (in shares) \| shares	(227)
Balance (in shares) \| shares	3,782
Weighted Average Grant Date Fair Value
Balance (in dollars per share) \| $ / shares	$ 34.02
Granted (in dollars per share) \| $ / shares	104.48
Vested (in dollars per share) \| $ / shares	25.83
Canceled/Forfeited (in dollars per share) \| $ / shares	49.39
Balance (in dollars per share) \| $ / shares	$ 64.78

Stock-Based Compensation - Comp

Stock-Based Compensation - Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Employee and non-employee stock options
Stock based compensation expense
Options granted (in shares)			391,000
Stock-based compensation expense	$ 26,459	$ 15,032	$ 84,797	$ 34,406
Unrecognized compensation expense	195,300		$ 195,300
Unrecognized compensation expense, weighted average period of recognition			2 years 9 months 18 days
Employee and non-employee stock options \| Cost of revenues
Stock based compensation expense
Stock-based compensation expense	1,262	458	$ 3,246	1,213
Employee and non-employee stock options \| Research and development
Stock based compensation expense
Stock-based compensation expense	6,652	3,098	17,142	7,853
Employee and non-employee stock options \| Selling, general and administrative
Stock based compensation expense
Stock-based compensation expense	18,544	11,476	64,409	25,340
Employee stock options
Stock based compensation expense
Stock-based compensation expense	25,982	14,943	83,645	33,790
Employee stock options \| Cost of revenues
Stock based compensation expense
Stock-based compensation expense	1,262	458	3,246	1,213
Employee stock options \| Research and development
Stock based compensation expense
Stock-based compensation expense	6,242	3,081	16,168	7,394
Employee stock options \| Selling, general and administrative
Stock based compensation expense
Stock-based compensation expense	$ 18,478	11,404	$ 64,231	25,183
Non-employee stock options
Stock based compensation expense
Options granted (in shares)			32,053
Options unvested (in shares)	1,459		1,459
Stock-based compensation expense	$ 477	89	$ 1,152	616
Non-employee stock options \| Research and development
Stock based compensation expense
Stock-based compensation expense	410	17	974	459
Non-employee stock options \| Selling, general and administrative
Stock based compensation expense
Stock-based compensation expense	$ 67	$ 72	$ 178	$ 157

Debt (Details)

Debt (Details) $ / shares in Units, shares in Thousands	Mar. 31, 2021USD ($)$ / shares	Apr. 30, 2020USD ($)D	Sep. 30, 2021USD ($)$ / sharesshares	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)$ / sharesshares	Sep. 30, 2020USD ($)	Dec. 31, 2020USD ($)$ / sharesshares	Sep. 30, 2015USD ($)
Debt Instrument [Line Items]
Proceeds from Convertible Note, net of issuance costs						$ 278,316,000
Common Stock, Par or Stated Value Per Share \| $ / shares			$ 0.0001		$ 0.0001		$ 0.0001
Common stock, shares issued \| shares			94,538		94,538		86,223
Accrued Interest			$ 2,695,000		$ 2,695,000		$ 1,078,000
Amortization of debt discount and issuance cost					917,000	149,000
Interest expense			2,078,000	$ 4,270,000	6,226,000	10,772,000
Convertible Notes
Debt Instrument [Line Items]
Aggregate principal amount		$ 287,500,000	287,500,000		$ 287,500,000
Proceeds from Convertible Note, net of issuance costs		$ 278,300,000
Per annum interest rate (as a percent)		2.25%			2.25%
Interest expense			$ 1,925,000		$ 5,769,000
Common Stock, Par or Stated Value Per Share \| $ / shares	$ 0.0001
Debt instrument, term					7 years
Effective interest rate (as a percent)			2.72%		2.72%
Principal amount per convertible note		$ 1,000
Number of threshold consecutive trading days \| D		30
Threshold business days \| D		5
Conversion price (in dollars per share) \| $ / shares	$ 38.79
Initial conversion rate	25.7785
Convertible to shares of common stock	7,411,704
Percentage of principal amount converted	100.00%
Carrying value			$ 280,085,000		$ 280,085,000
Convertible Notes \| Accounting Standards Update 2020-06
Debt Instrument [Line Items]
Carrying value							$ 279,167,000
5 consecutive trading day period \| Convertible Notes
Debt Instrument [Line Items]
Threshold trading days \| D		5
Percentage of conversion price		98.00%
20 trading days period \| Convertible Notes
Debt Instrument [Line Items]
Threshold trading days \| D		20
Percentage of conversion price		130.00%
Redeemable for cash on or after May 2024
Debt Instrument [Line Items]
Number of threshold consecutive trading days \| D		20
Threshold trading days \| D		30
Percentage of conversion price		130.00%
Percentage of principal amount converted		100.00%
Level 2
Debt Instrument [Line Items]
Fair value of liability			863,300,000		863,300,000
Line Of Credit-UBS
Debt Instrument [Line Items]
Maximum borrowing capacity								$ 50,000,000
Outstanding balance			$ 50,000,000		50,000,000
Interest expense				$ 200,000	$ 500,000	$ 700,000
Line Of Credit-UBS \| LIBOR
Debt Instrument [Line Items]
Spread on interest rate (as a percent)					1.10%
2017 Term Loan
Debt Instrument [Line Items]
Debt, repayment amount		$ 79,200,000

Debt - Discount and Issuance Co

Debt - Discount and Issuance Costs (Details) - Convertible Notes	9 Months Ended
	Sep. 30, 2021
Effective interest rate (as a percent)	2.72%
Debt instrument, term	7 years

Debt - Convertible Notes Balanc

Debt - Convertible Notes Balances (Details) - Convertible Notes - USD ($) $ in Thousands	Sep. 30, 2021	Mar. 31, 2021
Debt principal balance	$ 287,500	$ 287,500
Unamortized debt discount and debt issuance cost	(7,415)
Net carrying amount	$ 280,085

Debt - Interest Expense Recogni

Debt - Interest Expense Recognized Related To Convertible Notes (Details) - Convertible Notes - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021
Cash interest expense
Contractual interest expense	$ 1,617	$ 4,852
Non-cash interest expense
Amortization of debt discount and debt issuance cost	308	917
Total interest expense	$ 1,925	$ 5,769

Income taxes (Details)

Income taxes (Details) - USD ($)	3 Months Ended		9 Months Ended
Income taxes (Details) - USD ($)	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Income Taxes
Income tax expense	$ 272,000	$ 25,000	$ 648,000	$ 63,000
State income tax expense		$ 0		$ 0
Unrecognized tax benefits	13,600,000		13,600,000		$ 11,500,000
Interest and penalties accrued	0		0
Deferred tax assets acquired	5,800,000		5,800,000
NOL carryforwards subject to expiration	$ 12,100,000		$ 12,100,000

Net Loss per Share - Loss per S

Net Loss per Share - Loss per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Numerator:
Net loss used to compute net loss per share, basic and diluted	$ (151,273)	$ (58,323)	$ (331,152)	$ (153,331)
Denominator:
Weighted-average number of shares used in computing net loss per share, basic and diluted	92,558	80,908	89,130	79,430
Net loss per share, basic and diluted (in dollars per share)	$ (1.63)	$ (0.72)	$ (3.72)	$ (1.93)
Potentially dilutive shares not included in diluted per share calculation			17,548	18,699
Convertible Notes
Denominator:
Convertible, If-converted value in excess of principal			$ 564,600
Potentially dilutive shares not included in diluted per share calculation			7,411	7,411

Net Loss per Share - Potentiall

Net Loss per Share - Potentially Dilutive Shares (Details) - shares shares in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	17,548	18,699
Employee and non-employee stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	6,012	7,265
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	3,782	3,901
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	73	122
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
Estimated earnout shares for an asset acquisition
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potentially dilutive shares not included in diluted per share calculation	270