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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Mar. 31, 2023
Dec. 31, 2022
Mar. 31, 2022
Dec. 31, 2021
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 14,271 $ 18,948 $ 17,326 $ 17,210
Accrued charges for third-party testing 13,707 17,036    
Testing and laboratory materials from suppliers 15,203 13,281    
Marketing and corporate affairs 7,604 8,943    
Legal, audit and consulting fees 21,793 36,710    
Accrued shipping charges 1,004 485    
Sales and income tax payable 5,091 4,319    
Accrued third-party service fees 10,184 6,631    
Clinical trials and studies 11,373 23,301    
Operating lease liabilities, current portion 9,308 7,639    
Property and equipment purchases 1,777 1,821    
Other accrued interest 2,695 1,078    
Other accrued expenses 4,628 4,022    
Total other accrued liabilities $ 118,638 $ 144,214