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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2023
Sep. 30, 2022
Cash flows from operating activities    
Net loss $ (84,707) $ (95,957)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 11,434 9,930
Stock-based compensation 53,358 41,946
Amortization of premium and accretion of discounts, net (3,627) 216
Provision for doubtful accounts and contractual allowances 51,655 43,778
Amortization of operating lease right-of-use assets 4,243 4,865
Impairment charges 0 23,164
Other (366) 230
Changes in operating assets and liabilities:    
Accounts receivable (51,804) (57,882)
Inventory 1,885 (4,375)
Prepaid expenses and other current assets (1,549) 2,367
Other assets (21,796) (4,099)
Accounts payable (305) (3,105)
Accrued liabilities 10,910 8,072
Deferred revenue 332 (46)
Operating lease liabilities (3,792) (4,692)
Net cash used in operating activities (34,129) (35,588)
Cash flows from investing activities    
Purchases of property and equipment (26,907) (22,737)
Purchases of marketable securities (109,202) (137,548)
Sales of marketable securities 0 34,965
Maturities of marketable securities 136,500 81,000
Purchase of strategic investment (3,000) 0
Net cash used in investing activities (2,609) (44,320)
Cash flows from financing activities    
Payment of loans 0 (21,389)
Proceeds from term loan 0 35,000
Proceeds from issuance of common stock in connection with employee equity incentive plans 5,352 10,034
Payments of issuance costs for long-term debt 0 (77)
Net cash provided by financing activities 5,352 23,568
Effect of exchange rate changes 32 0
Net decrease in cash and cash equivalents (31,354) (56,340)
Cash and cash equivalents, beginning of period 78,832 127,562
Cash and cash equivalents, end of period 47,478 71,222
Supplemental disclosures of cash flow information:    
Interest paid 2,186 2,676
Cash taxes paid 794 0
Cash received from tenant improvement allowances 1,603 0
Non-cash investing and financing activities:    
Property and equipment included in accounts payable and accrued liabilities 89 1,179
Right-of-use assets obtained in exchange for operating lease liabilities 4,520 7,666
Capitalized stock-based compensation in property and equipment $ 5,596 $ 4,306