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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Mar. 31, 2024
Dec. 31, 2023
Mar. 31, 2023
Dec. 31, 2022
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 18,023 $ 23,245 $ 14,271 $ 18,948
Accrued charges for third-party testing 13,167 14,823    
Testing and laboratory materials from suppliers 17,880 11,229    
Marketing and corporate affairs 9,688 10,085    
Short term advances 7,050      
Legal, audit and consulting fees 34,141 43,897    
Accrued shipping charges 1,652 3,646    
Sales and income tax payable 4,329 3,731    
Accrued third-party service fees 7,764 7,111    
Clinical trials and studies 6,961 12,126    
Operating lease liabilities, current portion 11,957 11,621    
Property and equipment purchases 4,429 4,316    
Other accrued interest 2,695 1,078    
Other accrued expenses 2,492 2,497    
Total other accrued liabilities $ 142,228 $ 149,405