0001564590-21-013512 | 10-K | XBRL Viewer

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Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2020	Mar. 12, 2021
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	FY
Entity Central Index Key	0001439725
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-39659
Entity Registrant Name	Biodesix, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-3986492
Entity Address, Address Line One	2970 Wilderness Place
Entity Address, Address Line Two	Suite 100
Entity Address, City or Town	Boulder
Entity Address, State or Province	CO
Entity Address, Postal Zip Code	80301
City Area Code	303
Local Phone Number	417-0500
Title of 12(b) Security	Common Stock, par value $0.001 per share
ICFR Auditor Attestation Flag	false
Trading Symbol	BDSX
Security Exchange Name	NASDAQ
Entity Well Known Seasoned Issuer	No
Entity Voluntary Filers	Yes
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		26,577,782
Entity Public Float	$ 344,635,079
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Portions of the Company’s definitive Proxy Statement for its 2021 Annual Meeting of Shareholders are to be incorporated by reference into Part III, as specifically set forth in Part III.)

Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 62,126	$ 5,286
Accounts receivable, net	15,304	5,292
Other current assets	8,710	2,122
Total current assets	86,140	12,700
Non‑current assets
Property and equipment, net	3,178	2,120
Intangible assets, net	13,260	15,092
Other long-term assets	3,461	90
Goodwill	15,031	15,031
Total non‑current assets	34,930	32,333
Total assets	121,070	45,033
Current liabilities
Accounts payable	8,964	1,717
Accrued liabilities	7,789	4,180
Deferred revenue	3,532	1,283
Current portion of notes payable	11,840	12,159
Put option liability	3,400	3,261
Total current liabilities	32,125	22,600
Non‑current liabilities
Warrant liability		329
Long‑term notes payable	15,926	23,812
Contingent consideration	29,932	29,114
Other long-term liabilities	1,921	358
Total non‑current liabilities	47,779	53,613
Total liabilities	79,904	76,213
Commitments and contingencies
Convertible preferred stock
Convertible preferred stock, $0.001 par value, 0 (2020) and 174,237,067 (2019) authorized; 0 (2020) and 118,766,273 (2019) issued and outstanding; liquidation preference of $202,582 (2019)		193,959
Stockholders' equity (deficit)
Preferred stock, $0.001 par value, 5,000,000 (2020) and 0 (2019) authorized; 0 (2020 and 2019) issued and outstanding
Common stock, $0.001 par value, 200,000,000 (2020) and 190,000,000 (2019) authorized; 26,561,504 (2020) and 254,918 (2019) issued and outstanding	27	1
Additional paid‑in capital	299,953	2,324
Accumulated deficit	(258,814)	(227,464)
Total stockholders' equity (deficit)	41,166	(225,139)
Total liabilities, convertible preferred stock and stockholders' equity (deficit)	$ 121,070	$ 45,033

Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Statement Of Financial Position [Abstract]
Convertible preferred stock, par value	$ 0.001	$ 0.001
Convertible preferred stock, authorized	0	174,237,067
Convertible preferred stock, issued	0	118,766,273
Convertible preferred stock, outstanding	0	118,766,273
Convertible preferred stock, liquidation preference		$ 202,582
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, authorized	5,000,000	0
Preferred stock, issued	0	0
Preferred stock, outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, authorized	200,000,000	190,000,000
Common stock, issued	26,561,504	254,918
Common stock, outstanding	26,561,504	254,918

Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Income Statement [Abstract]
Revenues	$ 45,557	$ 24,552
Operating expenses:
Direct costs and expenses	21,998	6,074
Research and development	10,818	10,468
Sales, marketing, general and administrative	34,857	30,637
Change in fair value of contingent consideration	818	4,114
Total operating expenses	68,491	51,293
Loss from operations	(22,934)	(26,741)
Other income (expense):
Interest income	18	55
Interest expense	(7,604)	(3,008)
Change in fair value of warrant liability	(1,252)	(104)
Change in fair value of put option liability		(2,000)
Other income, net	422	1,072
Total other expense	(8,416)	(3,985)
Net loss	$ (31,350)	$ (30,726)
Net loss per share, basic and diluted	$ (6.48)	$ (126.97)
Weighted-average shares outstanding, basic and diluted	4,838	242

Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands	Total	Convertible Preferred Stock	Common Stock	Additional Paid-in Capital	Accumulated Deficit
Balance at Dec. 31, 2018	$ (194,630)	$ 183,962	$ 1	$ 2,107	$ (196,738)
Temporary Equity Balance, Shares at Dec. 31, 2018		110,071	215
Common stock issued upon exercise of stock options	47			47
Common stock issued upon exercise of stock options, shares			40
Issuance of Series H Preferred Stock		$ 9,997
Issuance of Series H Preferred Stock, shares		8,695
Stock‑based compensation expense	170			170
Net loss and comprehensive loss	(30,726)				(30,726)
Balance at Dec. 31, 2019	$ (225,139)	$ 193,959	$ 1	2,324	(227,464)
Temporary Equity Balance, Shares at Dec. 31, 2019	118,766,273	118,766	255
Common stock issued upon exercise of stock options	$ 1,340			1,340
Common stock issued upon exercise of stock options, shares	368,000		368
Stock‑based compensation expense	$ 3,709			3,709
Issuance of common stock in initial public offering, net of discounts and commission of $5,040 and direct offering costs of $3,203	63,757		$ 4	63,753
Issuance of common stock in initial public offering, net of discounts and commission and direct offering costs, shares			4,000
Conversion of preferred stock into common stock upon initial public offering	193,959	$ (193,959)	$ 20	193,939
Conversion of preferred stock into common stock, shares		(118,766)	20,091
Conversion of convertible debt into common stock upon initial public offering	26,616		$ 2	26,614
Conversion of convertible debt into common stock, shares			1,848
Reclassification of preferred stock warrant liability and put option into additional paid-in capital upon initial public offering	8,274			8,274
Net loss and comprehensive loss	(31,350)				(31,350)
Balance at Dec. 31, 2020	$ 41,166		$ 27	$ 299,953	$ (258,814)
Temporary Equity Balance, Shares at Dec. 31, 2020	0		26,562

Statements of Convertible Preferred Stock and Stockholders' Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands	1 Months Ended		12 Months Ended
	Mar. 31, 2019	Feb. 28, 2019	Dec. 31, 2019	Dec. 31, 2020
Discounts and commission				$ 5,040
Direct offering costs				$ 3,203
Series H Convertible Preferred Stock
Sale of stock, temporary equity, price per share	$ 1.15	$ 1.15
Issuance costs			$ 3

Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
Statements of Cash Flows - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities
Net loss	$ (31,350)	$ (30,726)
Adjustments to reconcile net loss to net cash, cash equivalents, and restricted cash used in operating activities
Depreciation and amortization	2,903	2,793
Amortization of convertible notes debt discount	4,389	262
Stock‑based compensation expense	3,709	170
Change in fair value of warrant liability	1,252	104
Change in contingent consideration	818	4,114
Change in fair value of put option		2,000
Accrued interest on notes payable and convertible notes payable	1,226	799
Amortization of debt issuance costs	144	144
Provision for doubtful accounts	296	246
Loss on disposals of assets	48	13
Changes in operating assets and liabilities, net of assets acquired and liabilities assumed in acquisitions:
Accounts receivable	(10,308)	(3,646)
Other current assets	(6,588)	1
Other long-term assets and liabilities	(1,808)	16
Accounts payable and other accrued liabilities	11,654	1,193
Deferred revenue	2,249	791
Net cash and cash equivalents and restricted cash used in operating activities	(21,366)	(21,726)
Cash flows from investing activities
Purchase of property and equipment	(1,945)	(1,310)
Patent costs and intangible asset acquisition, net	(232)	(106)
Payments to acquire Oncimmune assets	(750)	(456)
Net cash and cash equivalents and restricted cash used in investing activities	(2,927)	(1,872)
Cash flows from financing activities
Proceeds from initial public offering	72,000
Proceeds from exercise of common stock options	1,340	47
Proceeds from issuance of series H preferred stock		10,000
Proceeds from issuances of convertible notes payable	12,955	13,044
Proceeds from paycheck protection program note payable	3,085
Equity financing costs	(8,243)	(3)
Other	(6)	(116)
Net cash and cash equivalents and restricted cash provided by financing activities	81,131	22,972
Net increase (decrease) in cash and cash equivalents and restricted cash	56,838	(626)
Cash, cash equivalents, and restricted cash ‑ beginning of period	5,468	6,094
Cash, cash equivalents, and restricted cash ‑ end of period	62,306	5,468
Supplemental cash flow information
Conversion of preferred stock into common stock	193,959
Conversion of convertible notes and accrued interest into common stock	26,616
Reclassification of put option liability to additional paid-in capital	6,650
Value of put option recorded at issuance of convertible debt payable	3,389	1,261
Cash paid for interest	1,844	1,800
Reclassification of warrant liability to additional paid-in capital	$ 1,624
Accrued business combination payments		$ 750

Organization and Description of Business

12 Months Ended

Dec. 31, 2020

Organization And Description Of Business [Abstract]

Organization and Description of Business

Note 1 – Organization and Description of Business

Biodesix, Inc. (the “Company”, “Biodesix”, “we” and “our”), formerly Elston Technologies, Inc., was incorporated in Delaware in 2005. The Company’s headquarters are in Colorado, with laboratories in Colorado and Kansas. The Company conducts all of its operations within a single legal entity. Biodesix is a data-driven diagnostic solutions company leveraging state of the art technologies with its proprietary artificial intelligence platform to discover, develop, and commercialize solutions for clinical unmet needs, with a primary focus in lung disease. In addition to diagnostic tests, the Company provides biopharmaceutical companies with services that include diagnostic research, clinical trial testing, and the discovery, development, and commercialization of companion diagnostics.

The Company performs its blood-based diagnostic tests for lung cancer in its laboratory facilities, which are located in Boulder, Colorado and De Soto, Kansas. In May 2020, the Federal Drug Administration (FDA) authorized performance of Bio-Rad SARS-CoV-2 Droplet Digital™ polymerase chain reaction (ddPCR) test to detect Coronavirus Disease 2019 (COVID-19) infection. In April 2020, the FDA authorized our Platelia SARS-CoV-2 Total Ab test to detect COVID-19 antibodies. Medical products that are granted an Emergency Use Authorization (EUA) are only permitted to commercialize their products under the terms and conditions provided in the authorization. The FDA may revoke an EUA where it is determined that the underlying health emergency no longer exists or warrants such authorization, if the conditions for the issuance of the EUA are no longer met, or if other circumstances make revocation appropriate to protect the public health or safety.

Blood-Based Lung Tests

The Company offers four blood-based lung cancer tests across the lung cancer continuum of care:

•

Nodify XL2® and Nodify CDT™ tests, marketed as part of our Nodify Lung™ Nodule Risk Assessment testing strategy, assess the risk of lung cancer to help identify the most appropriate treatment pathway. We believe we are the only company to offer two commercial blood-based tests to help physicians reclassify risk of malignancy in patients with suspicious lung nodules.

•

GeneStrat® and VeriStrat® tests, marketed as part of our Biodesix Lung Reflex® testing strategy, are used following diagnosis of lung cancer to measure the presence of mutations in the tumor and the state of the patient’s immune system to establish the patient’s prognosis and help guide treatment decisions. The GeneStrat tumor profiling test and the VeriStrat immune profiling test have a three-day average turnaround time, providing physicians with timely results to facilitate treatment decisions.

COVID-19 Tests

Using the Bio-Rad SARS-CoV-2 ddPCR test and the Platelia SARS-CoV-2 Total Ab tests, we operate and have commercialized the Biodesix WorkSafe testing program. The Company offers two SARS-CoV-2 tests:

•

Bio-Rad SARS-CoV-2 ddPCR test, which is authorized by the FDA to be performed by Clinical Laboratory Institute Amendments (CLIA) authorized laboratories that perform high complexity tests. The ddPCR test is designed to detect the presence of infection by the SARS-CoV-2 virus.

•

Platelia SARS-CoV-2 Total Ab test, which is an antibody test, authorized by the FDA, intended for detecting a B-cell immune response to SARS-CoV-2, indicating recent or prior infection.

These tests are utilized by healthcare providers, including hospitals and nursing homes, and are also offered to businesses and educational systems to assist in their back-to-work or back-to-school strategies, a crucial element of restarting economic activity.

In developing the Company's products, the Company has built or gained access to unique biorepositories, proprietary technology, and bioinformatics that it believes are important to the development of new targeted therapies, determining clinical trial eligibility and guiding treatment selection.

All of the Company’s testing services are made available through its clinical laboratories.

Reverse Stock Split

On October 19, 2020, the Company obtained approval of an amended and restated certificate of incorporation effecting a 0.1684664-for-1 reverse stock split of its issued and outstanding common stock as converted. All common shares, stock options, and per share information presented in these financial statements and notes thereto have been adjusted, where applicable, to reflect the reverse stock split on a retroactive basis for all periods presented.

Approval of Amended and Restated Certificate of Incorporation

In October 2020, the Company’s Board of Directors and stockholders approved an amended and restated certificate of incorporation, which authorized 200,000,000 shares of common stock, par value $0.001 per share, and 5,000,000 shares of preferred stock, par value $0.001 per share. The amended and restated certificate of incorporation became effective on October 30, 2020.

Initial Public Offering

On October 27, 2020, the Company completed its initial public offering, in which it issued and sold 4,000,000 shares of its common stock at a public offering price of $18.00 per share. The Company received net proceeds of $63.8 million after deducting underwriting discounts and commissions and offering expenses payable by the Company. In addition, in connection with the initial public offering, all shares of the Company’s then-outstanding convertible preferred stock and convertible notes payable were automatically converted into 21,939,025 shares of common stock, and all then outstanding warrants to purchase the Company’s Series G convertible preferred stock were automatically converted into warrants to purchase 103,326 shares of the Company’s common stock.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2020

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Note 2 – Summary of Significant Accounting Policies

Basis of Presentation

The Company’s financial statements have been prepared in accordance with accounting principles generally accepted in the United States (U.S. GAAP). The 2019 balance sheet has been updated to reflect an increase in goodwill and a reduction in accumulated deficit of $3.4 million related to the correction of an immaterial error recorded as part of the acquisition of Integrated Diagnostics, Inc. in 2018. The Company determined that the reduction in the preexisting valuation allowance resulting from the acquisition should have been reflected as an income benefit within the tax provision rather than as a reduction in goodwill. The correction of the immaterial error had no impact on our 2020 or 2019 results of operations.

Certain prior period amounts have been reclassified to conform to the current period presentation.

Segment Reporting

The chief operating decision maker for the Company is the Chief Executive Officer, who reviews financial information for purposes of allocating resources and assessing financial performance. The Company has a single operating segment focused on providing diagnostic testing services to customers. Substantially all of the Company’s revenue and all long-lived assets were derived or located in the United States for the years ended December 31, 2020 and 2019.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Significant items subject to such estimates include: revenue recognition; the useful lives of property and equipment; the recoverability of long-lived assets; the estimation of the fair value of intangible assets; the valuation of contingent consideration related to a business combination; stock options; income tax uncertainties, including a valuation allowance for deferred tax assets; and contingencies. The Company bases these estimates on historical and anticipated results, trends, and various other assumptions that the Company believes are reasonable under the circumstances, including assumptions as to future events. These estimates form the basis for making judgments about the carrying values of assets and liabilities and recognized revenue and expenses that are not readily apparent from other sources. Actual results could differ from those estimates and assumptions.

Revenue Recognition

The Company generates revenues from (i) diagnostic tests and (ii) assay development and testing services (services revenue).

Diagnostic test revenues consist of blood-based lung tests and COVID-19 tests, which are recognized in the amount expected to be received in exchange for diagnostic tests when the diagnostic tests are delivered. The Company determines the transaction price related to its blood-based lung diagnostic test contracts using a portfolio approach by considering the nature of the payer and historical price concessions granted to groups of customers. The transaction price associated with COVID-19 testing arrangements are determined on the basis of the individual contract with each customer.

Services revenue consists of various types of tests or other scientific services for a purpose as defined by any individual customer, which are often larger biopharmaceutical companies, as defined by a written agreement between the Company and the customer. These services are generally completed upon the delivery of testing results, or achievement of contractual milestone(s) as defined in the customer agreements. Revenue for these services is recognized upon delivery of the completed test results, or upon completion of the contractual milestone(s).

The Company recognizes revenues related to blood-based lung diagnostic billings based on estimates of the amounts ultimately expected to be collected from customers on a portfolio approach as discussed above. In determining the amount to accrue for a delivered test, the Company considers factors such as payment history, payer coverage, whether there is a reimbursement contract between the payer and the Company, payment as a percentage of agreed upon rate (if applicable), amount paid per test and any current developments or changes that could impact reimbursement. Variable consideration, if any, is estimated based on an analysis of historical experience and adjusted as better estimates become available. These estimates require significant judgment by management.

The Company also provides services to patients with whom the Company does not have contracts as defined in Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC 606). The Company recognizes revenue for these patients when contracts as defined in ASC 606 are established at the amount of consideration to which it expects to be entitled, or when the Company receives substantially all of the consideration subsequent to satisfaction and delivery of the performance obligations.

See Note 13 — Revenue for additional information.

Deferred Revenue

Deferred revenue consists of payments received for research, development, and testing services fees received prior to the completion of performance of these tests and services. As of December 31, 2020, deferred revenue also includes $2.8 million in a Medicare advance payment on testing services which can either be paid back or earned back starting 1 year from receipt.

Direct Costs and Expenses

The components of our cost of diagnostic tests and testing services consist of cost of materials, direct labor, including bonus, benefit and stock-based compensation, depreciation of laboratory equipment, rent costs, amortization of leasehold improvements and information technology costs associated with acquiring and processing test samples, including sample accessioning, test performance, quality control analyses, charges to collect and transport samples; curation of test results for physicians; and in some cases, license or royalty fees due to third parties.

Royalties for licensed technology are calculated as a percentage of revenues generated using the associated technology and recorded as expense at the time the related revenue is recognized. One-time royalty payments related to signing of license agreements or other milestones, such as issuance of new patents, are amortized to expense over the expected useful life of the patents. Costs associated with performing tests are expensed as the test is processed regardless of whether and when revenue is recognized with respect to that test.

Research and Development Expenses

Research and development expenses include external and internal costs incurred to develop our technology, collect clinical samples, and conduct clinical studies to develop and support our products. External costs consist primarily of payments to clinical trial sites, sample acquisition costs and laboratory supplies purchased in connection with the Company’s discovery and preclinical activities, process development and clinical development activities. Internal costs consist primarily of salaries and benefits, reagents and supplies used in research and development laboratory work, infrastructure expenses, including allocated facility occupancy and information technology costs.

The Company estimates and accrues its expenses resulting from its obligations under contracts with vendors and consultants in connection with conducting research and development activities. The financial terms of these contracts vary from contract to contract and may result in payments that do not match the periods over which materials or services are provided under such contracts. The Company’s estimates depend on the timeliness and accuracy of the data provided by consultants and vendors regarding the status of each activity. The Company periodically evaluates the estimates to determine if adjustments are necessary or appropriate based on information received. Research and development costs are expensed as incurred.

Sales, Marketing, General and Administrative Expenses

Selling expenses consist primarily of costs associated with our sales organization, including our direct sales force and sales management, client services, marketing, and reimbursement, as well as business development personnel who are focused on our biopharmaceutical customers. These expenses consist primarily of salaries, commissions, bonuses, employee benefits, travel, and stock-based compensation, as well as marketing and educational activities and allocated overhead expenses.

Sales, marketing, general and administrative expenses also include costs for our marketing and sales organizations, and other functions including finance, legal, human resources, and information technology.

These expenses consist principally of salaries, bonuses, employee benefits, travel, and stock-based compensation, as well as professional services fees such as consulting, audit, tax and legal fees, and general corporate costs and allocated overhead expenses.

Concentrations of Credit Risk and Other Uncertainties

Substantially all of the Company’s cash and cash equivalents are deposited with one major financial institution in the United States. The Company continually monitors its positions with, and the credit quality of, the financial institution with which it holds cash. Periodically throughout the year, the Company has maintained balances in various operating accounts in excess of federally insured limits. The Company has not experienced any losses on its deposits of cash and cash equivalents.

Several of the components of the Company's sample collection kit and test reagents, and certain test systems and related test kits are obtained from single-source suppliers. If these single-source suppliers fail to satisfy the Company's requirements on a timely basis, it could suffer delays in being able to deliver its diagnostic solutions, a possible loss of revenue, or incur higher costs, any of which could adversely affect its operating results.

The Company’s customers in excess of 10% of total revenue, and their related revenue as a percentage of total revenue were as follows:

	Year Ended
	December 31, 2020
The Big Ten Conference		30	%
Centura Healthcare		17	%
Percent of total revenue		47	%

One customer, Covance, exceeded 10% of total revenue during 2019, representing 21% of total revenue. In addition to the above table, we collect reimbursement on behalf of customers covered by Medicare, which accounted for 17% and 36% of the Company’s total revenue for the years ended December 31, 2020 and 2019, respectively. The Company is subject to credit risk from its accounts receivable related to services provided to its customers. The Company does not perform evaluations of customers' financial condition and does not require collateral. The Company’s third-party payors and other customers in excess of 10% of accounts receivable, and their related accounts receivable as a percentage of total accounts receivable were as follows:

	As of December 31,
	2020			2019
The Big Ten Conference		35	%		—	%
Centura Healthcare		24	%		—	%
Medicare		6	%		18	%
Covance Central Laboratory Services		2	%		43	%
Janssen Research and Development, LLC		5	%		12	%
Pfizer, Inc		4	%		10	%
Percent of total accounts receivable		76	%		83	%

Cash and Cash Equivalents

Cash equivalents consist of short-term, highly-liquid instruments with an original maturity of three months or less from the date of purchase.

Restricted Cash

Restricted cash consists of deposits related to the Company’s corporate credit card and a letter of credit related to an operating lease agreement. As of December 31, 2020 and 2019, the Company had $0.2 million restricted cash, respectively, which was included in ‘Other current assets’ in the accompanying balance sheets.

Accounts Receivable and Allowance for Doubtful Accounts

Accounts receivable are stated at the amount management expects to collect from customers based on their outstanding invoices. Management reviews accounts receivable quarterly to determine if any receivable will potentially be uncollectible and to estimate the amount of allowance for doubtful accounts necessary to reduce accounts receivable to its estimated net realizable value based on historical experience, customer creditworthiness, facts, and circumstances specific to outstanding balances, and payment terms. The Company’s allowance for doubtful accounts was $0.2 million as of December 31, 2020 and 2019.

Inventory

Inventory consists primarily of material supplies, which are consumed in the performance of testing services and charged to cost of sales. Inventory is stated at cost and reported within ‘Other current assets’ in the balance sheet and were $3.2 million and $0.8 million as of December 31, 2020 and 2019, respectively.

Property and Equipment

Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, generally between three and five years. Leasehold improvements are amortized using the straight-line method over the shorter of the estimated useful life of the asset or the term of the lease. Maintenance and repairs are charged to expense as incurred, and improvements and betterments are capitalized. When assets are retired or otherwise disposed of, the cost and accumulated depreciation are removed from the balance sheet and any resulting gain or loss is reflected in the statements of operations and comprehensive loss in the period realized.

Long-lived assets to be held and used are evaluated for impairment when events or circumstances indicate the carrying value of a long-lived asset or asset group is less than the undiscounted cash flows from the use and eventual disposition over its remaining useful life. The Company assesses recoverability by comparing the sum or projected undiscounted cash flows from the use and eventual disposition of the asset or asset group to it carrying value, and records an impairment loss if the carrying value is greater than the undiscounted future cash flows. There were no impairments for the years ended December 31, 2020 or 2019.

Intangible Assets

Intangible assets primarily consist of intangible assets acquired as part of business combinations, external costs associated with patent applications that are expected to be successful, and trademark costs. Finite-lived intangibles are stated at cost, net of accumulated amortization. The Company amortizes finite-lived intangible assets using the straight-line method over their estimated useful lives of 9 to 10 years, based on management's estimate of the period over which their economic benefits will be realized, product life and patent life. Trademarks are considered indefinite lived and are not amortized.

Intangible assets are reviewed for impairment whenever events or changes in circumstances indicate a reduction to fair value below their carrying amounts. There were no impairments for the years ended December 31, 2020 or 2019.

Goodwill

Goodwill represents the excess of purchase price over amounts allocated to acquired assets and liabilities assumed in business combinations. The carrying value of goodwill is evaluated for impairment at least annually or more frequently when events or circumstances occur indicate a potential for impairment. The annual impairment test is performed on the last day of our fourth quarter. Prior to performing a quantitative evaluation, an assessment of qualitative factors may be performed to determine whether it is more likely than not that the fair value of the reporting unit exceeds its carrying value. In the event the Company determines that it is more likely than not the carrying value of our single reporting unit is higher than its estimated fair value, quantitative testing is performed comparing recorded values to estimated fair values. If impairment is present, the impairment loss is measured as the excess of the recorded goodwill over its implied fair value. There were no impairments for the years ended December 31, 2020 or 2019.

Fair Value of Financial Instruments

U.S. GAAP for fair value establishes a hierarchy that prioritizes fair value measurements based on the types of inputs used for the various valuation techniques (market approach, income approach, and cost approach). We utilize a combination of market and income approaches to value our financial instruments. Our financial assets and liabilities are measured using inputs from the three levels of the fair value hierarchy. Fair value measurements are categorized within the fair value hierarchy based upon the lowest level of the most significant inputs used to determine fair value. The three levels of the hierarchy and the related inputs are as follows:

Level		Inputs
1		Unadjusted quoted prices in active markets for identical assets and liabilities.
2		Unadjusted quoted prices in active markets for similar assets and liabilities;
		Unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active; or
		Inputs other than quoted prices that are observable for the asset or liability.
3		Unobservable inputs for the asset or liability.

The carrying amounts of certain financial instruments including cash and cash equivalents, accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities approximate fair value due to their relatively short maturities.

See Note 5 — Fair Value for further discussion related to estimated fair value measurements.

Contingent Consideration

In connection with the purchase transaction with Integrated Diagnostics, Inc. (Indi), the Company recorded contingent consideration for amounts potentially payable to Indi’s shareholder pursuant to the terms of the asset purchase agreement. The fair value of contingent consideration is assessed at each balance sheet date and changes, if any, to the fair value are recognized as operating expenses within the statements of operations. The estimated fair value of the contingent consideration is based upon significant assumptions including the probability of successful achievement of product gross margin targets included in the acquisition agreement, the estimated timing of achievement of the product gross margin targets, and discount rates. The estimated fair value could materially differ from actual values or fair values determined using different assumptions.

Warrant Liability

Prior to the completion of the Company’s initial public offering in October 2020, certain warrants issued to purchase convertible preferred stock were classified as liabilities with changes in the estimated fair value of these liabilities recognized in our results of operations. Upon completion of the Company’s initial public offering in October 2020, the warrants were automatically converted to warrants to purchase common stock. Accordingly, the warrants were remeasured to an estimate of fair value and recognized in our results of operations and then reclassified to additional paid-in capital.

Put Option Liability

During 2020 and 2019, the Company issued convertible debt with terms that provided for a conversion rate to the convertible debtholders that was more favorable than the price that other investors would pay for common stock in certain situations, including the completion of an initial public offering. As a result, the convertible debt is a financial instrument that was bifurcated into two instruments, a debt obligation and a put option liability, which represented the estimated fair value of the favorable conversion rate. The estimated fair value of the put option liability was separated from the convertible debt at inception and reported as a liability and debt discount, and amortized to interest expense. As a result of our initial public offering, the convertible debt was automatically converted to common stock and the put option liability was remeasured to an estimate of fair value and recognized in our results of operations and then reclassified to additional paid-in capital.

Share‑Based Compensation

Stock Options

The Company grants service condition and performance condition stock options. Stock options are granted with exercise prices equal to the fair market value of our common stock on the date of grant. The grant date fair value of each employee stock option is estimated on the date of grant using the Black-Scholes option-pricing model, which requires the use of assumptions, including the expected term of the option, expected volatility of our stock price, expected dividend yield, and the risk-free interest rate, among others. These assumptions involve inherent uncertainties including market conditions and employee behavior that are generally outside of the Company’s control. Service condition stock options are expensed based on the grant date fair value of the awards using the straight-line method over the requisite service period, adjusted for forfeitures as they occur. Performance-condition stock options vest based on achievement of multiple weighted performance goals, certification of performance achievement by the Compensation Committee of the Board of Directors, and continued service. For performance-condition stock options, compensation expense is updated for our expected performance level against performance goals at the end of each reporting period, which involves judgment as to achievement of certain performance metrics.

Prior to our initial public offering in October 2020, the fair value of our common stock was determined by the Board of Directors in accordance with the methodologies outlined in the American Institute of Certified Public Accountants Practice Aid, Valuation of Privately-Held-Company Equity Securities Issued as Compensation Practice Aid (Practice Aid). In doing so, the Board of Directors determined the best estimate of fair value of our common stock, exercising reasonable judgment and considering numerous objective and subjective factors, by first determining the enterprise value of our business, and then allocating the value among the various classes of our equity securities to derive a per share value of our common stock. Subsequent to the Company’s initial public offering, the fair value of the Company’s common stock is determined based on its traded market price.

Restricted Stock Units (RSUs)

The Company grants service-condition RSUs. As a result of our initial public offering, the grant date fair values of these RSUs are based on the closing market price of our common stock on the grant date. The service-condition RSUs vest based on continued service with compensation expense, net of forfeitures, recognized on a straight-line basis over the requisite service period.

See Note 14 — Share-Based Compensation for additional information related to share-based compensation.

Net Loss per Common Share

Basic net loss per common share is calculated by dividing net loss by the weighted-average number of common shares outstanding during the period, without consideration of common stock equivalents. Diluted net loss per common share is computed by dividing net loss by the weighted-average number of common share equivalents outstanding for the period, if dilutive, using the treasury stock method. Potentially dilutive securities consisting of options to purchase common stock, warrants to purchase common stock, restricted stock units and shares subject to purchase under our employee stock purchase plan were excluded from the calculation of diluted net loss per common share because their effect would be anti-dilutive for all periods presented.

Until the Company’s initial public offering in October 2020, basic and diluted net loss attributable to common stockholders per share was calculated using the two-class method. The net loss was attributable entirely to common stockholders because the participating securities did not have a contractual obligation to share in the Company’s losses. As the Company has reported a net loss for all periods presented, diluted net loss per common share is the same as basic net loss per common share for all periods presented.

Recent Accounting Pronouncements

12 Months Ended

Dec. 31, 2020

New Accounting Pronouncements And Changes In Accounting Principles [Abstract]

Recent Accounting Pronouncements

Note 3 – Recent Accounting Pronouncements

Recently Issued Accounting Standards Not Yet Adopted

In February 2016, the FASB issued Accounting Standards Update (ASU) No. 2016-2, Leases (Topic 842), which requires lessees to recognize a right-of-use asset and corresponding lease liability, including leases currently accounted for as operating leases. The ASU is effective for the Company for interim and annual periods beginning January 1, 2022. The Company expects to recognize right-of-use assets and lease obligations in its balance sheet upon adoption using the modified retrospective method as permitted by ASU No. 2018-11, Leases (Topic 842): Targeted Improvements. The Company does not currently expect adoption of this standard will have a significant effect on its statements of operations or cash flows.

In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments-Credit Losses: Measurement of Credit Losses on Financial Instruments. This ASU requires measurement and recognition of expected credit losses for financial assets. This guidance will become effective for the Company beginning January 1, 2022 with early adoption permitted. The Company has not yet begun evaluating the potential effect of this standard on its financial statements.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

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+ Details

Business Combinations

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Business Combinations

Note 4 – Business Combinations

Oncimmune Limited

On October 31, 2019, the Company purchased select assets and liabilities from Oncimmune Limited (Oncimmune) for total consideration of $1.2 million payable in quarterly installments commencing 30 days following the closing of the transaction. Concurrent with the Oncimmune purchase, the Company acquired an exclusive option to license rights within the United States to an additional indication for their product for $9.0 million. In September 2020, we notified Oncimmune that we would not exercise this option for the expansion of the field of use. As of December 31, 2020, the Company had paid the full $1.2 million consideration.

The acquisition was accounted for as business combination and resulted in the recognition of goodwill of $0.8 million representing expected synergies, including expected increases in future revenues as a result of expansion of the acquired technology into additional markets, and lower expected operating expenses. The Company finalized its purchase price allocation of the transaction as of December 31, 2019.

The following table summarizes the aggregate consideration paid by the Company and the allocation of the purchase price to assets acquired and liabilities assumed (in thousands):

Cash	$	1,206
Total fair value of consideration transferred	$	1,206

Deposit	$	6
Inventory		14
Property and equipment		241
Purchase option		121
Goodwill		827
Accrued liabilities		(3	)
	$	1,206

Integrated Diagnostics, Inc.

On June 30, 2018, the Company purchased select assets and liabilities from Integrated Diagnostics, Inc. (Indi) for total consideration of $27.6 million, consisting of $8.0 million in the Company’s Series G Preferred Stock and contingent consideration with an initial estimated fair value of $19.6 million. The acquisition was accounted for as a business combination and resulted in goodwill of $14.2 million representing expected synergies, including increases in future revenues as a result of expansion of the acquired technology into additional markets, and lower operating expenses.

The contingent consideration arrangement requires additional consideration to be paid by the Company to Indi upon attainment of a three-consecutive month gross margin target of $2.0 million within the seven-year period after the acquisition date. If the gross margin target is met, the Company is required to issue 2,520,108 shares of common stock. For the six months following the achievement of the gross margin target, Indi has the option to require the Company to redeem these common shares for $37.0 million in cash over eight equal quarterly installments. If Indi elects to not exercise its option, the Company has 12 months to repurchase the common stock in two equal and consecutive quarterly cash installments totaling $37.0 million.

Fair Value

12 Months Ended

Dec. 31, 2020

Fair Value Disclosures [Abstract]

Fair Value

Note 5 - Fair Value

Recurring Fair Value Measurements

Our borrowing instruments are recorded at their carrying values in the balance sheets, which may differ from their respective fair values. The fair values of outstanding borrowings, which are classified as Level 2, approximate their carrying values at December 31, 2020 and 2019, based on interest rates currently available for similar borrowings and were:

	As of December 31,
	2020				2019
	Carrying Value		Fair Value		Carrying Value		Fair Value
Borrowings	$	27,766	$	27,766	$	35,971	$	35,971

The financial liabilities that are measured and recorded at estimated fair value on a recurring basis consist of our contingent consideration associated with our acquisition of Indi, and prior to the completion of our initial public offering in October 2020, the warrant liability and put option liability granted to certain holders of our convertible preferred stock and debt instruments, which were accounted for as liabilities and remeasured through our statements of operations. The table below presents the reported fair values of these liabilities, all of which are classified as Level 3 in the fair value hierarchy, as of the dates indicated (in thousands):

	As of December 31,
Description	2020		2019
Contingent consideration	$	29,932	$	29,114
Put option liability		—		3,261
Warrant liability		—		372
Contingent value rights		—		60

The following table presents the changes in these financial liabilities for the year ended December 31, 2020 (in thousands):

Level 3 Rollforward	Contingent Consideration		Put Option Liability			Warrant Liability			Contingent Value Rights
Beginning balances	$	29,114	$	3,261		$	372		$	60
Additions		—		3,389			—			—
Changes in fair value		818		—			1,252			(60	)
Reclassified to additional paid-in capital		—		(6,650	)		(1,624	)		—
Ending balances	$	29,932	$	—		$	—		$	—

Contingent Consideration

In connection with the acquisition of Indi, the Company recorded contingent consideration for amounts contingently payable to Indi's selling shareholders pursuant to the Asset Purchase Agreement (See Note 4 – Business Combinations). The significant unobservable inputs used in the measurement of fair value include the probability of successful achievement of the specified product gross margin targets, the period in which the targets are expected to be achieved, and discount rates which ranged from 12.2% to 13.5%. Significant increases or decreases in any of these inputs would result in a significantly higher or lower fair value measurement.

Contingent consideration is recorded in the balance sheets as long-term liabilities. The net change to contingent consideration during the years ended December 31, 2020 and 2019 was an increase of $0.8 million and $4.1 million, respectively, and are recorded as operating expenses in the statements of operations.

Put Option Liability

The put option liability was valued based on the calculated returns as a result of the various discounts included in the Company’s convertible notes payable and the related probability assessments of the various settlement scenarios. During 2020, the Company recognized an addition to the put option liability of $3.4 million in connection with a favorable conversion rate granted to holders of issued convertible debt. The put option liability was settled upon the closing of the Company’s initial public offering in October 2020 and reclassified to additional paid-in capital.

Warrant Liability

In connection with entering into the 2018 Notes, the Company issued to the lender a warrant to purchase 613,333 shares of Series G convertible preferred stock, at an exercise price of $0.75 per share, subject to adjustment upon specified dilutive issuances. The warrant was immediately exercisable upon issuance and expires on February 23, 2028. The estimated fair value of the warrant on the issuance date of $0.3 million was recorded as a debt discount and as a preferred stock warrant liability. Through the effective date of the Company’s initial public offering, the Series G warrants were remeasured to an estimate of fair value using a Black Scholes pricing model. As a result of the Company’s initial public offering, the preferred stock warrants were automatically converted to warrants to purchase 103,326 shares of common stock with a weighted average exercise price of $4.46 and were also transferred to additional paid-in capital. During 2020, the Company recorded an increase in the value of the warrant liability of $1.3 million.

Contingent Value Rights

In addition to the shares of Series F Preferred Stock that were issued in January 2016, investors who purchased more than their pro‑rata amount in the financing described above received a calculated number of contingent value rights (CVRs). In connection with the Series F financing, the Company issued 3,999 CVRs originally valued at $0.5 million. One CVR represents 0.00375% of the Company’s interest in the drug ficlatuzumab. The initial estimated value of the CVRs were recorded as a liability and as a reduction to the Series F proceeds. Upon receipt by the Company or a milestone, royalty, or any other type of payment from the Company’s ownership rights in the drug, the Company was required to make a cash payment to the CVR holders equal to 15% of net proceeds, as defined. In September 2020, the Company exercised its opt-out right with AVEO Oncology (AVEO) for the payment of 50% of development and regulatory costs for ficlatuzumab. As a result, the CVRs were settled effective December 2, 2020. See Note 17 – Commitments and Contingencies for a discussion of the Co-Development Agreement with AVEO.

Non-Financial Assets and Liabilities

Our non-financial assets, which primarily consist of property and equipment, goodwill, and other intangible assets, are not required to be carried at fair value on a recurring basis and are reported at carrying value. There were no changes to the valuation methods during the periods presented.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Property and Equipment

12 Months Ended

Dec. 31, 2020

Property Plant And Equipment [Abstract]

Property and Equipment

Note 6 – Property and Equipment

Property and equipment consist of the following (in thousands):

	As of December 31,
	2020			2019
Lab equipment	$	5,730		$	4,221
Leasehold improvements		1,845			1,894
Computer equipment		871			869
Furniture and fixtures		424			427
Software		651			503
Construction in process		381			592
		9,902			8,506
Less accumulated depreciation		(6,724	)		(6,386	)
Total property and equipment, net	$	3,178		$	2,120

Depreciation expense related to property and equipment, reported in ‘Direct costs and expenses’ and ‘Sales, marketing, general and administrative’ was:

	Year ended December 31,
	2020		2019
Direct costs and expenses	$	361	$	183
Sales, marketing, general and administrative		478		636
Total	$	839	$	819

Disposals of Property and Equipment

Gains on disposal of property and equipment were not significant for the years ended December 31, 2020 and 2019, and are included in ‘Sales, marketing, general and administrative’ in the statements of operations.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

Note 7 – Goodwill and Intangible Assets

Goodwill

Changes in goodwill for the years ended December 31, 2020 and 2019 were (in thousands):


Balance at January 1, 2019	$	14,204
Attributable to acquisition of Oncimmune, Ltd.		827
Balance at December 31 2019	$	15,031

Balance at December 31, 2020	$	15,031

Intangible Assets, Net

Intangible assets consist of the following (in thousands):

	December 31, 2020							December 31, 2019
	Cost		Accumulated Amortization			Net Carrying Value		Cost		Accumulated Amortization			Net Carrying Value
Intangible assets subject to amortization
Patents	$	1,474	$	(494	)	$	980	$	1,245	$	(411	)	$	834
Purchased technology		16,900		(4,694	)		12,206		16,900		(2,817	)		14,083
Purchase option		—		—			—		121		(17	)		104
Intangible assets not subject to amortization
Trademarks		74		—			74		71		—			71
Total	$	18,448	$	(5,188	)	$	13,260	$	18,337	$	(3,245	)	$	15,092

Amortization expense related to definite-lived intangible assets was (in thousands):

	Year ended December 31,
	2020		2019
Direct costs and expenses	$	13	$	15
Sales, marketing, general and administrative		2,051		1,959
Total	$	2,064	$	1,974

Future estimated amortization expense of intangible assets is (in thousands):

	As of December 31, 2020
2021	$	1,946
2022		1,940
2023		1,936
2024		1,928
2025		1,924
Thereafter		3,512
Total	$	13,186

There have been no impairments of intangible assets for the twelve-month periods ended December 31, 2020 and December 31, 2019.

Accrued Liabilities

12 Months Ended

Dec. 31, 2020

Payables And Accruals [Abstract]

Accrued Liabilities

Note 8 – Accrued Liabilities

Amounts reported in ‘Accrued liabilities’ in the balance sheets were (in thousands):

	December 31,
	2020		2019
Compensation related accruals	$	3,975	$	1,165
Accrued clinical trial expense		715		620
Other expenses		3,099		2,352
Warrant liability, current	-			43
Total accrued liabilities	$	7,789	$	4,180

Debt

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

Debt

Note 9 – Debt

Notes Payable

Long-term notes payable were as follows (in thousands):

	As of December 31,
	2020			2019
2018 Notes	$	24,972		$	24,270
Payroll protection plan		3,107		—
Convertible notes payable	—				13,159
Unamortized debt discount and debt issuance costs		(313	)		(1,458	)
		27,766			35,971
Less: current maturities		11,840			12,159
Long-term notes payable	$	15,926		$	23,812

In February 2018, the Company issued long-term debt of $23.0 million to Innovatus Life Sciences Lending Fund (Innovatus or Lender) (the 2018 Notes). Innovatus is also a holder of the Company’s common stock.

At the time of issuance, the Company paid a facility fee of $0.2 million and issued a warrant to Innovatus, with an initial estimated fair value of $0.3 million, for the purchase of 613,333 shares of Series G preferred stock. The facility fee and the estimated warrant fair value were recorded as debt discount and is amortized to interest expense over the term of the 2018 Notes. The 2018 Notes bear annual interest at 10%, of which 7.5% is payable in cash, with the remaining 2.5% added to principal through December 31, 2020. Total interest added to principal was $1.7 million and $1.1 million as of December 31, 2020 and 2019, respectively. Commencing March 2021 and continuing through the maturity date February 2023, the outstanding principal is repayable in 24 equal monthly installments.

The loan may be prepaid by the Company at any time, subject to a prepayment penalty of up to 3% of the principal amount, depending on the date of prepayment. Upon payment of the 2018 Notes at maturity or prepayment on any earlier date, unless waived, a 2% back-end facility fee will apply to the amounts paid or prepaid. The 2% fee is recognized as additional interest expense over the loan term. The 2018 Notes are senior to all of the Company’s other indebtedness including any contingent consideration payable to Indi.

The 2018 Notes contain customary affirmative covenants, and contain negative covenants limiting the ability of the Company to, among other things, incur future debt, transfer assets except for the ordinary course of business, make acquisitions, make certain restricted payments, or to sell assets, subject to certain exceptions. In addition, the 2018 Notes require the Company to comply with a minimum daily liquidity covenant and a rolling monthly revenue requirement. Failure to comply with the covenants and loan requirements may result in early amortization of the loan in a 24- or 36-month payment schedule. As of December 31, 2020, the Company was in compliance with all terms and covenants.

The Company granted the Lender a security interest in all of the Company’s assets through a pledge and security agreement, patent security agreement and trademark security agreement, each between the Company and the Lender.

Paycheck Protection Program Note Payable

In April 2020, the Company entered into a loan pursuant to the Paycheck Protection Program under the CARES Act, as administered by the U.S. Small Business Administration (the SBA). The loan, in the principal amount of $3.1 million (the PPP Loan), was disbursed by JPMorgan Chase Bank (JPM) pursuant to a Paycheck Protection Program Promissory Note and Agreement (the Note and Agreement).

The PPP Loan matures on the two-year anniversary of the funding date, April 2022, and bears interest at a fixed rate of 1.00% per annum. Monthly principal and interest payments, less the amount of any potential forgiveness (as discussed below), will commence in September 2021. The Company did not provide any collateral or guarantees in connection with the PPP Loan, nor did the Company pay any facility charge to obtain the PPP Loan. The Note and Agreement provides for customary events of default, including those relating to failure to make payment, bankruptcy, breaches of representations and material adverse effects. The Company may prepay the principal of the PPP Loan at any time without incurring any prepayment charges.

All or a portion of the PPP Loan may be forgiven by the SBA and JPM upon application by the Company. Under the CARES Act, loan forgiveness is available for the sum of documented payroll costs, covered rent payments, and covered utilities during the eight-week period beginning on the approval date of the PPP Loan. For purposes of the CARES Act, payroll costs exclude compensation of an individual employee earning more than $100,000, prorated annually. Not more than 40% of the forgiven amount may be for non-payroll costs. Forgiveness is reduced if full-time headcount declines, or if salaries and wages for employees with salaries of $100,000 or less annually are reduced by more than 25%. The Company currently intends to repay the PPP loan in accordance with the underlying terms and conditions. To the extent we elect to seek forgiveness, the Company cannot assure that the PPP Loan will be forgiven, in whole or in part. If the loan is forgiven in part or in whole, and legal release is received, the Company will reduce the liability by the amount forgiven and record a gain on extinguishment in the statements of operations.

Convertible Notes Payable

March 2020 Notes

In March 2020, the Company issued $10.0 million of convertible notes primarily to existing stockholders that were originally scheduled to mature in August 2020 (the March 2020 Notes). In August 2020, the Company and its lenders agreed to extend the maturity date to June 30, 2021. The March 2020 Notes were issued in two tranches of $5.0 million, with the first in March 2020 and the second in June 2020. Interest on the March 2020 Notes was 3% per annum, payable in full upon maturity through conversion to Series H Preferred Stock at 80% of the original issuance price of $1.15 per share. Under the terms of the March 2020 Notes, on or before the maturity date and if the March 2020 Notes are unpaid, the outstanding principal and unpaid accrued interest under the March 2020 Notes shall be automatically converted into common stock in an initial public offering at a conversion price of 80% of the per share price of common stock sold in the initial public offering. The discount on the automatic conversion was separated from the March 2020 Notes and reported as a debt discount and put option liability of $2.5 million and was amortized over the term of the March 2020 Notes. Following the closing of the initial public offering in October 2020, the March 2020 Notes were automatically converted into 703,503 shares of common stock at a conversion price of $14.40, or 80% of the initial public offering price per common share.

December 2019 Notes

In December 2019, the Company issued $6.0 million of convertible notes primarily to existing preferred shareholders that were originally scheduled to mature in August 2020 (the December 2019 Notes). In August 2020, the Company and its lenders agreed to extend the maturity date to June 30, 2021. The December 2019 Notes were issued in two tranches of $3.0 million, the first in December 2019 and the second in February 2020. Interest on the December 2019 Notes was 3% per annum and payable in full upon maturity through the conversion to Series H Preferred Stock at 80% of the original issuance price of $1.15 per share. Under the terms of the December 2019 Notes, on or before the maturity date and if the December 2019 Notes are unpaid, the outstanding principal and unpaid accrued interest under the December 2019 Notes shall be automatically converted into common stock in an initial public offering at a conversion price of 80% of the per share price of common stock sold in the initial public offering. The discount on the automatic conversion was separated from the December 2019 Notes and reported as a debt discount and put option liability of $1.5 million and was amortized over the term of the December 2019 Notes. Following the closing of the initial public offering in October 2020, the December 2019 Notes were automatically converted into 426,386 shares of common stock at a conversion price of $14.40, or 80% of the initial public offering price per common share.

August 2019 Notes

In August and September 2019 (the August 2019 Notes), the Company issued $10.0 million of convertible notes primarily to existing preferred shareholders that were originally scheduled to mature in August 2020. In August 2020, the Company and its lenders agreed to extend the maturity date to June 30, 2021. Interest on the August 2019 Notes was 3% per annum and payable in full upon maturity through the conversion to Series H Preferred Stock at 95% of the original issuance price of $1.15 per share. Under the terms of the August 2019 Notes, on or before the maturity date and if the August 2019 Notes are unpaid, the outstanding principal and unpaid accrued interest under the August 2019 Notes shall be automatically converted into common stock in an initial public offering at a conversion price of 95% of the per share price of common stock sold in the initial public offering. In connection with the issuance of the December 2019 Notes, the conversion price on the August 2019 Notes was amended to 80%. The initial discount on the automatic conversion created an initial put option liability of $0.5 million that was separated from the August 2019 Notes. The amendment to the conversion price of the August 2019 Notes in December 2019 resulted in an increase to the put option liability of $2.0 million to a total estimated value of $2.5 million as of December 31, 2019. The increase in the value of the put option liability was reflected as a change in put option in the 2019 statement of operations. Following the closing of the initial public offering in October 2020, the August 2019 Notes were automatically converted into 718,391 shares of common stock at a conversion price of $14.40, or 80% of the initial public offering price per common share.

Scheduled principal repayments (maturities) of long-term obligations as of December 31, 2020 were as follows (in thousands):

Year Ending December 31,	As of December 31, 2020
2021	$	11,840
2022		13,919
2023		2,320
2024		—
2025		—
Thereafter	—
	$	28,079

Convertible Preferred Stock

12 Months Ended

Dec. 31, 2020

Class Of Stock Disclosures [Abstract]

Convertible Preferred Stock

Note 10 – Convertible Preferred Stock

The Company had issued convertible preferred stock from time to time to fund its operations and to make acquisitions. In February and March 2019, the Company issued 8,695,621 shares of Series H Preferred Stock at $1.15 per share for total cash proceeds of $10.0 million.

The Company’s convertible preferred stock was reported as temporary equity in the Company’s balance sheet because the preferred shareholders held a majority of the Company’s Board of Directors seats and as a result could have caused certain events to occur outside of the Company’s control, with the result the Company could have been obligated to redeem the convertible preferred stock.

Immediately prior to the Company’s initial public offering and as of December 31, 2019, the Company had issued 118,766,273 convertible preferred shares. On October 27, 2020, upon closing of the Company’s initial public offering, each outstanding share of Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, Series D Preferred Stock, Series E Preferred Stock, Series F Preferred Stock, Series G Preferred Stock and Series H Preferred Stock automatically converted into 0.1684664 share of common stock; and each share of Series B-1 Preferred Stock automatically converted into 0.196 shares of common stock. In the aggregate, all Series of preferred stock were converted into 20,090,745 shares of common stock. As a result, as of December 31, 2020 there are no longer any series of convertible preferred stock outstanding.

Warrants to Purchase Convertible Preferred Stock

12 Months Ended

Dec. 31, 2020

Warrants And Rights Note Disclosure [Abstract]

Warrants to Purchase Convertible Preferred Stock

Note 11 – Warrants to Purchase Convertible Preferred Stock

The Company issued warrants to purchase shares of convertible preferred stock in conjunction with the sale of certain of the convertible preferred shares and issuance of debt. The estimated grant date fair value as well as the estimated fair value at each reporting date of the warrants was determined using the Black‑Scholes option pricing model with weighted average assumptions substantially consistent with those disclosed for stock options (see Note 14 – Shared Based Compensation), other than term, which is the contractual term of the warrant and the use of the exercise price and estimated fair value of the underlying series of convertible preferred stock. At December 31, 2019 and through the closing of the Company’s initial public offering, the preferred warrants were classified as liabilities with estimated fair value remeasured at each reporting date reported within in the accompanying statements of operations.

The following table presents the activity for convertible preferred stock warrants (in thousands, except weighted average exercise price):

	Series E						Series G
	Warrants			Weighted Average Exercise price			Warrants			Weighted Average Exercise price
Outstanding ‑ December 31, 2019		925		$	5.00			613		$	0.75
Granted		—			—			—			—
Forfeited/canceled		(925	)		(5.00	)		—			—
Exercised		—			—			—			—
Reclassification of warrant liability to additional paid-in capital		—			—			(613	)		(0.75	)
Outstanding ‑ December 31, 2020		—		$	—		$	—		$	—

Upon closing of the Company’s initial public offering, the then outstanding Series G convertible preferred stock was automatically converted to common stock and the outstanding warrants to purchase Series G convertible preferred stock were automatically converted to warrants to purchase 103,326 shares of common stock at $4.46 per share and expire in February 2028. The warrants were remeasured to an estimate of fair value as of the initial public offering with the change in fair value of $1.3 million recognized in our statements of operations. The carrying value of the warrants was reclassified to additional paid-in capital as a result of the initial public offering.

Equity

12 Months Ended

Dec. 31, 2020

Stockholders Equity Note [Abstract]

Equity

Note 12 – Equity

Common Stock

The Company’s Restated Certificate of Incorporation authorizes the Company to issue up to 200,000,000 shares of common stock with a par value of $0.001 per share. The holder of each share of common stock is entitled to one vote per share. The common shareholders are entitled to dividends whenever funds and assets are legally available and when and if declared by the Board of Directors. The Company is currently subject to restrictions on the payment of dividends (see Note 9 - Debt) and no dividends have been declared as of December 31, 2020.

On October 27, 2020, the Company issued and sold 4,000,000 shares of common stock in a registered initial public offering at a price to the public of $18.00 per share. The net proceeds to the Company were approximately $63.8 million, after deducting underwriting discounts and commissions of $5.0 million and direct offering expenses of approximately $3.2 million.

Preferred Stock

The Company’s Restated Certificate of Incorporation authorizes the Company to issue up to 5,000,000 shares of preferred stock with a par value of $0.001 per share. As of December 31, 2020, no shares of preferred stock were issued or outstanding.

Revenue

12 Months Ended

Dec. 31, 2020

Revenue From Contract With Customer [Abstract]

Revenue

Note 13 - Revenue

The Company’s revenue is generated from (i) diagnostic tests and (ii) assay development and testing services. Diagnostic test revenues consist of blood-based lung tests and COVID-19 tests, which are recognized in the amount expected to be received in exchange for diagnostic tests when the diagnostic tests are delivered. The Company conducts diagnostic tests and delivers the completed test results to the prescribing physician or patient, as applicable. The fees for diagnostic tests are billed either to a third party such as Medicare, medical facilities, commercial insurance payers, or to the patient. The Company determines the transaction price related to its diagnostic test contracts by considering the nature of the payer and historical price concessions granted to groups of customers. For diagnostic test revenue, the Company estimates the transaction price, which is the amount of consideration it expects to be entitled to receive in exchange for providing services based on its historical collection experience, using a portfolio approach. The Company recognizes revenues for diagnostic tests upon delivery of the tests to the physicians requesting the tests or patient, as applicable.

Services revenue consists of on-market tests, pipeline tests, custom diagnostic testing, and other scientific services for a purpose as defined by any individual customer, which is often with large biopharmaceutical companies. The performance obligations and related revenue for these sales is defined by a written agreement between the Company and the customer. These services are generally completed upon the delivery of testing results, or other contractually defined milestone(s), to the customer. Revenue for these services is recognized upon delivery of the completed test results, or upon completion of the contractual milestone(s).

Revenues consisted of the following (in thousands):

	Year Ended December 31,
	2020		2019
Diagnostic tests	$	40,919	$	17,315
Services		4,638		7,237
Total revenue	$	45,557	$	24,552

The Company’s fiscal 2020 diagnostic test revenue consists of $28.3 million in COVID-19 test revenue, which began in late fiscal 2020, and $12.6 million in lung diagnostic revenue.

Contract Liabilities

Contract liabilities consist of cash payments from customers received in advance of delivery (advance deposits). As products are shipped and control transfers, the Company recognizes the deferred revenue in ‘Revenues’ in the statements of operations. At January 1 and December 31, 2020, $1.3 million and $3.5 million, respectively, of advance deposits were reported in ‘Deferred revenue’ in the accompanying balance sheets. Of the $1.3 million in deferred revenue recorded at January 1, 2020, $0.7 million was recognized in revenues during the year ended December 31, 2020. The deferred revenue of $3.5 million at December 31, 2020 is expected to be recognized in revenues during 2021 as test results are delivered.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Name Accounting Standards Codification
-Topic 606
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-Paragraph 10
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 13
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
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-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
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-Section 50
-Paragraph 12
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+ Details

Share Based Compensation

12 Months Ended

Dec. 31, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Share Based Compensation

Note 14 – Share Based Compensation

2016 Equity Incentive Plan and Predecessor 2006 Equity Incentive Plan

In February 2016, the Company adopted the 2016 Equity Incentive Plan (2016 Plan) as a successor to and continuation of the prior 2006 Equity Incentive Plan (2006 Plan). The 2016 Plan provides for the grant of incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock awards, restricted stock units, and other stock awards to directors, employees, and consultants. Awards granted under the 2016 Plan or the 2006 Plan that expired or otherwise terminated, or were forfeited, cancelled, or repurchased by the Company, became available for future issuance under the 2016 Plan. In addition, shares subject to an award were withheld to satisfy a participant’s tax withholding obligations, or were reacquired by the Company as consideration for the exercise or purchase price of a stock award also became available for future issuance under the 2016 Incentive Plan.

2020 Equity Incentive Plan

Effective upon the closing of our initial public offering, the Company’s Board of Directors approved the 2020 Equity Incentive Plan (2020 Plan), which replaced the 2016 Plan. The 2020 Plan provides for the grant of incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock awards, restricted stock units, performance awards and other stock awards. Officers, directors, employees, consultants, agents, and independent contractors who provide services to the Company may receive awards. The terms of all awards are governed by an agreement between the Company and the recipients, as administered and approved by the Compensation Committee of the Board of Directors.

Employee Stock Purchase Plan

Effective with our initial public offering in October 2020, the Company’s Board of Directors and its stockholders approved the Company’s Employee Stock Purchase Plan (ESPP). A total of 338,106 shares of our common stock have been reserved for issuance under the ESPP. The maximum number of shares of our common stock available under the ESPP will automatically increase on the first trading day of each calendar year, commencing January 2021, by an amount equal to the lesser of (i) 1% of the shares of our common stock issued and outstanding on December 31 of the immediately preceding calendar year, and (ii) an amount determined by our Board of Directors.

Subject to any plan limitations, the ESPP allows eligible employees to contribute, normally through payroll deductions, up to 15% of their earnings for the purchase of the Company’s common stock at a discounted price per share. The price at which common stock is purchased under the ESPP is equal to 85% of the fair market value of the Company’s common stock on the first or last day of the offering period, whichever is lower. No employee may participate in an offering period if the employee owns 5% or more of the total combined voting power or value of the Company’s stock. The initial offering period will commence from January 1, 2021 through August 31, 2021. On a going forward basis, the ESPP provides for successive six-month offering periods beginning on September 1st and March 1st of each year.

Shares Reserved Subject to All Plans

The number of shares reserved for issuance under the 2020 Plan is 1,893,395, plus an annual increase added on the first day of each calendar year, beginning with the calendar year ending December 31, 2022, and continuing until, and including, the calendar year ending December 31, 2030. The annual increase will be equal to the lesser of (i) 4% of the number of shares of our common stock issued and outstanding as of December 31st of the immediately preceding calendar year and (ii) such lesser amount determined by the Board of Directors. Up to 1,893,395 shares of our common stock that may be issued under the 2020 Plan may be issued in satisfaction of incentive stock option awards.

Under the 2006 Plan, the Company is authorized to grant incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock awards and restricted stock units up to 831,389 total award shares. No additional awards may be granted under the 2006 Plan. Unallocated shares under the 2006 Plan were added to the shares available for issuance under the 2016 Plan.

Under the 2016 Plan, which is a successor to and continuation of the 2006 Plan, the Company is authorized to grant incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock awards, restricted stock units and stock appreciation rights up to 1,431,964 total shares, plus any shares subject to stock awards made under the 2006 Plan.

Our Compensation Committee may grant other stock awards that are based on or related to shares of our common stock, such as awards of shares of common stock granted as bonus and not subject to any vesting conditions, deferred stock units, stock purchase rights, and shares of our common stock issued in lieu of our obligations to pay cash under any compensatory plan or arrangement. To date, the Company has granted service-condition RSUs.

To the extent an equity award granted under the 2020 Plan (other than any substitute award) or granted under any other equity plan maintained by us under which awards are outstanding as of the effective date of the 2020 Plan (the Prior Plans) expires or otherwise terminates without having been exercised or paid in full, or is settled in cash, the shares subject to such award will become available for future grant under the 2020 Plan. In addition, to the extent shares subject to an award are withheld to satisfy a participant’s tax withholding obligation upon the exercise or settlement of such award (other than any substitute award) or to pay the exercise price of a stock option granted under the 2020 Plan or a Prior Plan, such shares will become available for future grant under the 2020 Plan. The total number of shares available for grant under all Plans was 4,647,380 at December 31, 2020.

Description of Awards Granted

The Company has granted incentive stock options, non-statutory stock options, performance-based stock options, and restricted stock units.

Incentive stock options, which may only be issued to employees, are granted at an exercise price per share equal to the fair market value per share of the underlying common stock on the grant date, and vest over time as determined by the Compensation Committee, provided that the term of the options may not exceed ten years from the date of grant. Accelerated vesting may occur in the event of an optionee's death, disability, or other events.

Non-statutory stock options may be issued to non-employees and directors, with exercise prices, vesting conditions, option term and other conditions as determined by the Compensation Committee.

Performance-based stock options are typically granted on an annual basis and consist of a performance-based and service-based component. The performance targets and vesting conditions for performance-condition options are based on achievement of recognized revenue targets. Performance-based options vest in three equal annual installments beginning one year after the grant date, pending certification of performance achievement by the Compensation Committee and continued service. The fair value of performance-condition awards is based on the closing market price of the Company’s common stock on the grant date. Compensation expense, net of forfeitures, is updated for the Company’s expected performance level against performance goals at the end of each reporting period. On January 1, 2019, the Company granted 168,466 performance-condition options, with an exercise price of $0.77 per share and a term of ten years. During the year ended December 31, 2020, the performance conditions were met and 56,155 options vested. During the year ended December 31, 2019, the performance conditions were not met and 56,155 options were forfeited. As of December 31, 2020, there were 56,156 performance condition options outstanding with a remaining life of approximately eight years.

Restricted stock units and the related terms and conditions are awarded at the discretion of the Compensation Committee. RSU holders have a contractual right to receive a share of common stock when vested. RSUs generally vest over three years. RSU agreements may provide for accelerated vesting in the event of a stock unit holder's death, disability, or retirement or other events.

Bonus-To-Options Program

The Company also has a Bonus-to-Options Program (the “Bonus Option Program”), which is separate from predecessor Plans and was initially adopted by the Board of Directors in 2008, and subsequently amended and restated in 2010, 2011 and 2015. For fiscal year 2021, the Bonus Option Program is subject to the shares reserved under the 2020 Plan. The Bonus Option Program, which is limited to participation of the Chief Executive Officer, direct reports to the Chief Executive Officer and Vice Presidents of the Company, allows participants who so elect to convert all or a portion of their annual cash bonus into fully vested, non-qualified stock options to purchase shares of common stock (Bonus Options). The exercise price for the options under the Bonus Option Program equals the then current price for the shares of the common stock as of the grant date, as disclosed below under “Fair Value of Common Stock”. Bonus Options issued must be exercised within a ten-year term. A maximum of 1% of the fully diluted equity, as of December 31 of the year for which the bonus was awarded, may be issued in any one year to the participants. As of December 31, 2020, there were 173,229 options outstanding under the Bonus Option Program. These options are fully vested and have a weighted average exercise price of $11.11 per share and have an intrinsic value of approximately $1.6 million as of December 31, 2020.

During the twelve-month period ended December 31, 2020, the Company accrued $3.4 million as stock compensation expense associated with the estimate of options to be delivered to eligible participants under the Bonus Option Program and which were granted in February 2021 by the Compensation Committee of the Board of Directors. In determining the amount of stock compensation to recognize under the Bonus Option Program, the Company estimates the bonus attainment for the year and determines the expected number of options to be delivered to eligible participants. A Black-Scholes option pricing model is used to determine the estimated fair value of the expected number of options to be delivered to eligible participants. The key elements in determining the estimated fair value include assumptions for volatility, the risk free interest rate, expected dividends and strike price, utilizing the measurement date closing stock price until the grants are authorized.

Share-Based Compensation Expense

Pre-tax share-based compensation expense reported in the Company’s statements of operations was (in thousands):

	Year Ended December 31,
	2020		2019
Research and development	$	589	$	33
Sales, marketing, general and administrative		3,120		137
Total	$	3,709	$	170

The unrecognized remaining share-based compensation expense for options and RSUs was approximately $0.6 million as of December 31, 2020, and is expected to be amortized to expense over the next 3.7 years.

Stock Options

Stock option activity during the year ended December 31, 2020, excluding the Bonus Option Program described above, was (in thousands, except weighted average exercise price and weighted average contractual life):

	Number of Options			Weighted Average Exercise Price		Weighted Average Contractual Life (Years)		Aggregate Intrinsic Value
Outstanding - December 31, 2019		1,916		$	1.72		7.6	$	—
Granted		828			2.81		—		—
Forfeited/canceled		(55	)		0.60		—		—
Exercised		(368	)		3.65		—		—
Outstanding ‑ December 31, 2020		2,321		$	1.82		7.4	$	42,580
Exercisable ‑ December 31, 2020		1,190		$	2.35		6.3	$	21,194

Fair Value of Common Stock

Prior to the Company’s initial public offering, the fair value of the Company’s common stock underlying the stock options was determined by the Board of Directors with assistance from management and, in part, on input from an independent third-party valuation firm. The Board of Directors determined the fair value of common stock by considering a number of objective and subjective factors, including valuations of comparable companies, sales of convertible preferred stock, operating and financial performance, the lack of liquidity of the Company’s common stock and the general and industry-specific economic outlook. Subsequent to the Company’s initial public offering, the fair value of the Company’s common stock is determined based on its closing market price.

The fair value of each option grant prior was estimated on the grant date using the Black‑Scholes option pricing model with the following weighted average assumptions for the year ended December 31, 2020:

Risk‑free rate		0.34	%
Expected term (in years)		5.73
Expected dividend yield	—%
Expected volatility		77	%

The Company estimated volatility based on the historical volatility of its peer group and average expected life based on the review of historical exercise behavior of option grants with similar vesting periods.

Restricted Stock Units and Restricted Stock Unit Activity

Service-condition RSUs were granted to Board members and vest over three years, 40% over the first two years and the remaining 60% over the third year from the grant date. During the year ended December 31, 2020, the Company granted 52,736 service-condition RSUs. As of December 31, 2020, there were 79,104 RSUs outstanding, with a weighted average grant date fair value of $6.83 per share.

Earnings per Share

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

Earnings per Share

Note 15 – Earnings per Share

Excluded from determination of diluted net loss attributable to common stockholders for the periods presented because inclusion would be anti-dilutive are the instruments below, the terms of which are described in further detail in Note 14 – Share Based Compensation. The potentially dilutive securities as of December 31, 2020 and 2019 primarily represent the shares subject to future issuance under stock options awards, warrants and RSUs and would be subject to the treasury stock method when dilutive. The number of common shares that convertible debt was assumed to convert to was based on the Company’s estimated common stock price as of December 31, 2019, as determined by the Company’s Board of Directors with assistance from a valuation firm.

	Year Ended December 31
	2020			2019
Numerator
Net loss attributable to common stockholders	$	(31,350	)	$	(30,726	)

Denominator
Weighted-average shares outstanding used in computing net loss per share, basic and diluted		4,838			242
Net loss per share, basic and diluted	$	(6.48	)	$	(126.97	)

The following outstanding common stock equivalents were excluded from diluted net loss attributable to common stockholders for the periods presented because inclusion would be anti-dilutive (in thousands):

	Year Ended December 31
	2020		2019
Options to purchase common stock		2,495		2,104
Convertible preferred stock		—		119,257
Warrants		103		1,538
Restricted stock units		79		26
Convertible debt		—		21,131
Total		2,677		144,056

Income Taxes

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Income Taxes

Note 16 - Income Taxes

Since inception, the Company has incurred net taxable losses, and accordingly, no current provision for income taxes has been recorded. The effective income tax rate of the provision for income taxes differs from the federal statutory rate as follows:

	Years Ended December 31,
	2020			2019
Federal statutory income tax rate		21	%		21	%
State income taxes, net of federal benefit		2			4
Research and developments credits		(1	)		2
Permanent items		(6	)		(4	)
Change in valuation allowance		(16	)		(23	)
Effective income tax rate		—	%		—	%

The tax effects of temporary differences that give rise to significant portions of the deferred income tax assets and liabilities are as follows (in thousands):

	Years Ended December 31,
	2020			2019
Deferred Tax Assets:
Net operating loss carryforwards	$	53,128		$	50,360
Research and development tax credits		2,860			3,040
Property and equipment		279			370
Stock-based compensation		865			—
Accruals and reserves		1,406			286
Total		58,538			54,056
Valuation allowance		(56,083	)		(51,135	)
Total deferred tax assets after valuation allowance		2,455			2,921
Deferred Tax Liabilities:
Intangible assets		(2,455	)		(2,921	)
Total deferred tax liabilities		(2,455	)		(2,921	)
Net deferred tax assets and liabilities	$	—		$	—

At December 31, 2020, the Company had $233.6 million and $3.6 million of net operating loss and research and experimentation tax carryforwards, respectively, which are set to expire beginning in 2026. The Internal Revenue Code contains provisions that may limit the net operating loss carryovers available to be used in any year if certain events occur, including significant changes in ownership interest.

In assessing the realizability of its deferred tax assets, the Company considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. The Company considers the scheduled reversal of deferred tax liabilities, projected future taxable income, and tax planning strategies in making this assessment. As the Company does not have any historical taxable income, projections of future taxable income over the periods in which the deferred tax assets are deductible, and after consideration of the history of operating losses, the Company does not believe it is more likely than not that it will realize the benefits of net deferred tax assets and, accordingly, has established a valuation allowance equal to 100% of net deferred tax assets. The valuation allowance increased by $4.9 million during 2020 and $7.0 million during 2019.

During 2020, the Company determined that it now has uncertain tax positions related to its U.S. research and development credits. As of December 31, 2020 and 2019, there was no accrued interest related to uncertain tax positions. The Company does not believe it is reasonably possible that its unrecognized tax benefits will significantly change in the next twelve months. A reconciliation of beginning and ending balances for unrecognized tax benefits is as follows (in thousands):

	Year Ended December 31,
	2020
Balance at January 1	$	—
Additions for tax positions related to the current year		106
Additions for tax positions related to prior years		609
Reductions for tax positions related to prior years		—
Reductions related to settlements		—
Reductions related to a lapse of statute		—
Balance at December 31	$	715

The Company monitors proposed and issued tax law, regulations, and cases to determine the potential impact of uncertain income tax positions. At December 31, 2020, the Company had not identified any potential subsequent events that would have a material impact on unrecognized income tax benefits within the next twelve months.

All years will remain open for examining by federal and state authorities for three and four years, respectively, from the date of utilization of any net operating loss carryforwards.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References + Details

Commitments and Contingencies

12 Months Ended

Dec. 31, 2020

Commitments And Contingencies Disclosure [Abstract]

Commitments and Contingencies

Note 17 – Commitments and Contingencies

Leases

The Company leases facilities under non‑cancelable operating leases. Rent expense was $1.7 million and $2.1 million for the years ended December 31, 2020 and 2019, respectively.

Future minimum lease payments for operating lease obligations are as follows as of December 31, 2020 (in thousands):

Year Ending December 31,
2021	$	703
2022		724
2023		112
2024		—
2025		—
Thereafter		—
	$	1,539

Co‑Development Agreement

In April 2014 and amended in October 2016, the Company entered into a worldwide agreement with AVEO to develop and commercialize AVEO's hepatocyte growth factor inhibitory antibody ficlatuzumab with the Company's proprietary companion diagnostic test, BDX004, a version of the Company’s serum protein test that is commercially available to help physicians guide treatment decisions for patients with advanced non‑small cell lung cancer (NSCLC). Under the terms of the agreement, AVEO will conduct a proof‑of‑concept (POC) clinical study of ficlatuzumab for NSCLC in which BDX004 will be used to select clinical trial subjects (the NSCLC POC Trial). The Company and AVEO will share equally in the costs of the NSCLC POC Trial, and each will be responsible for 50% of development and regulatory costs associated with all future clinical trials agreed upon by the Company and AVEO. The Company and AVEO continue to conduct POC clinical trials of ficlatuzumab in combination with BDX004 with each responsible for 50% of development and regulatory costs.

In September 2020, the Company exercised its opt-out right with AVEO for the payment of 50% of development and regulatory costs for ficlatuzumab effective December 2, 2020. The Company had $0.3 million in remaining obligations related to the AVEO agreement as of the opt-out date. Following the effective date, the Company is entitled to a 10% royalty of net sales of ficlatuzumab and 25% of license income generated from the licensing of ficlatuzumab from AVEO.

Expenses related to this agreement for the years ended December 31, 2020 and 2019 were approximately $0.9 million and $0.9 million, respectively.

License Agreement

In August 2019, we entered into a non-exclusive license agreement with Bio-Rad Laboratories, Inc. (Bio-Rad) (the Bio-Rad License). Under the terms of the Bio-Rad License, the Company received a non-exclusive license, without the right to grant sublicenses, to utilize certain of Bio-Rad’s intellectual property, machinery, materials, reagents, supplies and know-how necessary for the performance of Droplet Digital PCR™ (ddPCR) in cancer detection testing for third parties in the United States. The Company also agreed to purchase all of the necessary supplies and reagents for such testing exclusively from Bio-Rad, pursuant to a separately executed supply agreement (the Supply Agreement) with Bio-Rad. As further consideration for the non-exclusive license, the Company agreed to pay a royalty of 2.5% on the net revenue received for the performance of such ddPCR testing collected from third parties. The Bio-Rad License expires in August 2024. Either party may terminate for the other’s uncured material breach or bankruptcy events. Bio-Rad may terminate the Bio-Rad License if the Company does not purchase licensed products under the Supply Agreement for a consecutive twelve-month period or for any material breach by us of the Supply Agreement. The Company incurred royalty expense of $0.1 million and $0.1 million for the years ended December 31, 2020 and 2019, respectively, under the Bio-Rad License.

Revenue Share Agreement

As part of the acquisition of Oncimmune, the Company entered into several agreements to govern the relationship between the parties. The Company agreed to a revenue share payment related to an acquired diagnostic test of 8% of recognized revenue for non-screen tests up to an annual minimum volume and 5% thereafter, with an escalating minimum through the first four years of sales. Revenue share expenses of $0.3 million were recognized for the year ended December 31, 2020.

Defined Contribution 401(k) Plan

12 Months Ended

Dec. 31, 2020

Compensation And Retirement Disclosure [Abstract]

Defined Contribution 401(k) Plan

Note 18 – Defined Contribution 401(k) Plan

The Company sponsors a 401(k) defined contribution plan covering all eligible employees. The Company did not make any discretionary or employer matching contributions under the plan during the years ended December 31, 2020 or 2019.

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2020

Accounting Policies [Abstract]

Reverse Stock Split

Approval of Amended and Restated Certificate of Incorporation

Initial Public Offering ("IPO")

Initial Public Offering

Basis of Presentation

Certain prior period amounts have been reclassified to conform to the current period presentation.

Segment Reporting

Use of Estimates

Revenue Recognition

The Company generates revenues from (i) diagnostic tests and (ii) assay development and testing services (services revenue).

See Note 13 — Revenue for additional information.

Deferred Revenue

Direct Costs and Expenses

Research and Development Expenses

Sales, Marketing, General and Administrative Expenses

Concentrations of Credit Risk and Other Uncertainties

The Company’s customers in excess of 10% of total revenue, and their related revenue as a percentage of total revenue were as follows:

	Year Ended
	December 31, 2020
The Big Ten Conference		30	%
Centura Healthcare		17	%
Percent of total revenue		47	%

	As of December 31,
	2020			2019
The Big Ten Conference		35	%		—	%
Centura Healthcare		24	%		—	%
Medicare		6	%		18	%
Covance Central Laboratory Services		2	%		43	%
Janssen Research and Development, LLC		5	%		12	%
Pfizer, Inc		4	%		10	%
Percent of total accounts receivable		76	%		83	%

Cash and Cash Equivalents

Cash equivalents consist of short-term, highly-liquid instruments with an original maturity of three months or less from the date of purchase.

Restricted Cash

Accounts Receivable and Allowance for Doubtful Accounts

Inventory

Property and Equipment

Intangible Assets

Goodwill

Fair Value of Financial Instruments

Level		Inputs
1		Unadjusted quoted prices in active markets for identical assets and liabilities.
2		Unadjusted quoted prices in active markets for similar assets and liabilities;
		Unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active; or
		Inputs other than quoted prices that are observable for the asset or liability.
3		Unobservable inputs for the asset or liability.

See Note 5 — Fair Value for further discussion related to estimated fair value measurements.

Contingent Consideration

Warrant Liability

Put Option Liability

Share-Based Compensation

Share‑Based Compensation

Stock Options

Restricted Stock Units (RSUs)

See Note 14 — Share-Based Compensation for additional information related to share-based compensation.

Net Loss per Common Share

Recently Issued Accounting Standards Not Yet Adopted

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2020

Accounting Policies [Abstract]

Summary of Revenue and Accounts Receivable by Third-party Payors and Other Customers

The Company’s customers in excess of 10% of total revenue, and their related revenue as a percentage of total revenue were as follows:

	Year Ended
	December 31, 2020
The Big Ten Conference		30	%
Centura Healthcare		17	%
Percent of total revenue		47	%

The Company’s third-party payors and other customers in excess of 10% of accounts receivable, and their related accounts receivable as a percentage of total accounts receivable were as follows:

	As of December 31,
	2020			2019
The Big Ten Conference		35	%		—	%
Centura Healthcare		24	%		—	%
Medicare		6	%		18	%
Covance Central Laboratory Services		2	%		43	%
Janssen Research and Development, LLC		5	%		12	%
Pfizer, Inc		4	%		10	%
Percent of total accounts receivable		76	%		83	%

Business Combinations (Tables)

12 Months Ended

Dec. 31, 2020

Business Combinations [Abstract]

Summary of Aggregate Consideration Paid by Company and Allocation of Purchase Price to Assets Acquired and Liabilities Assumed

The following table summarizes the aggregate consideration paid by the Company and the allocation of the purchase price to assets acquired and liabilities assumed (in thousands):

Cash	$	1,206
Total fair value of consideration transferred	$	1,206

Deposit	$	6
Inventory		14
Property and equipment		241
Purchase option		121
Goodwill		827
Accrued liabilities		(3	)
	$	1,206

Fair Value (Tables)

12 Months Ended

Dec. 31, 2020

Fair Value Disclosures [Abstract]

Summary of Fair Value of Outstanding Borrowings

The fair values of outstanding borrowings, which are classified as Level 2, approximate their carrying values at December 31, 2020 and 2019, based on interest rates currently available for similar borrowings and were:

	As of December 31,
	2020				2019
	Carrying Value		Fair Value		Carrying Value		Fair Value
Borrowings	$	27,766	$	27,766	$	35,971	$	35,971

Schedule of Reported Fair values of Liabilities

The table below presents the reported fair values of these liabilities, all of which are classified as Level 3 in the fair value hierarchy, as of the dates indicated (in thousands):

	As of December 31,
Description	2020		2019
Contingent consideration	$	29,932	$	29,114
Put option liability		—		3,261
Warrant liability		—		372
Contingent value rights		—		60

Schedule of Changes in Financial Liabilities

The following table presents the changes in these financial liabilities for the year ended December 31, 2020 (in thousands):

Level 3 Rollforward	Contingent Consideration		Put Option Liability			Warrant Liability			Contingent Value Rights
Beginning balances	$	29,114	$	3,261		$	372		$	60
Additions		—		3,389			—			—
Changes in fair value		818		—			1,252			(60	)
Reclassified to additional paid-in capital		—		(6,650	)		(1,624	)		—
Ending balances	$	29,932	$	—		$	—		$	—

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2020

Property Plant And Equipment [Abstract]

Schedule of Property and Equipment

Property and equipment consist of the following (in thousands):

	As of December 31,
	2020			2019
Lab equipment	$	5,730		$	4,221
Leasehold improvements		1,845			1,894
Computer equipment		871			869
Furniture and fixtures		424			427
Software		651			503
Construction in process		381			592
		9,902			8,506
Less accumulated depreciation		(6,724	)		(6,386	)
Total property and equipment, net	$	3,178		$	2,120

Schedule of Depreciation Expense Related to Property and Equipment

Depreciation expense related to property and equipment, reported in ‘Direct costs and expenses’ and ‘Sales, marketing, general and administrative’ was:

	Year ended December 31,
	2020		2019
Direct costs and expenses	$	361	$	183
Sales, marketing, general and administrative		478		636
Total	$	839	$	819

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2020

Goodwill And Intangible Assets Disclosure [Abstract]

Schedule of Changes in Goodwill

Changes in goodwill for the years ended December 31, 2020 and 2019 were (in thousands):


Balance at January 1, 2019	$	14,204
Attributable to acquisition of Oncimmune, Ltd.		827
Balance at December 31 2019	$	15,031

Balance at December 31, 2020	$	15,031

Schedule of Intangible Assets

Intangible assets consist of the following (in thousands):

	December 31, 2020							December 31, 2019
	Cost		Accumulated Amortization			Net Carrying Value		Cost		Accumulated Amortization			Net Carrying Value
Intangible assets subject to amortization
Patents	$	1,474	$	(494	)	$	980	$	1,245	$	(411	)	$	834
Purchased technology		16,900		(4,694	)		12,206		16,900		(2,817	)		14,083
Purchase option		—		—			—		121		(17	)		104
Intangible assets not subject to amortization
Trademarks		74		—			74		71		—			71
Total	$	18,448	$	(5,188	)	$	13,260	$	18,337	$	(3,245	)	$	15,092

Schedule of Amortization Expense Related to Definite-Lived Intangible Assets

Amortization expense related to definite-lived intangible assets was (in thousands):

	Year ended December 31,
	2020		2019
Direct costs and expenses	$	13	$	15
Sales, marketing, general and administrative		2,051		1,959
Total	$	2,064	$	1,974

Schedule of Future Estimated Amortization Expense of Intangible Assets

Future estimated amortization expense of intangible assets is (in thousands):

	As of December 31, 2020
2021	$	1,946
2022		1,940
2023		1,936
2024		1,928
2025		1,924
Thereafter		3,512
Total	$	13,186

Accrued Liabilities (Tables)

12 Months Ended

Dec. 31, 2020

Payables And Accruals [Abstract]

Schedule of Accrued Liabilities

Amounts reported in ‘Accrued liabilities’ in the balance sheets were (in thousands):

	December 31,
	2020		2019
Compensation related accruals	$	3,975	$	1,165
Accrued clinical trial expense		715		620
Other expenses		3,099		2,352
Warrant liability, current	-			43
Total accrued liabilities	$	7,789	$	4,180

Debt (Tables)

12 Months Ended

Dec. 31, 2020

Debt Disclosure [Abstract]

Summary of Long-term Notes Payable

Long-term notes payable were as follows (in thousands):

	As of December 31,
	2020			2019
2018 Notes	$	24,972		$	24,270
Payroll protection plan		3,107		—
Convertible notes payable	—				13,159
Unamortized debt discount and debt issuance costs		(313	)		(1,458	)
		27,766			35,971
Less: current maturities		11,840			12,159
Long-term notes payable	$	15,926		$	23,812

Scheduled Principal Repayments (Maturities) of Long-term Obligations

Scheduled principal repayments (maturities) of long-term obligations as of December 31, 2020 were as follows (in thousands):

Year Ending December 31,	As of December 31, 2020
2021	$	11,840
2022		13,919
2023		2,320
2024		—
2025		—
Thereafter	—
	$	28,079

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

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+ Details

Warrants to Purchase Convertible Preferred Stock (Tables)

12 Months Ended

Dec. 31, 2020

Warrants And Rights Note Disclosure [Abstract]

Summary of Activity for Convertible Preferred Stock Warrants

The following table presents the activity for convertible preferred stock warrants (in thousands, except weighted average exercise price):

	Series E						Series G
	Warrants			Weighted Average Exercise price			Warrants			Weighted Average Exercise price
Outstanding ‑ December 31, 2019		925		$	5.00			613		$	0.75
Granted		—			—			—			—
Forfeited/canceled		(925	)		(5.00	)		—			—
Exercised		—			—			—			—
Reclassification of warrant liability to additional paid-in capital		—			—			(613	)		(0.75	)
Outstanding ‑ December 31, 2020		—		$	—		$	—		$	—

Revenue (Tables)

12 Months Ended

Dec. 31, 2020

Revenue From Contract With Customer [Abstract]

Summary of Revenue

Revenues consisted of the following (in thousands):

	Year Ended December 31,
	2020		2019
Diagnostic tests	$	40,919	$	17,315
Services		4,638		7,237
Total revenue	$	45,557	$	24,552

Share Based Compensation (Tables)

12 Months Ended

Dec. 31, 2020

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Summary of Pre-tax Share-based Compensation Expense

Pre-tax share-based compensation expense reported in the Company’s statements of operations was (in thousands):

	Year Ended December 31,
	2020		2019
Research and development	$	589	$	33
Sales, marketing, general and administrative		3,120		137
Total	$	3,709	$	170

Summary of Stock Option Activity

	Number of Options			Weighted Average Exercise Price		Weighted Average Contractual Life (Years)		Aggregate Intrinsic Value
Outstanding - December 31, 2019		1,916		$	1.72		7.6	$	—
Granted		828			2.81		—		—
Forfeited/canceled		(55	)		0.60		—		—
Exercised		(368	)		3.65		—		—
Outstanding ‑ December 31, 2020		2,321		$	1.82		7.4	$	42,580
Exercisable ‑ December 31, 2020		1,190		$	2.35		6.3	$	21,194

Summary of Weighted Average Assumptions

Risk‑free rate		0.34	%
Expected term (in years)		5.73
Expected dividend yield	—%
Expected volatility		77	%

Earnings per Share (Tables)

12 Months Ended

Dec. 31, 2020

Earnings Per Share [Abstract]

Schedule of Computation of Basic and Diluted Net Loss per Share Attributable to Common Stockholders

	Year Ended December 31
	2020			2019
Numerator
Net loss attributable to common stockholders	$	(31,350	)	$	(30,726	)

Denominator
Weighted-average shares outstanding used in computing net loss per share, basic and diluted		4,838			242
Net loss per share, basic and diluted	$	(6.48	)	$	(126.97	)

Schedule of Common Stock Equivalents Excluded from Diluted Net Loss Attributable to Common Stockholders

	Year Ended December 31
	2020		2019
Options to purchase common stock		2,495		2,104
Convertible preferred stock		—		119,257
Warrants		103		1,538
Restricted stock units		79		26
Convertible debt		—		21,131
Total		2,677		144,056

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Schedule of Effective Income Tax Rate Reconciliation

The effective income tax rate of the provision for income taxes differs from the federal statutory rate as follows:

	Years Ended December 31,
	2020			2019
Federal statutory income tax rate		21	%		21	%
State income taxes, net of federal benefit		2			4
Research and developments credits		(1	)		2
Permanent items		(6	)		(4	)
Change in valuation allowance		(16	)		(23	)
Effective income tax rate		—	%		—	%

Schedule of Deferred Tax Assets and Liabilities

The tax effects of temporary differences that give rise to significant portions of the deferred income tax assets and liabilities are as follows (in thousands):

	Years Ended December 31,
	2020			2019
Deferred Tax Assets:
Net operating loss carryforwards	$	53,128		$	50,360
Research and development tax credits		2,860			3,040
Property and equipment		279			370
Stock-based compensation		865			—
Accruals and reserves		1,406			286
Total		58,538			54,056
Valuation allowance		(56,083	)		(51,135	)
Total deferred tax assets after valuation allowance		2,455			2,921
Deferred Tax Liabilities:
Intangible assets		(2,455	)		(2,921	)
Total deferred tax liabilities		(2,455	)		(2,921	)
Net deferred tax assets and liabilities	$	—		$	—

Reconciliation of Unrecognized Tax Benefits

A reconciliation of beginning and ending balances for unrecognized tax benefits is as follows (in thousands):

	Year Ended December 31,
	2020
Balance at January 1	$	—
Additions for tax positions related to the current year		106
Additions for tax positions related to prior years		609
Reductions for tax positions related to prior years		—
Reductions related to settlements		—
Reductions related to a lapse of statute		—
Balance at December 31	$	715

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2020

Commitments And Contingencies Disclosure [Abstract]

Summary of Future Minimum Lease Payments for Operating Lease Obligations

Future minimum lease payments for operating lease obligations are as follows as of December 31, 2020 (in thousands):

Year Ending December 31,
2021	$	703
2022		724
2023		112
2024		—
2025		—
Thereafter		—
	$	1,539

Organization and Description of Business - Additional Information (Details) $ / shares in Units, $ in Thousands			12 Months Ended
	Oct. 27, 2020 USD ($) $ / shares shares	Oct. 19, 2020	Dec. 31, 2020 USD ($) Test $ / shares shares	Oct. 31, 2020 $ / shares shares	Dec. 31, 2019 $ / shares shares
Organization And Description Of Business [Line Items]
Number of blood based lung cancer test \| Test			4
Number of commercial blood-based test \| Test			2
Number of SARS-CoV-2 test \| Test			2
Reverse stock split, description			0.1684664-for-1
Reverse stock split ratio		0.1684664
Common stock, shares authorized			200,000,000	200,000,000	190,000,000
Common stock, par value \| $ / shares			$ 0.001	$ 0.001	$ 0.001
Preferred stock, shares authorized			5,000,000	5,000,000	0
Preferred stock, par value \| $ / shares			$ 0.001	$ 0.001	$ 0.001
Proceeds from initial public offering \| $			$ 72,000
Warrants to purchase shares of common stock			103,326
Initial Public Offering
Organization And Description Of Business [Line Items]
Shares of common stock issued and sold	4,000,000
Common stock price per share \| $ / shares	$ 18.00
Proceeds from initial public offering \| $	$ 63,800
Convertible preferred stock and convertible notes payable converted into shares of common stock	21,939,025
Warrants to purchase shares of common stock	103,326		103,326

Summary of Significant Accounting Policies - Additional Information (Details)	12 Months Ended
	Dec. 31, 2020 USD ($) segment	Dec. 31, 2019 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Number of operating segments \| segment	1
Deferred revenue	$ 3,532,000	$ 1,283,000
Allowance for doubtful accounts	200,000	200,000
Impairment of long-lived assets	0	0
Impairment of intangible assets	0	0
Goodwill impairments loss	$ 0	0
Minimum
Summary Of Significant Accounting Policies [Line Items]
Property, plant and equipment, useful Lives	3 years
Minimum \| Product Life and Patent Life
Summary Of Significant Accounting Policies [Line Items]
Finite-lived intangible asset, useful life	9 years
Maximum
Summary Of Significant Accounting Policies [Line Items]
Property, plant and equipment, useful Lives	5 years
Maximum \| Product Life and Patent Life
Summary Of Significant Accounting Policies [Line Items]
Finite-lived intangible asset, useful life	10 years
Other Current Assets
Summary Of Significant Accounting Policies [Line Items]
Restricted cash	$ 200,000	200,000
Inventory	$ 3,200,000	$ 800,000
Revenue \| Customer Concentration Risk
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	47.00%
Revenue \| Customer Concentration Risk \| Covance Central Laboratory Services
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage		21.00%
Revenue \| Customer Concentration Risk \| Medicare
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	17.00%	36.00%
Testing Services
Summary Of Significant Accounting Policies [Line Items]
Deferred revenue	$ 2,800,000
Revision of Prior Period, Error Correction, Adjustment
Summary Of Significant Accounting Policies [Line Items]
Increase in goodwill		$ 3,400,000
Reduction in accumulated deficit		$ 3,400,000
Error corrections and prior period adjustments, description	The 2019 balance sheet has been updated to reflect an increase in goodwill and a reduction in accumulated deficit of $3.4 million related to the correction of an immaterial error recorded as part of the acquisition of Integrated Diagnostics, Inc. in 2018.

Summary of Significant Accounting Policies - Summary of Revenue and Accounts Receivable by Third-party Payors and Other Customers (Details) - Customer Concentration Risk	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Revenue
Concentration Risk [Line Items]
Concentration risk, percentage	47.00%
Revenue \| The Big Ten Conference
Concentration Risk [Line Items]
Concentration risk, percentage	30.00%
Revenue \| Centura Healthcare
Concentration Risk [Line Items]
Concentration risk, percentage	17.00%
Revenue \| Medicare
Concentration Risk [Line Items]
Concentration risk, percentage	17.00%	36.00%
Revenue \| Covance Central Laboratory Services
Concentration Risk [Line Items]
Concentration risk, percentage		21.00%
Accounts Receivable
Concentration Risk [Line Items]
Concentration risk, percentage	76.00%	83.00%
Accounts Receivable \| The Big Ten Conference
Concentration Risk [Line Items]
Concentration risk, percentage	35.00%
Accounts Receivable \| Centura Healthcare
Concentration Risk [Line Items]
Concentration risk, percentage	24.00%
Accounts Receivable \| Medicare
Concentration Risk [Line Items]
Concentration risk, percentage	6.00%	18.00%
Accounts Receivable \| Covance Central Laboratory Services
Concentration Risk [Line Items]
Concentration risk, percentage	2.00%	43.00%
Accounts Receivable \| Janssen Research and Development, LLC
Concentration Risk [Line Items]
Concentration risk, percentage	5.00%	12.00%
Accounts Receivable \| Pfizer, Inc
Concentration Risk [Line Items]
Concentration risk, percentage	4.00%	10.00%

Business Combinations - Additional Information (Details) $ in Thousands			12 Months Ended
	Oct. 31, 2019 USD ($)	Jun. 30, 2018 USD ($) Installment shares	Dec. 31, 2020 USD ($)	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)
Business Acquisition [Line Items]
Goodwill			$ 15,031	$ 15,031	$ 14,204
Oncimmune Limited
Business Acquisition [Line Items]
Total consideration amount	$ 1,206
Business acquisition description			quarterly installments commencing 30 days following the closing of the transaction.
Cash	1,206		$ 1,200
Goodwill	827
Integrated Diagnostics, Inc
Business Acquisition [Line Items]
Total consideration amount		$ 27,600
Business acquisition description			requires additional consideration to be paid by the Company to Indi upon attainment of a three-consecutive month
Cash		8,000
Goodwill		14,200
Contingent consideration estimated fair value		19,600
Business acquisition contingent consideration gross margin target		$ 2,000
Business acquisition contingent consideration gross margin target period		7 years
Integrated Diagnostics, Inc \| Common Stock
Business Acquisition [Line Items]
Business acquisition description			If Indi elects to not exercise its option, the Company has 12 months to repurchase the common stock in two equal and consecutive quarterly cash installments totaling $37.0 million.
Contingent consideration shares \| shares		2,520,108
Contingent consideration number of installments \| Installment		8
Contingent consideration arrangements, common shares, redemption amount		$ 37,000
Integrated Diagnostics, Inc \| Common Stock \| Repurchase
Business Acquisition [Line Items]
Contingent consideration number of installments \| Installment		2
Contingent consideration cash payment		$ 37,000
License Rights \| Oncimmune Limited \| United States
Business Acquisition [Line Items]
Payments to acquire license rights	$ 9,000

Business Combinations - Summary of Aggregate Consideration Paid by Company and Allocation of Purchase Price to Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands		12 Months Ended
	Oct. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill		$ 15,031	$ 15,031	$ 14,204
Oncimmune Limited
Business Acquisition [Line Items]
Cash	$ 1,206	$ 1,200
Total fair value of consideration transferred	1,206
Deposit	6
Inventory	14
Property and equipment	241
Purchase option	121
Goodwill	827
Accrued liabilities	(3)
Total	$ 1,206

Fair Value - Summary of Fair Value of Outstanding Borrowings (Details) - Fair Value, Recurring - Level 2 - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Carrying Value
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Borrowings	$ 27,766	$ 35,971
Fair Value
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Borrowings	$ 27,766	$ 35,971

Fair Value - Schedule of Reported Fair Values of Liabilities (Details) - Fair Value, Recurring - Level 3 - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Contingent Consideration
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Total liabilities	$ 29,932	$ 29,114
Put Option Liability
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Total liabilities		3,261
Warrant Liability
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Total liabilities		372
Contingent Value Rights
Fair Value Liabilities Measured On Recurring Basis [Line Items]
Total liabilities		$ 60

Fair Value - Schedule of Changes in Financial Liabilities (Details) - Fair Value, Recurring - Level 3 $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($)
Contingent Consideration
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balances	$ 29,114
Changes in fair value	818
Ending balances	29,932
Put Option Liability
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balances	3,261
Additions	3,389
Reclassified to additional paid-in capital	(6,650)
Warrant Liability
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balances	372
Changes in fair value	1,252
Reclassified to additional paid-in capital	(1,624)
Contingent Value Rights
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balances	60
Changes in fair value	$ (60)

Fair Value - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		12 Months Ended
	Sep. 30, 2020	Jan. 31, 2016	Dec. 31, 2020	Dec. 31, 2019	Oct. 27, 2020	Feb. 28, 2018
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Change in contingent consideration			$ 818	$ 4,114
Put option liability			$ 3,400	3,261
Warrant, exercise price			$ 4.46
Warrants, expires period			Feb. 23, 2028
Estimated air value of warrants issued			$ 300
Warrant issued to purchase shares			103,326
Increase in value of the warrant liability			$ 1,252	$ 104
Initial Public Offering
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant, exercise price			$ 4.46
Warrant issued to purchase shares			103,326		103,326
Series F Preferred Stock
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent value rights shares		3,999
Contingent value rights		$ 500
Contingent value rights percentage		0.00375%
Net proceeds percentage of cash payment to the CVR holders		15.00%
Series F Preferred Stock \| AVEO Oncology
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Percentage of development and regulatory costs exercised using opt-out right	50.00%
2018 Notes
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Estimated air value of warrants issued						$ 300
2018 Notes \| Series G Preferred Stock
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant issued to purchase shares			613,333			613,333
Warrant, exercise price			$ 0.75
Minimum
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Percentage of probabilities of contingent consideration successful achievement of specified product gross margin targets discount rates range			12.20%
Maximum
Fair Value Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Percentage of probabilities of contingent consideration successful achievement of specified product gross margin targets discount rates range			13.50%

Property and Equipment - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 9,902	$ 8,506
Less accumulated depreciation	(6,724)	(6,386)
Total property and equipment, net	3,178	2,120
Lab Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	5,730	4,221
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,845	1,894
Computer Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	871	869
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Property and equipment, gross	424	427
Software
Property Plant And Equipment [Line Items]
Property and equipment, gross	651	503
Construction in Process
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 381	$ 592

Property and Equipment - Schedule of Depreciation Expense Related to Property and Equipment (Details) - Property and Equipment - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Property Plant And Equipment [Line Items]
Depreciation expense	$ 839	$ 819
Direct Costs and Expenses
Property Plant And Equipment [Line Items]
Depreciation expense	361	183
Sales, Marketing, General and Administrative
Property Plant And Equipment [Line Items]
Depreciation expense	$ 478	$ 636

Goodwill and Intangible Assets - Schedule of Changes in Goodwill (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
Beginning balance	$ 14,204
Attributable to acquisition of Oncimmune, Ltd.	827
Ending balance	$ 15,031

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Net Carrying Value	$ 13,186
Intangible assets, Cost	18,448	$ 18,337
Intangible assets, Accumulated Amortization	(5,188)	(3,245)
Intangible assets, Net Carrying Value	13,260	15,092
Trademarks
Finite Lived Intangible Assets [Line Items]
Intangible assets not subject to amortization, Cost	74	71
Intangible assets not subject to amortization, Net Carrying Value	74	71
Patents
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Cost	1,474	1,245
Intangible assets subject to amortization, Accumulated Amortization	(494)	(411)
Intangible assets subject to amortization, Net Carrying Value	980	834
Purchased Technology
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Cost	16,900	16,900
Intangible assets subject to amortization, Accumulated Amortization	(4,694)	(2,817)
Intangible assets subject to amortization, Net Carrying Value	$ 12,206	14,083
Purchase Option
Finite Lived Intangible Assets [Line Items]
Intangible assets subject to amortization, Cost		121
Intangible assets subject to amortization, Accumulated Amortization		(17)
Intangible assets subject to amortization, Net Carrying Value		$ 104

Goodwill and Intangible Assets - Schedule of Amortization Expense Related to Definite-Lived Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Finite Lived Intangible Assets [Line Items]
Amortization expense related to definite-lived intangible assets	$ 2,064	$ 1,974
Direct Costs and Expenses
Finite Lived Intangible Assets [Line Items]
Amortization expense related to definite-lived intangible assets	13	15
Sales, Marketing, General and Administrative
Finite Lived Intangible Assets [Line Items]
Amortization expense related to definite-lived intangible assets	$ 2,051	$ 1,959

Goodwill and Intangible Assets - Schedule of Future Estimated Amortization Expense of Intangible Assets (Details) $ in Thousands	Dec. 31, 2020 USD ($)
Finite Lived Intangible Assets Future Amortization Expense [Abstract]
2021	$ 1,946
2022	1,940
2023	1,936
2024	1,928
2025	1,924
Thereafter	3,512
Intangible assets subject to amortization, Net Carrying Value	$ 13,186

Goodwill and Intangible Assets - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Impairments of intangible assets	$ 0	$ 0

Accrued Liabilities - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Payables And Accruals [Abstract]
Compensation related accruals	$ 3,975	$ 1,165
Accrued clinical trial expense	715	620
Other expenses	3,099	2,352
Warrant liability, current		43
Total accrued liabilities	$ 7,789	$ 4,180

Debt - Summary of Long-term Notes Payable (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Apr. 30, 2020	Dec. 31, 2019	Feb. 28, 2018
Debt Instrument [Line Items]
Convertible notes payable			$ 13,159
Unamortized debt discount and debt issuance costs	$ (313)		(1,458)
Notes payable, total	27,766		35,971
Less: current maturities	11,840		12,159
Long‑term notes payable	15,926		23,812
2018 Notes
Debt Instrument [Line Items]
Notes/Loan payable	24,972		$ 24,270	$ 23,000
PPP Loan \| CARES Act
Debt Instrument [Line Items]
Notes/Loan payable	$ 3,107	$ 3,100

Debt - Additional Information (Details) - USD ($)	1 Months Ended								2 Months Ended	12 Months Ended
Debt - Additional Information (Details) - USD ($)	Oct. 31, 2020	Aug. 31, 2020	Jun. 30, 2020	Apr. 30, 2020	Mar. 31, 2020	Feb. 29, 2020	Dec. 31, 2019	Feb. 28, 2018	Sep. 30, 2019	Dec. 31, 2020
Debt Instrument [Line Items]
Estimated air value of warrants issued										$ 300,000
Estimated value of put option liability							$ 3,261,000			$ 3,400,000
Common Stock
Debt Instrument [Line Items]
Debt instrument converted to common stock										20,091
March 2020 Notes
Debt Instrument [Line Items]
Interest rate					3.00%
Convertible notes payable					$ 10,000,000.0
Convertible notes, maturity date					Aug. 31, 2020
Extended debt instrument date		Jun. 30, 2021
Percentage of conversion price per share of common stock	80.00%				80.00%
Estimated value of put option liability					$ 2,500,000
Debt instrument converted to common stock	703,503
March 2020 Notes \| Common Stock
Debt Instrument [Line Items]
Conversion price	$ 14.40
March 2020 Notes \| First Tranche
Debt Instrument [Line Items]
Convertible notes payable					$ 5,000,000.0
March 2020 Notes \| Second Tranche
Debt Instrument [Line Items]
Convertible notes payable			$ 5,000,000.0
December 2019 Notes
Debt Instrument [Line Items]
Interest rate							3.00%
Convertible notes payable							$ 6,000,000.0
Convertible notes, maturity date							Aug. 31, 2020
Extended debt instrument date		Jun. 30, 2021
Percentage of conversion price per share of common stock	80.00%						80.00%
Estimated value of put option liability							$ 1,500,000
Debt instrument converted to common stock	426,386
December 2019 Notes \| Common Stock
Debt Instrument [Line Items]
Conversion price	$ 14.40
December 2019 Notes \| First Tranche
Debt Instrument [Line Items]
Convertible notes payable							3,000,000.0
December 2019 Notes \| Second Tranche
Debt Instrument [Line Items]
Convertible notes payable						$ 3,000,000.0
August 2019 Notes
Debt Instrument [Line Items]
Interest rate									3.00%
Convertible notes payable									$ 10,000,000.0
Convertible notes, maturity date									Aug. 31, 2020
Extended debt instrument date		Jun. 30, 2021
Percentage of conversion price per share of common stock	80.00%								95.00%
Estimated value of put option liability							$ 2,500,000		$ 500,000
Debt instrument converted to common stock	718,391
Percentage of conversion price per share of preferred stock							80.00%
Increase to put option liability							$ 2,000,000.0
August 2019 Notes \| Common Stock
Debt Instrument [Line Items]
Conversion price	$ 14.40
Series H Convertible Preferred Stock \| March 2020 Notes
Debt Instrument [Line Items]
Conversion rate					80.00%
Conversion price					$ 1.15
Series H Convertible Preferred Stock \| December 2019 Notes
Debt Instrument [Line Items]
Conversion rate							80.00%
Conversion price							$ 1.15
Series H Convertible Preferred Stock \| August 2019 Notes
Debt Instrument [Line Items]
Conversion price									$ 1.15
Percentage of conversion price per share of preferred stock									95.00%
2018 Notes
Debt Instrument [Line Items]
Loan principle amount							$ 24,270,000	$ 23,000,000.0		$ 24,972,000
Facility fee amount								200,000
Estimated air value of warrants issued								$ 300,000
Interest rate								10.00%
Percentage of interest rate, paid in cash								7.50%
Percentage of interest rate added to principal value of notes payable								2.50%
Interest added to principal value							$ 1,100,000			$ 1,700,000
Frequency of periodic payment										Commencing March 2021 and continuing through the maturity date February 2023, the outstanding principal is repayable in 24 equal monthly installments.
Debt instrument, prepayment penalty								3.00%
Debt instrument, back-end facility fee								2.00%
Debt instrument, additional interest expense fee								2.00%
2018 Notes \| Minimum
Debt Instrument [Line Items]
Early amortization of loan payment schedule								24 months
2018 Notes \| Maximum
Debt Instrument [Line Items]
Early amortization of loan payment schedule								36 months
2018 Notes \| Series G Preferred Stock
Debt Instrument [Line Items]
Warrant issued to purchase shares								613,333		613,333
PPP Loan
Debt Instrument [Line Items]
Loan description										The PPP Loan matures on the two-year anniversary of the funding date, April 2022, and bears interest at a fixed rate of 1.00% per annum. Monthly principal and interest payments, less the amount of any potential forgiveness (as discussed below), will commence in September 2021. The Company did not provide any collateral or guarantees in connection with the PPP Loan, nor did the Company pay any facility charge to obtain the PPP Loan.
PPP Loan \| Interest-bearing Deposits
Debt Instrument [Line Items]
Interest rate				1.00%
PPP Loan \| CARES Act
Debt Instrument [Line Items]
Loan principle amount				$ 3,100,000						$ 3,107,000
Percentage for non-payroll costs				40.00%
Upper limit of employee salary to reduce forgiveness				$ 100,000
Percentage of upper limit of employee salary to reduce forgiveness				25.00%
PPP Loan \| Minimum \| CARES Act
Debt Instrument [Line Items]
Payroll costs excludes compensation of an employee				$ 100,000

Debt - Scheduled Principal Repayments (Maturities) of Long-term Obligations (Details) $ in Thousands	Dec. 31, 2020 USD ($)
Maturities Of Long Term Debt [Abstract]
2021	$ 11,840
2022	13,919
2023	2,320
Long-term debt	$ 28,079

Convertible Preferred Stock - Additional Information (Details) $ / shares in Units, $ in Thousands			1 Months Ended		12 Months Ended
	Oct. 27, 2020 shares	Oct. 19, 2020	Mar. 31, 2019 USD ($) $ / shares shares	Feb. 28, 2019 USD ($) $ / shares shares	Dec. 31, 2019 USD ($) $ / shares shares	Dec. 31, 2020 $ / shares shares
Class Of Stock [Line Items]
Convertible preferred stock, issued					118,766,273	0
Convertible preferred stock, par value \| $ / shares					$ 0.001	$ 0.001
Proceeds from issuance of series H preferred stock \| $					$ 10,000
Reverse stock split ratio		0.1684664
Number of preferred stock converted into common stock	20,090,745
Convertible preferred stock, outstanding					118,766,273	0
Series H Convertible Preferred Stock
Class Of Stock [Line Items]
Convertible preferred stock, issued			8,695,621	8,695,621
Convertible preferred stock, par value \| $ / shares			$ 1.15	$ 1.15
Proceeds from issuance of series H preferred stock \| $			$ 10,000	$ 10,000
Reverse stock split ratio	0.1684664
Series A-1 Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series A2 Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series A3 Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series B Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series C Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series D Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series E Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series F Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series G Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.1684664
Series B1 Convertible Preferred Stock
Class Of Stock [Line Items]
Reverse stock split ratio	0.196

Warrants to Purchase Convertible Preferred Stock - Summary of Activity for Convertible Preferred Stock Warrants (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2020 $ / shares shares
Series E Convertible Preferred Stock Warrants
Class Of Warrant Or Right [Line Items]
Outstanding ‑ December 31, 2019, warrants \| shares	925
Forfeited/canceled, warrants \| shares	(925)
Weighted average exercise price, Outstanding ‑ December 31, 2019 \| $ / shares	$ 5.00
Weighted average exercise price, Forfeited/canceled \| $ / shares	$ (5.00)
Series G Convertible Preferred Stock Warrants
Class Of Warrant Or Right [Line Items]
Outstanding ‑ December 31, 2019, warrants \| shares	613
Reclassification of warrant liability to additional paid-in capital, warrants \| shares	(613)
Weighted average exercise price, Outstanding ‑ December 31, 2019 \| $ / shares	$ 0.75
Weighted average exercise price, Reclassification of warrant liability to additional paid-in capital \| $ / shares	$ (0.75)

Warrants to Purchase Convertible Preferred Stock - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Warrants And Rights Note Disclosure [Abstract]
Warrants to purchase shares of common stock	103,326
Warrant, exercise price	$ 4.46
Warrants expiry date	Feb. 29, 2028
Change in fair value of warrant liability	$ 1,252	$ 104

Equity - Additional Information (Details) - USD ($)		12 Months Ended
Equity - Additional Information (Details) - USD ($)	Oct. 27, 2020	Dec. 31, 2020	Oct. 31, 2020	Dec. 31, 2019
Class Of Stock [Line Items]
Common stock, authorized		200,000,000	200,000,000	190,000,000
Common stock, par value		$ 0.001	$ 0.001	$ 0.001
Common stock, voting rights		The holder of each share of common stock is entitled to one vote per share.
Dividends		$ 0
Proceeds from initial public offering		$ 72,000,000
Preferred stock, authorized		5,000,000	5,000,000	0
Preferred stock, par value		$ 0.001	$ 0.001	$ 0.001
Preferred stock, issued		0		0
Preferred stock, outstanding		0		0
Initial Public Offering
Class Of Stock [Line Items]
Shares of common stock issued and sold	4,000,000
Common stock price per share	$ 18.00
Proceeds from initial public offering	$ 63,800,000
Underwriting discounts and commissions	5,000,000.0
Direct offering expenses	$ 3,200,000

Revenue - Summary of Revenue (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Disaggregation Of Revenue [Line Items]
Revenues	$ 45,557	$ 24,552
Diagnostic Tests
Disaggregation Of Revenue [Line Items]
Revenues	40,919	17,315
Services
Disaggregation Of Revenue [Line Items]
Revenues	$ 4,638	$ 7,237

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
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+ Details

Revenue - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Jan. 01, 2020
Disaggregation Of Revenue [Line Items]
Revenues	$ 45,557	$ 24,552
Revenue recognized	700
Deferred revenue	3,532	$ 1,283
Deferred Revenue
Disaggregation Of Revenue [Line Items]
Advance deposits	3,500		$ 1,300
COVID-19 Test Revenue
Disaggregation Of Revenue [Line Items]
Revenues	28,300
Lung Diagnostic Revenue
Disaggregation Of Revenue [Line Items]
Revenues	$ 12,600

- Definition

+ References

+ Details

Share Based Compensation - Additional Information (Details) $ / shares in Units, $ in Thousands		12 Months Ended
	Jan. 01, 2019 $ / shares shares	Dec. 31, 2020 USD ($) Installment $ / shares shares	Dec. 31, 2019 USD ($) shares	Oct. 31, 2020 shares	Feb. 29, 2016 shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of performance-condition options granted		828,000
Exercise price \| $ / shares		$ 2.81
Number of outstanding stock options granted		2,321,000	1,916,000
Remaining life of outstanding performance condition options		7 years 4 months 24 days	7 years 7 months 6 days
Intrinsic value \| $		$ 42,580
Stock compensation expense \| $		$ 3,709	$ 170
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
RSUs outstanding		79,104
Weighted average grant date fair value \| $ / shares		$ 6.83
Bonus-To-Options Program
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Intrinsic value \| $		$ 1,600
Stock compensation expense \| $		3,400
Options and Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized remaining stock based compensation balance \| $		$ 600
Amortization period		3 years 8 months 12 days
Service Condition R S Us
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting term		vest over three years, 40% over the first two years and the remaining 60% over the third year from the grant date.
Number of RSUs granted		52,736
Service Condition R S Us \| Share-based Payment Arrangement, Tranche One
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting percentage		40.00%
Service Condition R S Us \| Share-based Payment Arrangement, Tranche Two
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting percentage		60.00%
Maximum \| Bonus-To-Options Program
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Option expiration period		10 years
Number of outstanding stock options granted		173,229
Percentage of fully diluted equity for bonus awarded		1.00%
Weighted average exercise price,vested \| $ / shares		$ 11.11
Minimum \| Service Condition R S Us
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		3 years
2020 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares reserved for issuance		1,893,395
2020 Equity Incentive Plan \| Performance Condition Options
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Option expiration period	10 years
Vesting term		Performance-based options vest in three equal annual installments beginning one year after the grant date
Number of equal annual installments for award vesting \| Installment		3
Number of performance-condition options granted	168,466
Exercise price \| $ / shares	$ 0.77
Options vested		56,155
Options forfeited			56,155
Number of outstanding stock options granted		56,156
Remaining life of outstanding performance condition options		8 years
2020 Equity Incentive Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Option expiration period		10 years
2020 Equity Incentive Plan \| Minimum \| Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period		3 years
2020 Equity Incentive Plan \| Common Stock
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Percentage of number of shares of common stock issued and outstanding		4.00%
2020 Equity Incentive Plan \| Common Stock \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of common stock may be issued under incentive plan		1,893,395
2006 Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares authorized		831,389
2016 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Additional stock awards granted					0
2016 Plan \| Maximum
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares authorized					1,431,964
2006 Plan, 2016 Plan and 2020 Equity Incentive Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Additional stock awards granted		4,647,380
Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of shares reserved for issuance				338,106
Percentage of number of shares of common stock issued and outstanding		1.00%
Percentage of earnings used for purchase of common stock		15.00%
Percentage of fair market value of common stock for purchase under plan		85.00%
Description of voting power or value of stock for employee participation in offering period		No employee may participate in an offering period if the employee owns 5% or more of the total combined voting power or value of the Company’s stock.
Description of offering period under plan		The initial offering period will commence from January 1, 2021 through August 31, 2021. On a going forward basis, the ESPP provides for successive six-month offering periods beginning on September 1st and March 1st of each year.

Share Based Compensation - Summary of Pre-tax Share-based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total pre-tax share-based compensation expense	$ 3,709	$ 170
Research and Development
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total pre-tax share-based compensation expense	589	33
Sales, Marketing, General and Administrative
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total pre-tax share-based compensation expense	$ 3,120	$ 137

Share Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Options, Outstanding ‑ December 31, 2019	1,916
Stock Options, Granted	828
Stock Options, Forfeited/canceled	(55)
Stock Options, Exercised	(368)
Stock Options, Outstanding ‑ December 31, 2020	2,321	1,916
Stock Options, Exercisable ‑ December 31, 2020	1,190
Weighted Average Exercise Price, Outstanding ‑ December 31, 2019	$ 1.72
Weighted Average Exercise Price, Granted	2.81
Weighted Average Exercise Price, Forfeited/canceled	0.60
Weighted Average Exercise Price, Exercised	3.65
Weighted Average Exercise Price, Outstanding ‑ December 31, 2020	1.82	$ 1.72
Weighted Average Exercise Price, Exercisable ‑ December 31, 2020	$ 2.35
Weighted Average Contractual Life (Years), Outstanding - December 31, 2019	7 years 4 months 24 days	7 years 7 months 6 days
Weighted Average Contractual Life (Years), Granted	0 years
Weighted Average Contractual Life (Years), Exercisable ‑ December 31, 2020	6 years 3 months 18 days
Aggregate Intrinsic Value, Outstanding - December 31, 2020	$ 42,580
Aggregate Intrinsic Value, Outstanding - Exercisable ‑ December 31, 2020	$ 21,194

Share Based Compensation - Summary of Weighted Average Assumptions (Details)	12 Months Ended
	Dec. 31, 2020
Share Based Compensation Arrangement By Share Based Payment Award Fair Value Assumptions And Methodology [Abstract]
Risk‑free rate	0.34%
Expected term (in years)	5 years 8 months 23 days
Expected volatility	77.00%

Earnings per Share - Schedule of Computation of Basic and Diluted Net Loss per Share Attributable to Common Stockholders (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Numerator
Net loss attributable to common stockholders	$ (31,350)	$ (30,726)
Denominator
Weighted-average shares outstanding, basic and diluted	4,838	242
Net loss per share, basic and diluted	$ (6.48)	$ (126.97)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

Earnings per Share - Schedule of Common Stock Equivalents Excluded from Diluted Net Loss Attributable to Common Stockholders (Details) - shares shares in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	2,677	144,056
Convertible Preferred Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total		119,257
Options to Purchase Common Stock
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	2,495	2,104
Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	103	1,538
Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total	79	26
Convertible Debt
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Total		21,131

Income Taxes - Additional Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Provision for income taxes	$ 0
Net operating loss carryforwards	233,600,000
Research and experimentation tax carryforwards	$ 3,600,000
Description of tax credit carryforward expiration	expire beginning in 2026
Valuation allowance, deferred tax asset, explanation of change	Company does not believe it is more likely than not that it will realize the benefits of net deferred tax assets and, accordingly, has established a valuation allowance equal to 100% of net deferred tax assets.
Percentage of valuation allowance equal to net deferred tax assets	100.00%
Increase in valuation allowance	$ 4,900,000	$ 7,000,000.0
Accrued interest related to uncertain tax positions	$ 0	$ 0
Income tax examination details	All years will remain open for examining by federal and state authorities for three and four years, respectively, from the date of utilization of any net operating loss carryforwards.

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Federal statutory income tax rate	21.00%	21.00%
State income taxes, net of federal benefit	2.00%	4.00%
Research and developments credits	(1.00%)	2.00%
Permanent items	(6.00%)	(4.00%)
Change in valuation allowance	(16.00%)	(23.00%)

Income Taxes - Schedule of Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Deferred Tax Assets:
Net operating loss carryforwards	$ 53,128	$ 50,360
Research and development tax credits	2,860	3,040
Property and equipment	279	370
Stock-based compensation	865
Accruals and reserves	1,406	286
Total	58,538	54,056
Valuation allowance	(56,083)	(51,135)
Total deferred tax assets after valuation allowance	2,455	2,921
Deferred Tax Liabilities:
Intangible assets	(2,455)	(2,921)
Total deferred tax liabilities	$ (2,455)	$ (2,921)

Income Taxes - Reconciliation of Unrecognized Tax Benefits (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($)
Reconciliation Of Unrecognized Tax Benefits Excluding Amounts Pertaining To Examined Tax Returns Roll Forward
Additions for tax positions related to the current year	$ 106
Additions for tax positions related to prior years	609
Balance at December 31	$ 715

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Thousands		1 Months Ended		12 Months Ended
	Dec. 02, 2020	Sep. 30, 2020	Aug. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Oct. 31, 2020
Loss Contingencies [Line Items]
Rent expense				$ 1,700	$ 2,100
Research and development				$ 10,818	10,468
Revenue Share Agreement \| Oncimmune Limited
Loss Contingencies [Line Items]
Percentage of revenue share payment related to acquired diagnostic test recognized revenue for non-screening tests				8.00%
Minimum annual volume percentage thereafter				5.00%
Period of escalations of sales				through the first four years of sales
Revenue share expenses				$ 300
Bio-Rad License
Loss Contingencies [Line Items]
Percentage of royalty payments on net revenue			2.50%
License expiry date			2024-08
Royalty expense				100	100
AVEO Oncology
Loss Contingencies [Line Items]
Remaining estimated obligation	$ 300
Research and development				$ 900	$ 900
AVEO Oncology \| NSCLC POC Trial
Loss Contingencies [Line Items]
Responsible percentage of development and regulatory costs						50.00%
Ficlatuzumab \| AVEO Oncology
Loss Contingencies [Line Items]
Percentage of development and regulatory costs exercised using opt-out right		50.00%
Percentage of royalty payments on net sales	10.00%
Percentage of license income generated from licensing	25.00%
BDX004 \| Ficlatuzumab \| AVEO Oncology \| POC Clinical Trials
Loss Contingencies [Line Items]
Responsible percentage of development and regulatory costs						50.00%

Commitments and Contingencies - Summary of Future Minimum Lease Payments for Operating Lease Obligations (Details) $ in Thousands	Dec. 31, 2020 USD ($)
Leases [Abstract]
2021	$ 703
2022	724
2023	112
Total	$ 1,539

Defined Contribution 401(k) Plan - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Compensation And Retirement Disclosure [Abstract]
Defined contribution plan, employer discretionary contributions amount	$ 0	$ 0
Defined Contribution Plan, Plan Name [Extensible List]	bdsx:FourZeroOneKPlanMember	bdsx:FourZeroOneKPlanMember