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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Jun. 30, 2024
Dec. 31, 2023
Jun. 30, 2023
Dec. 31, 2022
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 16,465 $ 23,245 $ 15,480 $ 18,948
Accrued charges for third-party testing 10,574 14,823    
Testing and laboratory materials from suppliers 14,142 11,229    
Marketing and corporate affairs 11,792 10,085    
Short term advances 13,899      
Legal, audit and consulting fees 31,979 43,897    
Accrued shipping charges 1,800 3,646    
Sales and income tax payable 4,053 3,731    
Accrued third-party service fees 8,173 7,111    
Clinical trials and studies 7,502 12,126    
Operating lease liabilities, current portion 12,384 11,621    
Property and equipment purchases 5,330 4,316    
Other accrued interest 1,078 1,078    
Other accrued expenses 2,060 2,497    
Total other accrued liabilities $ 141,231 $ 149,405