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Summary of Significant Accounting Policies (Tables)
12 Months Ended
Dec. 31, 2020
Accounting Policies [Abstract]  
Schedule of Changes in Allowance for Doubtful Accounts
The following table presents the changes in the allowance for doubtful accounts (in thousands):
Year ended December 31,
202020192018
Balance, beginning of year$9,049 $7,296 $4,486 
Add: adoption of ASC 326461 — — 
Add: provision for doubtful accounts10,515 9,129 7,353 
Less: write-offs, net of recoveries and other adjustments(7,314)(7,376)(4,543)
Balance, end of year$12,711 $9,049 $7,296 
Schedule of Changes in Contractual Allowance
The following table presents the changes in the contractual allowance (in thousands):
Year ended December 31,
202020192018
Balance, beginning of year$15,433 $9,205 $6,345 
Add: allowance for contractual adjustments20,916 15,518 9,095 
Less: contractual adjustments(15,068)(9,290)(6,235)
Balance, end of year$21,281 $15,433 $9,205 
Disaggregated Revenue by Payor Type and Major Service Line
The Company disaggregates revenue from contracts with customers by payor type. The Company believes these categories aggregate the payor types by nature, amount, timing and uncertainty of its revenue streams. Disaggregated revenue by payor type and major service line for the years ended December 31, 2020 and December 31, 2019 were as follows (in thousands):
Year Ended December 31,
202020192018
Contracted third-party payors$135,939 $101,845 $56,949 
Non-contracted third-party payors15,295 10,770 12,447 
Centers for Medicare & Medicaid72,536 58,918 40,482 
Healthcare institutions41,396 43,019 37,399 
Total$265,166 $214,552 $147,277 
Schedule of Impact of Adoption of ASU 2014-09 on Financial Statements
The following table presents the impact of adoption of ASU 2014-09 on the Consolidated Statement of Operations and the Consolidated Balance Sheet (in thousands):

Year Ended December 31, 2018
Consolidated Statement of Operations Impact:As ReportedWithout the adoption of Topic 606Impact
Revenue$147,293 $145,320 $1,973 
Sales, General & Administrative Expense$131,582 $132,603 $(1,021)
Net Loss$(48,280)$(51,274)$2,994 
Year Ended December 31, 2018
Consolidated Balance Sheet Impact:As ReportedWithout the adoption of Topic 606Impact
Accounts Receivable, net$21,977 $17,629 $4,348 
Accumulated Deficit$(203,515)$(207,863)$4,348