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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Cash flows from operating activities      
Net loss $ (116,155) $ (101,361) $ (43,830)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization 13,405 9,842 6,900
Stock-based compensation 57,740 54,527 41,515
Amortization of premium and accretion of discounts on investments, net (474) 1,641 430
Provision for doubtful accounts and contractual allowances 58,349 37,074 31,431
Amortization of operating lease right-of-use assets 6,204 6,752 6,030
Impairment charges 23,164 0 0
Other 264 0 0
Changes in operating assets and liabilities:      
Accounts receivable (61,837) (53,572) (37,957)
Inventory (5,108) (4,960) (1,389)
Prepaid expenses and other current assets (862) (2,329) (3,027)
Other assets (6,200) (1,831) (6,149)
Accounts payable (2,993) 6,135 (3,881)
Accrued liabilities 14,473 7,946 1,308
Deferred revenue 2 2,119 (321)
Operating lease liabilities (6,263) (2,087) (4,819)
Reimbursement of tenant improvement allowance 3,279 2,351 0
Net cash used in operating activities (23,012) (37,753) (13,759)
Cash flows from investing activities      
Purchases of property and equipment (29,830) (28,067) (13,551)
Purchases of short-term investments (188,569) (122,184) (277,510)
Sales of short-term investments 34,965 0 14,525
Maturities of short-term investments 131,000 255,515 144,145
Net cash (used in) provided by investing activities (52,434) 105,264 (132,391)
Cash flows from financing activities      
Payment of loans (21,389) (11,667) (1,944)
Proceeds from term loans 35,000 0 0
Issuance of common stock in connection with follow-on public offering, net 0 0 206,025
Proceeds from issuance of common stock in connection with employee equity incentive plans 13,182 8,943 20,244
Tax withholding upon vesting of restricted stock awards 0 (25,853) (10,009)
Payment of issuance costs for long-term debt (77) 0 0
Net cash provided by (used in) financing activities 26,716 (28,577) 214,316
Net (decrease) increase in cash and cash equivalents (48,730) 38,934 68,166
Cash and cash equivalents, beginning of year 127,562 88,628 20,462
Cash and cash equivalents, end of year 78,832 127,562 88,628
Supplemental disclosures of cash flow information:      
Interest paid 3,317 1,194 1,502
Cash taxes paid 287 0 0
Non-cash investing and financing activities:      
Property and equipment costs included in accounts payable and accrued liabilities 160 9 3
Right-of-use assets obtained in exchange for operating lease liabilities 7,686 6,625 621
Capitalized stock-based compensation $ 5,863 $ 3,593 $ 1,129