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Stock Incentive Plans
 3 Months Ended
Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]  
Stock Incentive Plans STOCK INCENTIVE PLANS
Stock Options and Restricted Stock Units (“RSU”)
The following table summarizes option and RSU activity under the Company’s 2014 Equity Incentive Plan, 2016 Inducement Equity Incentive Plan and 2019 Inducement Equity Incentive Plan, and related information:
Shares
Available
for Grant		Stock
Options
Outstanding		Weighted-
Average
Exercise
Price		Number of
RSU Shares		Weighted-
Average
Grant Date
Fair Value
Balance—December 31, 2023869,111 3,055,208 $25.21 5,006,775 $19.02 
Additional shares authorized2,060,135 — — — — 
Common stock awards for services(6,813)— — — — 
RSUs granted(2,716,211)— — 2,716,211 9.36 
RSUs vested— — — (319,737)27.50 
Options granted— — — — — 
Options exercised— (1,501)5.63 — — 
Repurchase of common stock under employee incentive plans65,601 — — — — 
RSUs forfeited158,348 — — (158,348)18.56 
Options forfeited13,190 (13,190)28.32 — — 
Options expired66,475 (66,475)30.46 — — 
Balance—March 31, 2024509,836 2,974,042 $25.08 7,244,901 $15.17 
The total intrinsic value of options exercised was less than $0.1 million for each of the three months ended March 31, 2024 and 2023.
As of March 31, 2024, the total intrinsic value of outstanding RSUs was approximately $78.5 million and there were $63.9 million of unrecognized compensation costs related to RSUs, which are expected to be recognized over a weighted-average period of 2.28 years.
The Company granted performance restricted stock units ("PSUs"), included in RSUs, under the 2014 Plan. The PSUs granted to employees consist of financial and operational metrics to be met over a performance period of 2 years. The number of shares outstanding was 412,843 and 472,116 as of March 31, 2024 and 2023, respectively. The weighted-average remaining recognition period was 0.84 years and 1.74 years for the three months ended March 31, 2024 and 2023, respectively.
Options outstanding that have vested and are expected to vest at March 31, 2024 are as follows:
Number of Shares Issued
(In thousands)		Weighted-Average
Exercise Price		Weighted-Average Remaining Contractual Life (Years)Aggregate Intrinsic Value
(In thousands)
Vested1,982 $25.24 6.53$1,483 
Expected to vest921 24.58 8.38172 
Total2,903 $1,655 

The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock at March 31, 2024 for stock options that were in-the-money.
The total fair value of options that vested during the three months ended March 31, 2024 was $3.7 million. As of March 31, 2024, there were approximately $14.7 million of unrecognized compensation costs related to stock options, which are expected to be recognized over a weighted-average period of 2.11 years.
2014 Employee Stock Purchase Plan
The Company has an Employee Stock Purchase Plan (the “ESPP”), under which employees can purchase shares of its common stock based on a percentage of their compensation, but not greater than 15% of their respective earnings; provided, however, an eligible employee’s right to purchase shares of the Company’s common stock may not accrue at a rate which exceeds $25,000 of the fair market value of such shares for each calendar year in which such rights are outstanding. The ESPP has consecutive offering periods of approximately six months in length. The purchase price per share must be equal to the lower of 85% of the fair value of the common stock on the first day of the offering period or on the exercise date.
During the offering period in 2023 that ended on December 31, 2023, 73,759 shares were purchased pursuant to the ESPP for aggregate proceeds of $0.5 million from the issuance of such shares, which occurred on January 2, 2024. 
Valuation Assumptions
The estimated fair values of employee stock options and ESPP shares were estimated using the Black-Scholes option pricing model based on the following weighted average assumptions:
Three Months Ended March 31,
20242023
Employee stock options
Expected term (in years)N/A6.0
Expected volatilityN/A78.63%
Risk-free interest rateN/A3.46%
Expected dividend yieldN/A—%
Employee stock purchase plan
Expected term (in years)0.50.5
Expected volatility75.91%77.88%
Risk-free interest rate5.38%4.94%
Expected dividend yield—%—%
Risk-free Interest Rate: The Company based the risk-free interest rate over the expected term of the award based on the constant maturity rate of U.S. Treasury securities with similar maturities as of the date of grant.
Volatility: The Company used an average historical stock price volatility of its own stock.
Expected Term: The expected term represents the period for which the Company’s stock-based compensation awards are expected to be outstanding and is based on analyzing the vesting and contractual terms of the awards and the holders’ historical exercise patterns and termination behavior.
Expected Dividends: The Company has not paid and does not anticipate paying any dividends in the near future.
Stock-Based Compensation Expense
The following table summarizes stock-based compensation expense relating to employee and non-employee stock-based awards for the three months ended March 31, 2024 and 2023, included in the condensed consolidated statements of operations as follows (in thousands):
Three Months Ended March 31,
20242023
Cost of testing services$457 $479 
Cost of product317 360 
Cost of patient and digital solutions372 402 
Research and development1,760 1,962 
Sales and marketing3,044 3,737 
General and administrative7,394 6,814 
Total$13,344 $13,754 
No tax benefit was recognized related to stock-based compensation expense since the Company has never reported taxable income and has established a full valuation allowance to offset all of the potential tax benefits associated with its deferred tax assets. In addition, no amounts of stock-based compensation expense were capitalized for the periods presented.