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Summary of Significant Accounting Policies (Tables) | 12 Months Ended
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Dec. 31, 2020
Accounting Policies [Abstract] |
Schedule of accounts receivable and allowance for doubtful accounts |
|  | Years Ended December 31, 2020, 2019 and 2018
December 31, 2020 |  | Balance at Beginning of Period |  | ASU 2016-13 Adoption Adjustment |  | Charged to Revenue |  | Charged to Costs and Expenses |  | Write-offs |  | Utilization |  | Balance at End of Period
Allowance for doubtful accounts |  | $ | 2,771 |  | $ | 1,169 |  | $ | — |  | $ | 5,562 |  | $ | — |  | $ | — |  | $ | 9,502
Allowance for service changes and cancellations(1) |  |  | 3,549 |  |  | — |  |  | 13,349 |  |  | — |  |  | — |  |  | (10,201) |  |  | 6,697
|  |  | 6,320 |  |  | 1,169 |  |  | 13,349 |  |  | 5,562 |  |  | — |  |  | (10,201) |  |  | 16,199
December 31, 2019 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Allowance for doubtful accounts |  | $ | 1,175 |  | $ | — |  | $ | — |  | $ | 1,606 |  | $ | (10) |  | $ | — |  | $ | 2,771
Allowance for service changes and cancellations(1) |  |  | 2,311 |  |  | — |  |  | 7,742 |  |  | — |  |  | — |  |  | (6,504) |  |  | 3,549
|  |  | 3,486 |  |  | — |  |  | 7,742 |  |  | 1,606 |  |  | (10) |  |  | (6,504) |  |  | 6,320
December 31, 2018 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Allowance for doubtful accounts |  | $ | 590 |  | $ | — |  | $ | — |  | $ | 824 |  | $ | (239) |  | $ | — |  | $ | 1,175
Allowance for service changes and cancellations(1) |  |  | 500 |  |  | — |  |  | 3,414 |  |  | — |  |  | — |  |  | (1,603) |  |  | 2,311
|  |  | 1,090 |  |  | — |  |  | 3,414 |  |  | 824 |  |  | (239) |  |  | (1,603) |  |  | 3,486
| (1) |  | Represents the allowance released as a result of the cancellation or adjustment to an authorized fertility benefits service treatment.

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- Definition Tabular disclosure of allowance for credit loss on accounts receivable. + References Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef -Publisher FASB -Name Accounting Standards Codification -Topic 326 -SubTopic 20 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=121599337&loc=SL82919249-210447 + Details
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