View Filing Data

Print Document View Excel Document

Document and Entity Information - USD ($) $ / shares in Units, $ in Billions	12 Months Ended
	Dec. 31, 2019	Feb. 28, 2020
Cover [Abstract]
Entity Central Index Key	0001551306
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2019
Document Transition Report	false
Entity File Number	001-39100
Entity Registrant Name	Progyny, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-2220139
Entity Address, Address Line One	1359 Broadway
Entity Address, City or Town	New York
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	10018
City Area Code	212
Local Phone Number	888-3124
Title of 12(b) Security	Common Stock,$0.0001 par value per share
Trading Symbol	PGNY
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Shell Company	false
Entity Public Float	$ 1.1
Entity Common Stock, Shares Outstanding		84,838,934
Entity Listing, Par Value Per Share	$ 0.0001
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	FY
Amendment Flag	false

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 80,382	$ 127
Accounts receivable, net of $6,320 and $3,486 of allowances at December 31, 2019 and December 31, 2018, respectively	47,059	23,325
Prepaid expenses and other current assets	5,003	885
Assets of discontinued operations, current		200
Total current assets	132,444	24,537
Property and equipment, net	3,083	776
Goodwill	11,880	11,880
Intangible assets, net	2,375	3,859
Other assets	652	272
Total assets	150,434	41,324
Current liabilities:
Accounts payable	19,388	15,578
Accrued expenses and other current liabilities	16,775	9,782
Convertible preferred stock warrant liabilities		4,589
Short term debt		253
Total current liabilities	36,163	30,202
Total liabilities	36,163	30,202
Commitments and Contingencies (Note 11)
Convertible preferred stock (Note 12), $0.0001 par value; 100,000,000 and 314,930,070 shares authorized as of December 31, 2019 and December 31, 2018; zero and 65,428,088 shares issued and outstanding at December 31, 2019 and December 31, 2018, respectively; aggregate liquidation preference of $0 and $106,369 as of December 31, 2019 and December 31, 2018, respectively		106,237
STOCKHOLDERS' EQUITY (DEFICIT)
Common stock, $0.0001 par value; 1,000,000,000 shares authorized at December 31, 2019 and 417,000,000 at December 31, 2018; 84,188,202 and 5,155,407 shares issued and outstanding at December 31, 2019 and December 31, 2018, respectively	8	1
Additional paid-in capital	228,755	10,622
Treasury stock, at cost, $0.0001 par value; 615,980 shares outstanding at December 31, 2019 and 589,320 at December 31, 2018	(1,009)	(884)
Accumulated deficit	(113,483)	(104,854)
Total stockholders' equity (deficit)	114,271	(95,115)
Total liabilities, convertible preferred stock, and stockholders' equity (deficit)	$ 150,434	$ 41,324

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Allowances for accounts receivable
Allowances for accounts receivable	$ 6,320	$ 3,486
Convertible preferred stock
Convertible preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Convertible preferred stock, shares authorized (in shares)	100,000,000	314,930,070
Convertible preferred stock, shares issued (in shares)	0	65,428,088
Convertible preferred stock, shares outstanding (in shares)	0	65,428,088
Convertible preferred stock, aggregate liquidation preference	$ 0	$ 106,369
Common stock
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized (in shares)	1,000,000,000	417,000,000
Common stock, shares issued (in shares)	84,188,202	5,155,407
Common stock, shares outstanding (in shares)	10,046,705	5,155,407
Treasury stock
Treasury stock, shares outstanding (in shares)	615,980	589,320

Consolidated Statements of Operations and Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Condensed Consolidated Statements of Operations and Comprehensive Loss
Revenue	$ 229,683	$ 105,400	$ 48,584
Revenue, type	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember
Cost of services	$ 184,178	$ 85,966	$ 41,184
Cost of services, type	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember
Gross profit	$ 45,505	$ 19,434	$ 7,400
Operating expenses:
Sales and marketing	11,901	7,285	4,258
General and administrative	23,927	15,601	14,147
Total operating expenses	35,828	22,886	18,405
Income (loss) from continuing operations	9,677	(3,452)	(11,005)
Other expense:
Interest expense, net	(58)	(497)	(740)
Convertible preferred stock warrant valuation adjustment	(18,176)	(2,944)	(714)
Total other expense, net	(18,234)	(3,441)	(1,454)
Loss from continuing operations, before tax	(8,557)	(6,893)	(12,459)
Benefit (provision) for income taxes	(12)	1,777	3
Net loss from continuing operations	(8,569)	(5,116)	(12,456)
Net income from discontinued operations, net of taxes		5,777	4
Net (loss) income	(8,569)	661	(12,452)
Comprehensive (loss) income	(8,569)	661	(12,452)
Net loss attributable to common stockholders	$ (8,569)	$ (5,541)	$ (13,468)
Basic and Diluted
Continuing operations (in dollars per share)	$ (0.41)	$ (1.00)	$ (2.37)
Discontinued operations (in dollars per share)		1.04
Total net loss per share attributable to common stockholders basic and diluted (in dollars per share)	$ (0.41)	$ 0.04	$ (2.37)
Weighted-average shares used in computing net (loss) earnings per share:
Basic and Diluted (in shares)	20,735,202	5,539,739	5,677,860

Consolidated Statements of Changes in Convertible Preferred Stock - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Increase (Decrease) in Convertible Preferred Stock
Balance at beginning of period	$ 106,237	$ 108,312
Balance at beginning of period (in shares)	65,428,088	66,630,284
Repurchase of convertible preferred		$ (2,075)
Repurchase of convertible preferred (in shares)		(1,202,196)
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering	$ (106,237)
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering (in shares)	(65,428,088)
Balance at end of period		$ 106,237
Balance at end of period (in shares)	0	65,428,088

Consolidated Statements of Changes in Stockholders' Deficit - USD ($) $ in Thousands	Common Stock	Treasury Stock	Additional Paid in Capital	Accumulated Deficit	Total
Balance at beginning of period at Dec. 31, 2017	$ 1		$ 6,933	$ (104,556)	$ (97,622)
Balance at beginning of period (in shares) at Dec. 31, 2017	5,690,083
Increase (Decrease) in Stockholders’ Equity
Repurchase of convertible preferred stock				(425)	(425)
Repurchase of common stock		$ (884)		(321)	(1,205)
Repurchase of common stock (in shares)	(589,321)
Non-cash contribution			414		414
Stock option exercise			65		65
Options exercised (in shares)	54,645
Stock-based compensation			2,997		2,997
Impact of adoption of 2016- 09			213	(213)
Net loss				661	661
Balance at end of period at Dec. 31, 2018	$ 1	(884)	10,622	(104,854)	$ (95,115)
Balance at end of period (in shares) at Dec. 31, 2018	5,155,407				5,155,407
Increase (Decrease) in Stockholders’ Equity
Repurchase of common stock		(125)		(60)	$ (185)
Repurchase of common stock (in shares)	(26,659)
Stock option exercise			6,536		$ 6,536
Options exercised (in shares)	6,490,059				6,490,059
Stock-based compensation			5,061		$ 5,061
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering	$ 7		106,230		106,237
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering (in shares)	65,428,088
Conversion of convertible Preferred Stock Warrants to common stock warrants upon initial public offering			22,765		22,765
Warrant exercise			62		62
Warrant exercise (in shares)	441,307
Issuance of Common Stock in connection with initial public offering, net of issuance costs of $5.9 million and $3.7 million in offering costs			77,479		77,479
Issuance of Common Stock in connection with initial public offering, net of issuance costs of $5.9 million and $3.7 million in offering costs (in shares)	6,700,000
Net loss				(8,569)	(8,569)
Balance at end of period at Dec. 31, 2019	$ 8	$ (1,009)	$ 228,755	$ (113,483)	$ 114,271
Balance at end of period (in shares) at Dec. 31, 2019	84,188,202				10,046,705

Consolidated Statements of Changes in Stockholders' Deficit (Parenthetical) $ in Millions	12 Months Ended
	Dec. 31, 2019 USD ($)
Statement of Stockholders' Equity [Abstract]
Issuance costs	$ 5.9
Offering costs	$ 3.7

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
OPERATING ACTIVITIES
Net (loss) income	$ (8,569)	$ 661	$ (12,452)
Less: Income from discontinued operations, net of income tax		(5,777)	(4)
Adjustments to reconcile net (loss) income to net cash provided by (used in) operating activities:
Deferred tax expense (benefit)	12	(1,777)	(3)
Loss on debt extinguishment		88
Depreciation and amortization	2,133	1,883	1,559
Stock-based compensation expense	5,061	2,997	1,559
Bad debt expense	1,606	824	431
Loss on disposal of property and equipment	1		2
Accretion of debt discount and debt issuance costs		75	200
Change in fair value of warrant liabilities	18,176	2,944	714
Changes in operating assets and liabilities:
Accounts receivable	(25,342)	(12,776)	(2,044)
Prepaid expenses and current other assets	(4,118)	(179)	(198)
Other assets	(380)	100	(279)
Accounts payable	3,501	10,448	(909)
Accrued expenses and other current liabilities	6,385	2,761	2,005
Net cash provided by (used in) continuing operations	(1,534)	2,272	(9,419)
Net cash provided by (used in) discontinued operations			(55)
Net cash provided by (used in) operating activities	(1,534)	2,272	(9,474)
INVESTING ACTIVITIES
Purchase of property and equipment, net	(2,956)	(579)	(612)
Net cash provided by (used in) continuing operations	(2,956)	(579)	(612)
Net cash provided by (used in) discontinued operations	200	2,481
Net cash provided by (used in) investing activities	(2,756)	1,902	(612)
FINANCING ACTIVITIES
Proceeds from issuance of common stock upon initial public offering, net of issuance and offering costs	78,385
Repayment of term loan		(5,351)	(3,259)
Proceeds from revolving line of credit	182,025	64,421
Repayments made against revolving line of credit	(182,278)	(64,168)
Repurchase of convertible preferred stock		(2,500)
Repurchase of common stock	(185)	(1,205)
Exercise of stock options	6,536	65	25
Exercise of stock warrants	62
Proceeds from issuance of convertible preferred stock and warrants, net			15,000
Net cash provided by (used in) continuing operations	84,545	(8,738)	11,766
Net cash provided by (used in) financing activities	84,545	(8,738)	11,766
Net increase (decrease) in cash and cash equivalents	80,255	(4,564)	1,680
Cash and cash equivalents, beginning of year	127	4,691	3,011
Cash and cash equivalents, end of year	80,382	127	4,691
SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION
Cash paid for interest	176	505	$ 542
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING AND FINANCING ACTIVITIES
Non-cash settlement of liability		414
Non-cash liability forgiveness related to divestiture		$ 4,869
Non-cash preferred stock warrant conversion to common stock warrant upon IPO	(22,765)
Non-cash deferred initial public offering costs in accounts payable and accrued liabilities	$ 906

Business and Basis of Presentation	12 Months Ended
Business and Basis of Presentation	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business and Basis of Presentation	1. Business and Basis of Presentation Description of Business Progyny, Inc. (referred to as “Progyny” or the “Company”) was incorporated in the state of Delaware on April 3, 2008, and maintains its corporate headquarters in New York, NY. Prior to its 2015 acquisition of Fertility Authority, LLC, the Company was exclusively a medical device company in the field of reproductive medicine, translating scientific discoveries related to early embryo development into clinical tools. The Company’s product, the Early Embryo Viability Assessment Test (“Eeva”), was designed to assist clinicians and patients in assessing the likelihood of certain in vitro fertilization (“IVF”) outcomes. With the acquisition of Fertility Authority, LLC, in March 2015, the Company established and operated as two segments; (i) medical device and (ii) the fertility benefits solution. In January 2018, the Company executed an agreement with a related party to sell the Eeva business, representing all of the medical device segment. Subsequent to the sale of the Eeva business, Progyny is a provider of a fertility benefits solution. The fertility benefits solution consists of a significant service that integrates: (1) the treatment services (“Smart Cycles”) that the Company has designed, (2) access to the Progyny network of high-quality fertility specialists that perform the Smart Cycle treatments and (3) active management of the selective network of high-quality provider clinics, real-time member eligibility and treatment authorization, member-facing digital tools and detailed quarterly reporting supported by the Company’s dedicated account management teams, and end to end comprehensive concierge member support provided by Progyny’s in-house staff of Patient Care Advocates (“PCAs”) (collectively, the “care management services”). The Company enhanced its fertility benefits solution with the launch of Progyny Rx, its pharmacy benefits solution, effective January 1, 2018. As part of this solution, the Company provides formulary plan design, simplified authorization, assistance with prescription fulfillment, and timely delivery of the medications by the Company’s network of specialty pharmacies, as well as medication administration training, pharmacy support services, and continuing PCA support. As a pharmacy benefits solution provider, Progyny manages the dispensing of pharmaceuticals through the Company’s specialty pharmacy contracts. The pharmacy benefits solution is only available as an add-on service to its fertility benefits solution. Reverse Stock Split On October 14, 2019, the shareholders of Progyny approved a one-for-4.5454 reverse stock split of its common and convertible preferred stock. The par value of the common stock and convertible preferred stock was not adjusted as a result of the reverse stock split. Accordingly, the consolidated financial statements and notes retroactively reflect Progyny’s capital structure after giving effect to the reverse stock split. Initial Public Offering On October 29, 2019, the Company completed its initial public offering (“IPO”) in which it issued and sold 6,700,000 shares of its common stock at a public offering price of $13.00 per share. As part of the IPO, certain selling stockholders offered and sold an additional 4,800,000 shares (including 1,500,000 shares sold pursuant to the exercise of the underwriters’ over-allotment option), at an equivalent public offering price of $13.00 per share. The Company received net proceeds of $77.5 million from the IPO, after deducting underwriters’ discounts and commissions of $5.9 million and offering costs of $3.7 million. Offering costs were initially capitalized and consisted of fees and expenses incurred in connection with the sale of common stock in the IPO, including legal, accounting, printing and other IPO-related costs. Upon completion of the IPO, these offering costs were reclassified to stockholders’ equity and offset against the proceeds from the offering on the balance sheet. Immediately prior to the completion of the IPO, all shares of convertible preferred stock then outstanding were converted into 65,428,088 shares of common stock on a one-to-one basis, $106.2 million of convertible preferred stock was reclassified to additional paid-in-capital and $7,000 of convertible preferred stock was reclassified to common stock on the Company’s balance sheet. Emerging Growth Company Status The Company is an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”). Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act, until such time as those standards apply to private companies. The Company has elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it is (i) no longer an emerging growth company or (ii) affirmatively and irrevocably opt out of the extended transition period provided in the JOBS Act. As a result, the Company’s consolidated financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates. The Company will remain an emerging growth company until the earliest of (1) December 31, 2024; (2) the last day of the Company’s first fiscal year in which the Company has total annual gross revenue of at least $1.07 billion; (3) the date on which the Company has issued more than $1.0 billion in non-convertible debt securities during the prior three-year period; and (4) the last day of the Company’s first fiscal year in which the market value of the Company’s common stock that is held by non-affiliates exceeds $700.0 million as of the prior June 30th. Basis of Presentation The accompanying consolidated financial statements include those of the Company and its wholly owned subsidiary, Fertility Authority LLC. Effective June 2018, the Company legally dissolved the Fertility Authority LLC legal entity. All intercompany balances and transactions have been eliminated in consolidation. The consolidated financial statements and accompanying notes were prepared in accordance with accounting principles generally accepted in United Sates (“U.S. GAAP”). Segment Information Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker (“CODM”), or decision-making group, in making decisions on how to allocate resources and assess performance. Following the divestiture of Eeva, the Company operates and manages in one operating segment, providing fertility and pharmacy benefits solutions. The Company defines its CODM as its Chief Executive Officer and its President, Chief Financial and Operating Officer. All long-lived assets are located in the United States and all revenue is attributed to the United States. Since the Company operates in one operating segment, all required financial segment information can be found in the consolidated financial statements. Use of Estimates The preparation of financial statements in conformity with U.S. GAAP generally requires management to make estimates and assumptions that affect the reported amount of certain assets, liabilities, revenue, and expenses, and the related disclosure of contingent assets and liabilities. Specific accounts that require management estimates include accrued receivables, accrued claims payable, allowance for doubtful accounts, accrued rebates, convertible preferred stock warrant liabilities and stock-based compensation. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2019

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

2. Summary of Significant Accounting Policies

Cash and Cash Equivalents

Cash and cash equivalents are stated at fair value. The Company considers all highly liquid investments purchased with original maturities of three months or less at the time of purchase to be cash equivalents. Cash and cash equivalents consist of cash, bank deposits, and treasury bills, as of December 31, 2019 and 2018.

Revenue Recognition

Revenue is recognized when control of the promised goods or services is transferred to clients in an amount that reflects the consideration the Company expects to be entitled to in exchange for those goods or services.

The Company applies the following five-step model to recognize revenue from contracts with clients:

Identification of the contract, or contracts, with a client

Identification of the performance obligations in the contract

Determination of the transaction price

Allocation of the transaction price to the performance obligations in the contract

Recognition of revenue when, or as, a performance obligation is satisfied

Progyny’s contracts typically have a stated term of three years and include contractual termination options after the first year, allowing the client to terminate the contract with 30 to 90 days’ notice.

Fertility Benefits Revenue

Progyny primarily generates revenue through its fertility benefits solution, in which Progyny provides self-insured enterprise entities (‘‘clients’’) and their employees and partners (together, ‘‘members’’) with fertility benefits. As part of the fertility benefits solution, Progyny provides access to effective and cost-efficient fertility treatments, referred to as Smart Cycles, as well as other related services. Smart Cycles are proprietary treatment bundles that include certain medical services available to members through Progyny’s proprietary, credentialed network of provider clinics. In addition to access to Progyny’s Smart Cycle treatment bundles and access to Progyny’s network of provider clinics, the fertility benefits solution includes other comprehensive services, which Progyny refers to as care management services, such as active management of the provider clinic network, real-time member eligibility and treatment authorization, member-facing digital tools throughout the Smart Cycle and detailed quarterly reporting all supported by client facing account management and end-to-end comprehensive member support provided by Progyny’s in house staff of PCAs.

The promises within Progyny’s fertility benefits contract with a client represent a single performance obligation because Progyny provides a significant service of integrating the Progyny designed Smart Cycles and access to the fertility treatment services provided by provider clinics with the other comprehensive services into the combined fertility benefits solution that the client contracted to receive. Progyny’s fertility benefits solution is a stand-ready obligation that is satisfied over the contract term.

Progyny’s contracts include the following sources of consideration, which are all variable: a per employee per month (‘‘PEPM’’) administration fee (in most, but not all contracts) and a fixed rate per Smart Cycle. The PEPM administration fee is allocated between the fertility benefits solution and the pharmacy benefits solution based on standalone selling price, estimated using an expected cost-plus margin method. The Company allocates the variable consideration related to the fixed rate per Smart Cycle to the distinct period during which the related services were performed as those fees relate specifically to the Company’s efforts to provide its fertility benefits solution to its clients in the period and represents the consideration the Company is entitled to for the fertility benefit services provided. As a result, the fixed rate per Smart Cycle is included in the transaction price and recognized in the period in which the Smart Cycle is provided to the member.

Progyny’s contracts also include potential service level agreement refunds related to outcome-based service metrics. These service level refunds, which are determined based on results of a full plan year, if met, are based on a percentage of the PEPM fee paid by clients. The Company estimates the variable consideration related to the total PEPM administration fee, less estimated refunds related to service level agreements, and recognizes the amounts allocated to the fertility benefits solution ratably over the contract term. Progyny’s estimate of service level agreement refunds, have not historically resulted in significant adjustments to the transaction price.

Clients are invoiced on a monthly basis for the PEPM administration fee. Progyny invoices its clients and members for their respective portions of the fixed rate per Smart Cycle bundle when all treatment services within a Smart Cycle are completed by the provider clinic. Once an invoice is issued, payment terms are typically between 30 to 60 days.

The Company assesses whether it is the principal or the agent for each arrangement with a client, since fertility treatment services are provided by a third party—the provider clinics. The Company is the principal in its arrangements with clients and therefore presents revenue gross of the amounts paid to the provider clinics because Progyny controls the specified service (the fertility benefits solution) before it is transferred to the client. Progyny integrates the fertility treatment services provided by the provider clinics into the overall fertility benefits solution that the client contracted to receive. In addition, Progyny defines the scope of the potential services to be performed by the provider clinics and monitors the performance of the provider clinics. Furthermore, Progyny is primarily responsible for fulfilling the promise to the client and has discretion in setting the pricing, as Progyny separately negotiates agreements with the provider clinics, which establish pricing for each treatment service. Pricing of services from provider clinics is independent from the fees charged to clients.

Pharmacy Benefits Revenue

For clients that have the fertility benefits solution, Progyny offers, as an add-on, its pharmacy benefits solution, which is a separate, fully integrated pharmacy benefit. As part of the pharmacy benefits solution, Progyny provides care management services, which include Progyny’s formulary plan design, prescription fulfillment, simplified authorization and timely delivery of the medications used during treatment through Progyny’s network of specialty pharmacies, and clinical services consisting of member assessments, UnPack It calls, telephone support, online education, medication administration training, pharmacy support services and continuing PCA support.

The pharmacy-related promises represent a single performance obligation because Progyny provides a significant service of integrating the formulary plan design, prescription fulfillment, clinical services and PCA support into the combined pharmacy benefits solution that the client contracted to receive. The pharmacy benefits solution is a stand-ready obligation that is satisfied over the contract term.

Progyny’s contracts include the following sources of consideration, all of which are variable: a PEPM administration fee (in most, but not all contracts) and a fixed fee per fertility drug. As described above, the PEPM administration fee, less estimated refunds related to service level agreements, is allocated to the pharmacy benefits solution and recognized ratably over the contract term. The Company allocates the variable consideration related to the fixed fee per fertility drug to the distinct period during which the related services were performed, as those fees relate specifically to the Company’s efforts to provide its pharmacy benefits solution to clients in the period and represents the consideration the Company is entitled to for the pharmacy benefit services provided. As a result, the fixed fee per fertility drug is included in the transaction price and recognized in the period in which the Company is entitled to consideration from a client, which is when a prescription is filled and delivered to the members.

As stated above, clients are invoiced on a monthly basis for the PEPM administration fee. Progyny invoices the client and the member for their respective portions of the fixed fee per fertility drug, when the prescription services are completed by the specialty pharmacy. Once an invoice is issued, payment terms are typically between 30 to 60 days.

The Company assesses whether it is the principal or the agent for each arrangement with a client, as prescription fulfillment and clinical services are provided by a third party—the specialty pharmacies. The Company is the principal in its arrangements with clients, and therefore presents revenue gross of the amounts paid to the specialty pharmacies. Progyny controls the specified service (the pharmacy benefits solution) before it is transferred to the client. Progyny integrates the prescription fulfillment and clinical services provided by the pharmacies and PCAs into the overall pharmacy benefits solution that the client contracted to receive. In addition, Progyny defines the scope of the potential services to be performed by the specialty pharmacies and monitors the performance of the specialty pharmacies. Furthermore, Progyny is primarily responsible for fulfilling the promise to the client and has discretion in setting the pricing, as Progyny separately negotiates agreements with pharmacies, which establish pricing for each drug. Pricing of fertility drugs is independent from the fees charged to clients.

The Company does not disclose the transaction price allocated to remaining performance obligations because all of the transaction price is variable and is allocated to the distinct periods to which the services relate, as discussed above. The remaining contract term is typically less than one year, due to the client’s contractual termination options.

Accrued Receivable and Accrued Claims Payable

Accrued receivables are estimated based on historical experience for those fertility benefit services provided but for which a claim has not been received from the provider clinic. At the same time, cost of services and accrued claims payables are estimated based on the amount to be paid to the provider clinic and historical gross margin achieved on fertility benefit services. Estimates are adjusted to actual at the time of billing. Adjustments to original estimates have not been material.

As of December 31, 2019, accrued receivables and accrued claims payables were $16.0 million, and $9.8 million, respectively as compared to $9.5 million, and $6.7 million, respectively, as of December 31, 2018. Accrued receivables are included within accounts receivable in the consolidated balance sheet. Accrued claims payable are included within accrued expenses and other current liabilities in the consolidated balance sheet. Claims payable are paid within 30 days based on contractual terms.

As of December 31, 2019 and December 31, 2018, unbilled receivables, which represent claims received and approved but unbilled at the end of the reporting period, were $8.5 million and $3.6 million, respectively. Unbilled receivables are typically billed to clients within 30 days of the approved claim based on the contractual billing schedule agreed upon with the client. Unbilled receivables are included in accounts receivable in the consolidated balance sheet.

Accounts Receivable and Allowance for Doubtful Accounts

The accounts receivable balance primarily includes amounts due from clients and members. Accounts receivable also includes certain accrued receivables for fertility benefits claims from provider clinics at the end of each period for services provided that have not yet been received. The Company estimates an allowance for changes and cancellations of services based upon historical experience and estimates member uncollectible amounts based upon historical bad debts, current member receivable balances and the age of member receivable balances.


	Years Ended December 31, 2019 and 2018
December 31, 2019	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
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.

Cost of Services

Fertility Benefit Services

Fertility benefit services costs include: (1) fees paid to provider clinics within our network, labs and anesthesiologists; (2) costs incurred (including salaries, bonuses, benefits, stock-based compensation, other related costs, and an allocation of our general overhead, depreciation and amortization) for those employees associated with our care management service functions: Provider Account Management, PCA and Provider Relations teams; and (3) related information technology support costs. Our contracts with provider clinics are typically for a term of one to two years.

Pharmacy Benefit Services

Pharmacy benefit services costs include: (1) the fees for prescription drugs dispensed and clinical services provided during the reporting period by our specialty pharmacy partners; (2) costs incurred (including salaries, bonuses, benefits, stock-based compensation, other related costs, and an allocation of our general overhead, depreciation and amortization) for those employees associated with our care management service functions: PCA and Provider Relations teams; and (3) related information technology support costs. Contracts with the specialty pharmacies are typically for a term of one year.

In the specialty pharmacy contracts, the contractual fees of prescription drugs sold includes the cost of the prescription drugs purchased and shipped to members by the Company’s specialty mail service dispensing pharmacy, net of any volume-related or other discounts.

Vendor rebates

The Company receives a rebate on formulations purchased and dispensed by the Company’s specialty pharmacy. The Company’s contractual arrangements with pharmaceutical manufacturers provide for the Company to receive a discount (or rebate) from established list prices paid subsequent to dispensing when products are purchased indirectly from a pharmaceutical manufacturer (e.g., through a specialty pharmacy.) These rebates are recognized as a reduction of Cost of services when prescriptions are dispensed and are generally estimated and billed to manufacturers within 15 days of the end of each month. The effect of adjustments resulting from the reconciliation of rebates recognized to the amounts billed and collected has not been material to the Company’s results of operations.

Concentration of Credit Risk and Off-Balance-Sheet Risk

Financial instruments that potentially subject the Company to concentrations of credit risk consists primarily of cash and cash equivalents and accounts receivable.

The Company invests its cash and cash equivalents with highly rated financial institutions and management believes that the financial risks associated with its cash equivalents are minimal. Substantially all of the Company’s cash is maintained with one financial institution with a high credit standing. From time to time, such deposits may exceed federally insured limits.

The Company regularly reviews the outstanding accounts receivable, including consideration of factors such as the age of the receivable balance. Two customers accounted for 17% and 14% each, or 31% total receivables as of December 31, 2019. Three customers accounted for 25%, 13% and 10% each, or 48% of total accounts receivables as of December 31, 2018. To manage credit risk related to accounts receivable, the Company evaluates client’s financial condition and collateral is generally not required.

Impairment of Long-Lived Assets

Long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of such assets or asset groups may not be recoverable. In such instances, the recoverability of assets to be held and used is measured first by a comparison of the carrying amount of an asset group to future undiscounted net cash flows expected to be generated by the assets. If such assets are considered to be impaired, an impairment loss would be recognized if the carrying amount of the asset exceeds the fair value of the asset or asset group. The fair value is determined based on valuation techniques such as a comparison to fair values of similar assets or using a discounted cash flow analysis. There were no impairments recorded for the years ended December 31, 2019 and 2018.

Property and Equipment

Property and equipment consist of computer equipment, machinery and equipment, furniture and fixtures, and leasehold improvements. The assets are stated at cost less accumulated depreciation and amortization. Depreciation is calculated using the straight-line method based on estimated useful lives and in the case of leasehold improvements, the shorter of the useful life or the remaining term of the lease (see Note 5).

Goodwill and Intangible Assets

Goodwill represents the excess of the consideration transferred over the fair value of the assets acquired and liabilities assumed in a business combination. Other intangible assets consist of trademarks, physician network, and the websites acquired in the Fertility Authority acquisition. Goodwill, including other definite-lived intangible assets, are carried at their initial acquisition date fair value less any impairment. Other intangible assets are recorded at fair value at the date of acquisition, less accumulated amortization. Amortization is calculated using the straight-line method based on estimated useful lives.

Goodwill is reviewed for impairment annually as of October 1st of each year or when an interim triggering event has occurred indicating potential impairment. Events or changes in circumstances which could trigger an impairment review, which are assessed at the reporting unit level, include significant changes in the manner of the Company’s use of the acquired assets or the strategy for the Company’s overall business, significant negative industry or economic trends, significant underperformance relative to historical or projected future results of operations, a significant adverse change in the business climate, an adverse action or assessment by a regulator, unanticipated competition or a loss of key personnel. The Company has the option to first assess qualitative factors to determine whether the existence of events or circumstances leads to a determination that it is more likely than not that the fair value of the reporting unit is less than its carrying amount. If, after assessing the totality of events or circumstances, an entity determines it is not more likely than not that the fair value of the reporting unit is less than its carrying amount, then additional impairment testing is not required. However, if an entity concludes otherwise, then it is required to perform the first of a two-step impairment test.

The first step involves comparing the estimated fair value of the reporting unit with its respective book value, including goodwill. If the estimated fair value exceeds book value, goodwill is considered not to be impaired and no additional steps are necessary. If the carrying amount of goodwill exceeds the implied fair value of the goodwill, an impairment loss is recognized in an amount equal to the excess.

The Company tests for goodwill impairment on each of its one reporting unit, which is at the operating segment or one level below the operating segment. This analysis requires us to make a series of critical assumptions to (1) evaluate whether any impairment exists and (2) measure the amount of impairment. There was no impairment of goodwill or intangible assets for the years ended December 31, 2019, 2018, and 2017.

Convertible Preferred Stock Warrants

Freestanding warrants to purchase the Company’s convertible preferred stock are classified as liabilities on the accompanying consolidated balance sheets. The convertible preferred stock warrants are recorded as liabilities because the underlying shares of convertible preferred stock are contingently redeemable, upon a deemed liquidation event which may obligate the Company to transfer assets at some point in the future to settle these warrants. The warrants are recorded at estimated fair value and are subject to remeasurement at each balance sheet date and recorded in Other Income (expense), in the accompanying consolidated statement of operations and comprehensive (loss) income. In connection with the IPO, all convertible preferred stock warrants were converted to common stock warrants.

Stock-Based Compensation

The Company accounts for share-based compensation awards in accordance with FASB ASC Topic 718, Compensation—Stock Compensation (ASC 718). ASC 718 requires all share-based payments, including grants of stock options, to be recognized in the consolidated statements of operations and comprehensive income (loss) based on their respective fair values. For non-employee awards a measurement date is normally reached when performance is completed, and the fair value is remeasured as the stock options vest.

The fair value of the Company’s stock options has been determined using the Black-Scholes option-pricing model, which requires the input of subjective assumptions, including (i) the expected stock price volatility, (ii) the expected term of the award, (iii) the risk-free interest rate and (iv) expected dividends. Due to the lack of historical and implied volatility data of the Company’s common stock, the expected stock price volatility has been estimated based on the historical volatilities of a specified group of companies in Progyny’s industry for a period equal to the expected life of the option. Progyny selected companies with comparable characteristics to the Company, including enterprise value, risk profiles and position within the industry and with historical share price information sufficient to meet the expected term of the stock options. The historical volatility data has been computed using the daily closing prices for the selected companies.

The expected life of the options granted represents the period of time that options granted are expected to be outstanding and is calculated using the simplified method, which is the mid-point between the vesting date and the end of the contractual term for each option. We have estimated the expected term of non-employee service-based and performance-based awards based on the remaining contractual term of such awards. The risk-free interest rate is based on a zero coupon, United States Treasury instrument whose term is consistent with the expected life of the stock option. The Company has not paid, and does not anticipate paying, cash dividends on its shares of common stock; therefore, the expected dividend yield is zero.

Effective January 1, 2018, the Company adopted ASU 2016-09, Compensation—Stock Compensation which in turn resulted in a change in accounting policy to account for forfeitures as they occur. Prior to January 1, 2018, forfeitures were estimated at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differed from those estimates. The adoption resulted in a transition adjustment of $213,000, recorded to Accumulated deficit.

The Company’s share-based awards are subject to either service-based or performance-based vesting conditions. The Company recognizes compensation expense for service-based awards over the vesting period of the award on a straight-line basis. Compensation expense related to awards with performance-based vesting conditions is recognized when achievement of the performance condition is considered probable over the requisite service period.

Common Stock Valuation

The Company has historically granted stock options at exercise prices equal to the fair value as determined by the Board of Directors on the date of grant. Prior to the IPO and in the absence of a public trading market, the Board of Directors, with input from management, exercised significant judgement and considered numerous objective and subjective factors to determine the fair value of the Company’s common stock as of the date of each stock option grant, including:

the Company’s financial performance

the rights, preferences and privileges of the convertible preferred stock relative to those of the common stock; and

general economic and financial conditions, and the trends specific to the markets in which the Company operates

In addition, the Board of Directors considered the independent valuations completed by a third-party valuation consultant. The valuations of the Company’s common stock were determined in accordance with the guidelines outlined in the American Institute of Certified Public Accountants Practice Aid, Valuation of Privately-Held-Company Equity Securities Issued as Compensation. In performing these valuations, the Board of Directors considered a variety of relevant factors and valuation methodologies in accordance with the guidelines. Following the IPO, the Board of Directors determines the fair market value for all common stock grants based on the closing market price of our common stock, on the date of grant, as reported by Nasdaq.

Income Taxes

The Company accounts for income taxes in accordance with FASB ASC Topic 740, Income Taxes (“ASC 740”). Deferred income taxes are recorded for the expected tax consequences of temporary differences between the tax basis of assets and liabilities for financial reporting purposes and amounts recognized for income tax purposes. The Company periodically reviews the recoverability of deferred tax assets recorded on the consolidated balance sheet and provides valuation allowances as deemed necessary to reduce such deferred tax assets to the amount that will, more likely than not, be realized. Income tax expense consists of taxes currently payable and changes in deferred tax assets and liabilities calculated according to local tax rules.

Significant judgment is required in determining any valuation allowance recorded against deferred tax assets. In assessing the need for a valuation allowance, the Company considers all available evidence for each jurisdiction including past operating results, estimates of future taxable income and the feasibility of ongoing tax planning strategies. In the event the Company changes its determination as to the amount of deferred tax assets that can be realized, the Company will adjust its valuation allowance with a corresponding impact to income tax expense in the period in which such determination is made.

The amount of deferred tax provided is calculated using tax rates enacted at the balance sheet date. The impact of tax law changes is recognized in periods when the change is enacted.

A two-step approach is applied pursuant to ASC 740 in the recognition and measurement of uncertain tax positions taken or expected to be taken in a tax return. The first step is to determine if the weight of available evidence indicates that it is more likely than not that the tax position will be sustained in an audit, including resolution of any related appeals or litigation processes. The second step is to measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement.

The Company’s policy is to recognize interest and penalty expenses associated with uncertain tax positions as a component of income tax expense in the consolidated statements of operations and comprehensive (loss) income. As of December 31, 2019, 2018 and 2017, the Company had no accrued interest or penalties related to uncertain tax positions and no amounts have been recognized in the Company’s consolidated statements of operations and comprehensive (loss) income.

Fair Value of Financial Instruments and Fair Value Measurements

The Company determines the fair value of financial assets and liabilities using the fair value hierarchy established in the accounting standards. The hierarchy describes three levels of inputs that may be used to measure fair value, as follows:

Level 1—Quoted prices in active markets for identical assets and liabilities.

Level 2—Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.

Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurements. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and consider factors specific to the asset or liability.

The carrying amounts of certain of the Company’s financial instruments, including cash equivalents, accounts receivable accounts payable and the term loan approximate fair value due to their short maturities. Warrants to purchase shares of the Company’s convertible preferred stock are stated at fair value and remeasured at the end of each reporting period.

Net (Loss) Income per Share Attributable to Common Stockholders

Basic net (loss) income per share attributable to common stockholders is calculated by dividing the net income (loss) attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. The Company adjusts its net income (loss) attributable to common stockholders to reflect the impact of deemed dividends recorded for convertible preferred stock during the period.

The Company’s convertible preferred stock was entitled to receive noncumulative dividends, prior and in preference to any declaration or payment of any dividend on common stock and thereafter participate pro rata on an as-converted basis with the common stockholders in any distributions to common stockholders and were therefore considered to be participating securities. As a result, the Company calculated the net (loss) income per share using the two-class method. Accordingly, the net (loss) income attributable to common stockholders is derived from the net (loss) income for the period and, in periods in which the Company has net income attributable to common stockholders, an adjustment is made for the allocations of undistributed earnings to participating securities based on their outstanding shareholder rights. Under the two-class method, the net loss attributable to common stockholders is not allocated to the convertible preferred stock as the convertible preferred stockholders did not have a contractual obligation to share in the Company’s losses.

Diluted net (loss) income attributable to common stockholders is computed by adjusting (loss) income attributable to common stockholders to allocate undistributed earnings based on the potential impact of dilutive securities, including outstanding stock options, convertible preferred stock, convertible preferred stock warrants, and common stock warrants. Diluted net (loss) income per share attributable to common stockholders is computed by dividing the diluted net (loss) income attributable to common stockholders by the weighted average number of common shares outstanding for the period, including common stock equivalents. In periods when the Company has incurred a net loss, convertible preferred stock, options to purchase common stock, convertible preferred stock warrants, and common stock warrants are considered common stock equivalents but have been excluded from the calculation of diluted net loss per share attributable to common stockholders as their effect is antidilutive.

Recently Adopted Accounting Pronouncements

In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606), to achieve a consistent application of revenue recognition within the U.S., resulting in a single revenue model to be applied by reporting companies under GAAP. Under the new model, recognition of revenue occurs when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, the revised guidance required that reporting companies disclose the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The Company adopted this standard on January 1, 2019 using the full retrospective approach. The adoption of the new standard had an immaterial impact on the consolidated financial statements.

In November 2015, the FASB issued ASU 2015-17, Balance Sheet Classification of Deferred Taxes, requiring companies to classify all deferred tax assets and liabilities as noncurrent on the balance sheet instead of separating deferred taxes into current and noncurrent amounts. The Company prospectively adopted this guidance effective January 1, 2018, which did not have a significant effect on the Company’s consolidated financial statements.

In March 2016, the FASB issued ASU 2016-09, Compensation—Stock Compensation (“ASC 718”): Improvements to Employee Share-Based Payment Accounting, which changes the accounting for share-based payment transactions, including income tax consequences, classification of awards as either equity or liabilities, and classification in the statement of cash flows. The Company adopted this standard on a prospective basis as of January 1, 2018, which resulted in a transition adjustment of $213,000, recorded through Accumulated deficit. The adoption had no other effect on the net deferred tax balances, the consolidated statement of cash flows or otherwise on its consolidated financial statements.

In September 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (“ASC 230”): Classification of Certain Cash Receipts and Cash Payments (a consensus of the Emerging Issues Task Force), which changes how certain cash receipts and cash payments are presented and classified in the statement of cash flows. The Company adopted this guidance effective January 1, 2018, which did not have a significant effect on the Company’s consolidated financial statements.

In January 2017, the FASB issued ASU No. 2017-04, Intangibles—Goodwill and Other: Simplifying the Test for Goodwill Impairment, to simplify the subsequent measurement of goodwill by eliminating Step 2 from the goodwill impairment test. The new standard requires goodwill impairment to be based upon the results of Step 1 of the goodwill impairment test, which evaluates the extent, if any, by which the carrying value of a reporting unit exceeds its fair value, with any resulting impairment not exceeding the carrying amount of goodwill. The Company early adopted ASU 2017-04 on a prospective basis effective January 1, 2018. The adoption of this guidance did not have a significant effect on the Company’s consolidated financial statements.

In January 2017, the FASB issued ASU No. 2017-01, Clarifying the definition of a business. The new standard clarifies the definition of a business to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. The new standard is effective for the Company for fiscal years beginning after December 15, 2018 and interim periods within annual periods beginning after December 15, 2019. The Company adopted this guidance effective January 1, 2019, which did not have a significant effect on the Company’s consolidated financial statements.

In May 2017, the FASB issued ASU No. 2017-09, Compensation—Stock Compensation (Topic 718): Scope of Modification Accounting. The amendments provide guidance on determining which changes to the terms and conditions of share-based payment awards require an entity to apply modification accounting under ASC 718. An entity should account for the effects of a modification unless all the following are met: 1. The fair value (or calculated value or intrinsic value, if such an alternative measurement method is used) of the modified award is the same as the fair value (or calculated value or intrinsic value, if such an alternative measurement method is used) of the original award immediately before the original award is modified. If the modification does not affect any of the inputs to the valuation technique that the entity uses to value the award, the entity is not required to estimate the value immediately before and after the modification. 2. The vesting conditions of the modified award are the same as the vesting conditions of the original award immediately before the original award is modified. 3. The classification of the modified award as an equity instrument or a liability instrument is the same as the classification of the original award immediately before the original award is modified. The Company adopted the guidance effective January 1, 2018. The adoption of this guidance did not have a significant effect on the Company’s consolidated financial statements.

In March 2018, the FASB issued ASU No. 2018-05, Income Taxes (ASC 740), to conform to SEC Staff Accounting Bulletin No. 118 (“SAB 118”). The standard was issued to allow registrants to record provisional amounts during a measurement period not to extend beyond one year from the enactment date in instances when a registrant does not have the necessary information available, prepared, or analyzed in reasonable detail to complete the accounting for certain income tax effects of the Tax Cuts and Jobs Act (the “Tax Reform Act”). The standard was effective upon issuance. The adoption of this guidance did not have a significant effect on the Company’s consolidated financial statements.

In June 2018, the FASB issued ASU No. 2018-07, Compensation—Stock Compensation (ASC 718): Improvements to Employee Share-Based Payment Accounting, which changes the accounting for share-based payment transactions with nonemployees. For private companies the new standard is effective for fiscal years beginning after December 15, 2019, and for interim periods therein. The Company adopted this guidance effective January 1, 2019. The adoption of this guidance did not have a significant effect on the Company’s consolidated financial statements.

Accounting Pronouncements Issued but Not Yet Adopted

In February 2016, the FASB issued ASU No. 2016‑02, Leases (Topic 842). The new standard establishes a right-of-use (“ROU”) model that requires a lessee to record a ROU asset and a lease liability on the balance sheet for all leases with terms longer than 12 months. Leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. The new standard is effective for the Company for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years. On July 17, 2019, the FASB voted to propose a deferral of the effective date of the standard to fiscal years beginning after December 15, 2020. The Company plans to adopt this standard as of the effective date for private companies using the modified retrospective approach of all leases entered into before the effective date. The Company is currently evaluating the impact this ASU will have on its consolidated financial statements.

In August 2018, the FASB issued final guidance requiring a customer in a cloud computing arrangement that is a service contract to follow the internal use software guidance in Accounting Standards Codification (“ASC”) 350-402 Intangibles—Goodwill and Other—Internal Use Software (Subtopic 350-40) to determine which implementation costs to capitalize as assets. The amendments in this ASU are effective for fiscal years beginning after December 15, 2019. Early adoption of the amendments is permitted, including adoption in any interim period, for all entities and should be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. The Company is currently reviewing its cloud computing arrangements to evaluate the impact of adoption of the final guidance but does not expect that the pending adoption of this ASU will have a material effect on its consolidated financial statements.

In June 2016, the FASB issued ASU 2016-13 which replaces the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. On July 17, 2019, the FASB voted to propose a deferral of the effective date of the standard to fiscal years beginning after December 15, 2022. As the Company elected the private company transition rules as part of the IPO process, the ASU is effective for the Company for annual periods beginning after December 15, 2022, and interim periods within those years. The Company is currently evaluating the impact this ASU will have on its consolidated financial statements.

Revenue

12 Months Ended

Dec. 31, 2019

Revenue from Contract with Customer [Abstract]

Revenue

3. Revenue

Disaggregated revenue

The following table disaggregates revenue by service (in thousands):


	Year Ended
	December 31,
	2019		2018
Revenue
Fertility benefit services revenue	$	189,618	$	99,786
Pharmacy benefit services revenue		40,065		5,614
Total revenue	$	229,683	$	105,400

Concentration of Major Clients

For the year ended December 31, 2019, three clients accounted for 16%, 15% and 10%, or 41% of our total revenue. For the year ended December 31, 2018 three clients accounted for 24%, 14%, and 10%, or 48% of our total revenue.

Fair Value Measurement

12 Months Ended

Dec. 31, 2019

Fair Value Disclosures [Abstract]

Fair Value Measurement

4. Fair Value Measurement

Assets and liabilities measured at fair value on a recurring basis were as follows (in thousands):

December 31, 2019

Total

Level 1

Level 2

Level 3

Liabilities:

Convertible preferred stock warrant liability

—

Total

—


	December 31, 2018
	Total		Level 1		Level 2		Level 3
Liabilities:
Convertible preferred stock warrant liability	$	4,589	$	—	$	—	$	4,589
Total	$	4,589	$	—	$	—	$	4,589

The estimated fair values of the convertible preferred stock warrant liabilities (see Note 10) were determined using Level 3, or significant unobservable inputs. Changes to the estimated fair value of the warrants are recorded in other income or other expense in the statements of operations and comprehensive income (loss). The following table provides the changes in the estimated fair value of the convertible preferred stock warrants (in thousands):


	Convertible
	Preferred Stock
	Warrants
Balance as of December 31, 2018	$	4,589
Changes in estimate fair value of warrants		18,176
Conversion of convertible preferred stock warrants to common stock warrants upon IPO		(22,765)
Balance at December 31, 2019	$	—

During the years ended December 31, 2019 and 2018, there were no transfers between Level 1, Level 2, or Level 3 assets or liabilities reported at fair value on a recurring basis and the valuation techniques used to value the Level 3 liabilities did not change.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Property and Equipment, Net

12 Months Ended

Dec. 31, 2019

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

5. Property and Equipment, Net

Property and equipment consist of the following (in thousands):


	Estimated
	Useful Life	December 31,
	(in years)	2019		2018

Machinery and equipment	3-5	$	13	$	13
Computers and software	3		1,353		798
Leasehold improvements	lease term		2,391		346
Furniture and fixtures	7		459		102
			4,216		1,259
Less: accumulated depreciation			(1,133)		(483)
Total property and equipment, net		$	3,083	$	776

Depreciation expense was approximately $650,000, $400,000, and $76,000 for the years ended December 31, 2019, 2018 and 2017, respectively.

Divestitures

12 Months Ended

Dec. 31, 2019

Discontinued Operations and Disposal Groups [Abstract]

Stockholders' Equity (Deficit)

6. Divestitures

On January 18, 2018, the Company completed the divestiture of its Eeva business, the primary operations of our previous medical device segment, to a related party, Ares Trading S.A. a subsidiary of Merck Serono, S.A. (“Merck”), a shareholder in the Company. The Eeva business was sold to Merck for $7.9 million, consisting of cash of $3.0 million and the forgiveness of the $4.9 million liability remaining from the previous license agreement for the Eeva product between the two parties. The cash consideration includes $300,000 of deferred consideration, of which the last payment was received by the Company in March 2019.

The Company determined that the Eeva business met the criteria to be classified as held for sale as of December 31, 2016, representing a strategic shift in Progyny’s operations. With the amendment of the license agreement in May 2016, management committed to a plan to sell the business and move from the medical device business to the fertility benefits business which represented a strategic shift. The Board of Directors approved the ultimate sale of Eeva in December 2017.

In accordance with the applicable accounting guidance, upon the sale of the Eeva business on January 18, 2018, the Company reflected the Eeva business as discontinued operations in the consolidated financial statements.

Excluding the $200,000 of assets representing the remaining deferred consideration, there was no other assets or liabilities associated with the Eeva business as of December 31, 2018.

This transaction had no impact on the consolidated statement of operations and comprehensive income (loss) for the fiscal year of 2019. The following is a summary of the operating results of Eeva which have been reflected within income from discontinued operations, net of tax (in thousands):


	Year Ended
	December 31,
	2019		2018		2017
Revenue		—		—	$	328
Cost of service		—		—		59
Gross profit		—		—		269
Operating expenses:
Research and development		—		—		241
General and administration		—		—		21
Total operating expenses		—		—		262
Income from discontinued operations		—		—		7
Gain on sale of discontinued operations	$	—	$	7,554	$	—
Income from discontinued operations, before taxes		—		7,554		7
Provision for income taxes		—		(1,777)		(3)
Net income from discontinued operations, net of taxes	$	—	$	5,777	$	4

The significant components of the consolidated statement of cash flows for Eeva are as follows (in thousands):


	Year Ended
	December 31,
	2019		2018		2017
OPERATING ACTIVITIES
Depreciation expense		—		—		18
Deferred license revenue		—		—		(73)

INVESTING ACTIVITIES
Deferred consideration		—		200		—
Proceeds from sale of business, net of costs		200		2,481		—

Intangible Assets, Net

12 Months Ended

Dec. 31, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets, Net

7. Intangible Assets, Net

Intangible assets consist of the following (in thousands):


	Estimated
	Useful Life	December 31,
	(in years)	2019		2018
Trademarks	8	$	4,000	$	4,000
Physician Network	6		3,500		3,500
Website	5		2,000		2,000
			9,500		9,500
Less: accumulated amortization			(7,125)		(5,641)
Total intangible assets, net		$	2,375	$	3,859

Amortization expense was $1.5 million for the years ended December 31, 2019, 2018, and 2017.

As of December 31, 2019, the future amortization expense of other intangible assets is as follows (in thousands):


Year ending December 31:
2020	$	1,162
2021		614
2022		500
Thereafter		99
Total	$	2,375

Accrued Expenses and Other Current Liabilities

12 Months Ended

Dec. 31, 2019

Accrued Liabilities and Other Liabilities [Abstract]

Accrued Expenses and Other Current Liabilities

8. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consist of the following (in thousands):


	December 31,
	2019		2018

Accrued claims payable	$	9,795	$	6,656
Accrued compensation		2,559		1,490
Accrued commission		1,216		966
Professional fees		1,315		274
Other		1,890		396
Total accrued expenses and other current liabilities	$	16,775	$	9,782

Debt	12 Months Ended
Debt	Dec. 31, 2019
Debt Disclosure [Abstract]
Debt	9. Debt The Company’s $8.0 million term loan, entered into in November 2015 (“Term Loan”), carried an interest rate equal to the greater of 7.5% or LIBOR plus 7.3%. The terms contain a prepayment fee of 3.0% of the outstanding principal if repaid after the effective date but on or prior to the first anniversary, 2.0% if repaid after the first anniversary of the effective date but on or prior to the second anniversary, and 1.0% if repaid after the second anniversary of the effective date but prior to the maturity date. Additionally, the terms contained an additional significant final payment representing 8.0% of the original principal. In June 2018, the Company entered into a loan agreement with Silicon Valley Bank for a revolving line of credit up to $15.0 million based upon an advance rate of 80% on “eligible” accounts receivable to fund its working capital and other general corporate needs (“SVB Line of Credit”). Eligible accounts receivable is defined in the loan agreement as accounts billed with aging 90 days or less and excludes accounts receivable due for member copayments, coinsurance, and deductibles. Upon execution of the SVB Line of Credit, the Term Loan was paid off in full including the remaining principal balance of $2.9 million, final balloon payment of $640,000 and the 1.0% early payment penalty fee of $15,000. The repayment of the Term Loan was treated as a debt extinguishment and the Company recognized the remaining unamortized debt discount of $88,000 as a loss on debt extinguishment in Interest expense, net for the year ended December 31, 2018. The Company is required to pay a revolving line commitment fee of $225,000 in three equal annual installments of $75,000 starting on the one-year anniversary of the revolving line. The Company made the first installment payment of $75,000 in June 2019 and accrues this cost monthly. The SVB Line of Credit matures in June 2021. When the Company holds unrestricted cash balances greater than $5.0 million interest accrues at a floating rate per annum equal to the greater of prime rate or 4.75%. If the unrestricted cash balance is less than $5.0 million interest accrues at a floating rate per annum equal to the greater of prime rate plus 0.5% or 4.75%, with interest payable monthly. Interest is paid based upon the borrowed funds. The SVB Line of Credit contains customary affirmative covenants, financial covenants, as well as negative covenants that, among other things, restrict the Company’s ability to incur additional indebtedness (including guarantees of certain obligations); create liens; engage in mergers, consolidations, liquidations and dissolutions; sell assets; maintain collateral; pay dividends or make other payments in respect of capital stock; make acquisitions; make investments, loans and advances; enter into transactions with affiliates; make payments with respect to or modify subordinated debt instruments; and enter into agreements with negative pledge clauses or clauses restricting subsidiary distributions. The financial covenant requires the Company achieve minimum revenue targets established at 75% of the annual financial projections approved by the Board of Directors. The Company was in compliance with all requirements and its covenant of the revolving credit facility as of December 31, 2019 and December 31, 2018. Prior to the repayment of the Term Loan, the Company recorded interest of $163,000 and accretion of the debt discount of $75,000 in Interest expense, net for the year ended December 31, 2018. As of December 31, 2019, and December 31, 2018, the Company had $0 and $253,000 drawn on the SVB Line of Credit, respectively. During the year ended December 31, 2019, the Company recorded interest expense on the SVB Line of Credit of $213,000.

Convertible Preferred Stock Warrants

12 Months Ended

Dec. 31, 2019

Warrants and Rights Note Disclosure [Abstract]

Convertible Preferred Stock Warrants

10. Convertible Preferred Stock Warrants

In connection with the IPO on October 25, 2019 the convertible preferred warrants converted to common stock warrants. Therefore, as of December 31, 2019 the Company had no outstanding convertible preferred warrants. Prior to the conversion, the convertible preferred stock warrants were valued using the price as of the IPO date of $13 less the exercise price of $1.73 per common share. In the fourth quarter of 2019, 482,661 common stock warrants were exercised for 441,307 shares of common stock at a weighted average exercise price of $1.59.

As of December 31, 2018 the Company had issued and outstanding warrants to acquire 2,019,245 shares of Series B convertible preferred stock for $1.73 per share with a fair value of $4.6 million that were issued in conjunction with various equity and financing transactions.

The Company recognized the warrants at fair value at the time of issuance and remeasures the warrants at their fair value on a recurring basis thereafter. Given the deemed liquidation provisions of the underlying convertible preferred stock, the convertible preferred stock warrant liabilities are recorded at fair value and are subject to remeasurement at each balance sheet date. The Company calculates the warrants’ fair value as follows:

The Company’s equity value is estimated using the market approach.

The Company’s equity value is then allocated among classes of its capital structure, including Series B convertible preferred shares. The allocation is performed using the Option Pricing Methodology. This method treats securities as options with the Company. The allocation is used to determine the value of Series B convertible preferred shares, as well as the Series B convertible preferred stock warrants. The Company assumes that any exercise of the warrants would be to purchase Series B convertible preferred Shares, and assumes scenarios where the warrants will not be exercised.

No warrants were issued in 2019 or 2018. The warrants outstanding at December 31, 2018, were valued at approximately $2.27 per share utilizing an option pricing model, time to liquidity of two years, underlying stock volatility of 43% and a risk-free interest rate of 2.3%.


Rollforward of warrants and fair value	Warrants	Liability
		(in thousands)
Total warrants and liability as of December 31, 2018	2,019,245	$	4,589
Revaluation of remaining warrants			18,176
Conversion of preferred stock warrants to common stock warrants	(2,019,245)		(22,765)
Total warrants and liability as of December 31, 2019	—	$	—

Commitments and Contingencies

12 Months Ended

Dec. 31, 2019

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

11. Commitments and Contingencies

In September 2019, the Company entered into a lease agreement for its corporate offices in New York, NY. The lease is for a 25,212 square foot office and will expire in May 2029. Pursuant to the lease, the Company will pay the base rent of approximately $1.3 million per annum through the end of the fifth lease year and approximately $1.4 million per annum thereafter through the expiration date.

Future minimum facility lease payments as of December 31, 2019, are as follows (in thousands):


	Operating
Year Ending December 31:	Lease
2020	$	885
2021		1,286
2022		1,286
2023		1,286
2024		1,326
Thereafter		6,213
Total	$	12,282

Rent expense under operating leases was approximately $1,165,000, $878,000 and $650,000 for the years ended December 31, 2019, 2018, and 2017 respectively. The terms of the facility lease provide for rental payments on a monthly basis and on a graduated scale. The Company recognizes rent expense on a straight-line basis over the lease period and has accrued for rent expense incurred but not paid.

Arbitration/Litigation

On January 14, 2019, a vendor filed a Demand for Arbitration and Statement of Claim against the Company (“Demand”) for alleged breach of the November 10, 2017 Preferred Specialty Pharmacy Agreement (“Agreement”) between the Company and the vendor. On March 13, 2019, the Company terminated the Agreement for material breach with the vendor. On April 3, 2019, the vendor filed a Second Amended Demand for Arbitration (“SAD”) for breach of the Agreement. The vendor seeks damages, fees, interest and cost. Pursuant to a schedule set forth by the Arbitration Panel, on May 3, 2019, the Company filed a Motion to Dismiss the SAD. That Motion was fully briefed on June 14, 2019 and was decided on July 31, 2019. The Arbitration Panel dismissed two of the vendor’s four claims. The Company believes the vendor’s claims are without merit and intends to vigorously defend against the claims in the Arbitration. Due to the inherent uncertainties of litigation, the Company cannot predict the outcome of the actions at this time and can give no assurances that the asserted claim will not have a material adverse effect on the financial position or results of operations of the Company.

The Company believes there is no other litigation pending that could have, individually or in the aggregate, a material adverse effect on the Company’s financial position, results of operations, or cash flows.

Indemnifications

The Company indemnifies each of its officers and directors for certain events or occurrences, subject to certain limits, while the officer or director is or was serving at the Company’s request in such capacity, as permitted under Delaware law and in accordance with its certificate of incorporation and bylaws. The term of the indemnification period lasts as long as an officer or a director may be subject to any proceeding arising out of acts or omissions of such officer or director in such capacity. The maximum amount of potential future indemnification is unlimited; however, the Company currently holds director and officer liability insurance. This insurance allows the transfer of risk associated with the Company’s exposure and may enable it to recover a portion of any future amounts paid. The Company believes that the fair value of these indemnification obligations is minimal. Accordingly, it has not recognized any liabilities relating to these obligations for any period presented.

Stockholders' Equity (Deficit)

12 Months Ended

Dec. 31, 2019

Stockholders' Equity Note [Abstract]

Stockholders’ Deficit

12. Stockholders’ Equity (Deficit)

Common Stock

The common stock confers upon its holders the right to receive dividends out of any assets legally available, when and as declared by the Board of Directors, but subject to the prior right of the holders of the Series Preferred as described above.

Common stock reserved for future issuance consisted of the following:


	December 31,	December 31,
	2019	2018

Convertible preferred stock	-	65,428,088
Warrants in Series B convertible preferred stock issued and outstanding	-	2,019,245
Common stock warrants	1,607,864	140,394
Shares available for grants under stock option plan	3,124,254	143,710
Options issued and outstanding under stock plan	15,721,085	15,932,040
Total common stock reserved for future issuance	20,453,203	83,663,477

In September 2018, the Company repurchased 589,320 shares of common stock, held by former employees, at a price per share of $2.04, for total consideration of $1.2 million. The difference of $321,000 between the fair value on the date of repurchase (at $1.49 per share) and the cash consideration paid has been recorded as a dividend as of December 31, 2018 as there were no ongoing services being delivered by the ex-employees since the date of termination. The Company has not retired the shares repurchased and as such, have recorded the shares repurchased at cost $884,000 and treated them as treasury shares.

In August 2019, the Company repurchased 26,659 shares of common stock at an average price per share of $6.91 pursuant to its contractual right of first refusal for offers made by third parties to acquire outstanding shares from existing stockholders. The repurchased shares were recorded as treasury shares.

As of December 31, 2019 and December 31, 2018, the Company had 615,980 and 589,320 shares respectively of treasury stock.

Stock Incentive Plan

In October 2019, the Company’s Board of Directors and stockholders adopted and approved the 2019 Equity Incentive Plan, (the “2019 Plan”), as the successor to continuation of the Company’s 2017 Equity Incentive Plan (the “2017 Plan”). No further grants were made under the 2017 Plan from the date that the 2019 Plan became effective. Initially, the maximum number of shares issuable under the 2019 Plan will not exceed 19,198,875 shares of common stock, which is the sum of 1) 2,640,031 new shares and 2) an additional number of shares not to exceed 16,558,844 consisting of (a) shares that remain available for the issuance of awards under the 2017 Plan immediately prior to the effective date of the 2019 Plan and (b) shares of our common stock subject to outstanding stock options or other stock awards granted under our 2017 Plan that, on or after the date the 2019 Plan became effective, terminate, expire or are cancelled prior to exercise or settlement; are forfeited or repurchased because of the failure to vest; or are reacquired or withheld (or not issued) to satisfy a tax withholding obligation or the purchase or exercise price, if any, as such shares become available from time to time.

As of December 31, 2018, the Company maintained two stock-based compensation plans: (i) the 2008 Stock Plan (the “2008 Plan”) and (ii) the 2017 Plan. All awards issued in 2018 were issued pursuant to the 2017 Plan.

Under the Company’s 2017 Plan and consistent with the 2008 Plan, options and other stock awards to purchase shares of common stock may be granted to employees, directors, and consultants. Incentive stock options are granted to employees and non-statutory stock options are granted to consultants and directors at an exercise price not less than 100% of the fair value (as determined by the Board of Directors) of the Company’s common stock on the date of grant. The exercise price of options granted to stockholders who hold 10% or more of the Company’s common stock on the option grant date shall not be less than 110% of the fair value of the Company’s common stock on the date of grant for both incentive and non-qualified stock option grants. These options generally vest over four years and expire ten years from the date of grant. Stock option grants may be exercisable upon grant, and any unvested shares purchased are subject to repurchase. There were no unvested shares subject to repurchase as of December 31, 2019 and December 31, 2018.

Stock Option Activity

A summary of the Company’s stock option activity is as follows:


					Weighted
	Shares		Weighted		Average
	Available		Average		Remaining	Aggregate
	for	Number of	Exercise		Contractual	Intrinsic
	Future Grant	Shares	Price		Life (Years)	Value
						(In thousands)
Balances at December 31, 2018	143,710	15,932,040	$	1.00	8.5	$	33,886
Additional shares authorized for grant	9,708,653	—		—
Options granted	(7,069,628)	7,069,628		2.68
Options exercised	—	(6,490,059)		0.64
Options forfeited	500,882	(500,882)		1.34
Options cancelled	289,642	(289,642)		0.61
Shares expired due to termination of 2008 Plan	(449,005)
Balances at December 31, 2019	3,124,254	15,721,085	$	2.44	8.4	$	165,906

Options exercisable at December 31, 2018		7,499,936	$	0.95	8.2	$	16,096

Options vested and expected to vest at December 31, 2019		15,721,085		2.44	8.4	$	165,906

Options exercisable at December 31, 2019		4,349,090	$	0.96	7.4	$	52,367

The total intrinsic value of options exercised was $50,846 and $59,000 for the years ended December 31, 2019 and 2018, respectively.

The weighted average fair value of options to purchase common stock granted was $2.68 and $1.14 in the years ended December 31, 2019 and 2018, respectively.

The fair value of options to purchase common stock vested was $2.8 million and $3.7 million in the years ended December 31, 2019 and 2018.

Immediately prior to the IPO, options representing 1,311,944 shares of common stock were exercised at an average exercise price of $0.94.

Certain weighted-average information and assumptions used in the option-pricing model for options granted to employees, directors, and non-employees are as follows:


	Year Ended December 31
	2019	2018
Expected term (in years)	5.63 - 6.28	5.38 - 6.10
Risk-free interest rate	1.5% - 2.5%	2.6% - 3.1%
Expected volatility	48.6% - 49.0%	48.1% - 48.9%
Expected dividend rate	—	—

The following table summarizes stock-based compensation expense for employees, which was included in the statements of operations and comprehensive loss as follows (in thousands):


	Year Ended
	December 31
	2019		2018
Cost of services	$	537	$	96
Selling and marketing		900		366
General and administrative		3,624		2,535
Total stock-based compensation expense	$	5,061	$	2,997

At December 31, 2019, the total compensation cost related to unvested stock-based awards granted to employees under the Company’s stock option plan but not yet recognized was approximately $19.3 million. This cost will be amortized on a straight-line basis over the remaining vesting period and will be adjusted for subsequent changes in estimated forfeitures. The weighted-average remaining recognition period is approximately 3.1 years.

In February and June of 2016, the Company issued common stock warrants to non-employees to acquire 71,280 and 69,114 shares of the Company’s common stock at an exercise price of $0.86 and $1.41 per share, respectively. The common stock warrants expire on the fifth anniversary of the grant. As of December 31, 2017 and 2018, all warrants remain outstanding. In 2019, 482,661 warrants were exercised for 441,307 shares of common stock at a weighted average exercise price of $1.59. In addition, 69,114 warrants were cancelled in 2019. For the years ended December 31, 2017 and 2018, the Company recognized total compensation expense $259,000, relating to the common stock warrants. All warrants were fully vested as of January 1, 2019. As a result of the adoption of ASU No. 2018-07, mark-to-market fair value accounting is not required and as all warrants were fully vested as of January 1, 2018, the Company did not recognize compensation expense relating to the common stock warrants for the year ended December 31, 2019.

The fair value of the common stock warrants was determined using the Black-Scholes option-pricing model with the following assumptions:



		2018
Contractual remaining life (years)		1
Risk-free interest rate		2.4%
Expected volatility		48.6%
Expected dividend yield		—

Income Taxes

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Income Taxes

13. Income Taxes

A tax provision of $12,000, and a tax benefit of $1.8 million and $3,000 was recorded for the year ended December 31, 2019, 2018, and 2017, respectively, as part of continuing operations.

The provision/(benefit) from income taxes is composed of the following (in thousands):


	December 31,
	2019		2018		2017
Current
Federal	$	—	$	(1,446)	$	(3)
State		12		(331)		—
Total Current		12		(1,777)		(3)
Deferred:
Federal		—		—		—
State		—		—		—
Total Deferred		—		—		—
Total provision/(benefit) from Income taxes	$	12	$	(1,777)	$	(3)

A reconciliation of the U.S. statutory income tax rate to the Company’s effective tax rate is as follows:


	December 31,
	2019		2018		2017
Income tax provision at statutory rate	21	%	21	%	34	%
State income taxes, net of federal benefit	6		5		4
Share-based compensation	56		(2)		(1)
Warrant valuation	(45)		(10)		—
Change in valuation allowance	(35)		13		63
Effect of tax legislation	—		—		(97)
State rate change	—		2		—
Other	(3)		(3)		(3)
Effective tax rate	—	%	26	%	—	%

Deferred Tax Balances

The components of the Company’s net deferred tax assets and liabilities are as follows (in thousands):


	December 31,
	2019		2018
Deferred tax assets:
Net operating loss carryforwards	$	24,104	$	22,446
Capitalized start‑up costs		13		15
Research and development credits		1,039		1,059
Accruals and reserves		2,860		1,895
Property and equipment		103		37
Intangibles		624		375
Total deferred tax assets		28,743		25,827
Valuation allowance		(28,743)		(25,781)
Deferred tax assets after valuation allowance	$	—	$	46
Deferred tax liabilities:
Deferred gain		—		(46)
Total deferred tax liabilities		—		(46)
Net deferred tax assets	$	—	$	—

Assessing the realizability of deferred tax assets requires the determination of whether it is more-likely-than-not that some portion or all the deferred tax assets will not be realized. In assessing the need for a valuation allowance, the Company considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, loss carryback and tax-planning strategies. Generally, more weight is given to objectively verifiable evidence, such as the cumulative loss in recent years, as a significant piece of negative evidence to overcome. The valuation allowance decreased by approximately $1.1 million during the year ended December 31, 2018 and increased by $2.9 million during the year ended December 31, 2019. As of December 31, 2019, the Company continues to maintain a full valuation allowance against its net deferred tax assets.

As of December 31, 2019, the Company has net operating loss carryforwards for federal and state income tax purposes of approximately $92 million and $71 million, respectively, which expire beginning in the year 2031. The federal and California research and development tax credits are approximately $729,000 and $830,000 respectively. The federal research credits will begin to expire in 2030 and the California research and development credits have no expiration date. Utilization of the net operating loss carryforwards and credits may be subject to a substantial annual limitation due to ownership changes that may have occurred previously or that could occur in the future, as provided by Section 382 of the Internal Revenue Code of 1986, as well as similar state provisions. Such annual limitation could result in the expiration of net operating losses and credits before their utilization. The Company has not performed a detailed analysis to determine if an ownership change has occurred as a result of the initial public offering.

As of December 31, 2019 and 2018, the Company had not accrued any interest or penalties related to uncertain tax positions.

Unrecognized Tax Benefits

A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands):


	December 31,
	2019		2018		2017
Balance at the beginning of the year	$	397	$	397	$	397
Reductions based upon tax positions related to the current year		(7)		—		—
Balance at the end of the year	$	390	$	397	$	397

None of unrecognized tax benefits would materially impact the effective tax rate if realized during the year due to the Company’s full valuation allowance position. The Company does not anticipate any material change in its unrecognized tax benefits over the next twelve months.

The Company files U.S. federal and state income tax returns with varying statutes of limitations. All tax years since inception remain open to examination due to the carryover of unused net operating losses and tax credits.

The Tax Cuts and Jobs Act (the “Tax Act”) was enacted on December 22, 2017 and introduced significant changes to U.S. income tax law. Effective in 2018, The Tax Act reduced the U.S. corporate statutory tax rate from 35% to 21%, allowed for immediate expensing of certain qualified capital property, eliminated the net operating loss carryback but allowed for indefinite net operating loss carryforwards that can reduce up to 80% of taxable income and created a new limitation on the deductibility of interest expense.

Accounting for the income tax effects of the Tax Act requires significant judgments and estimates in the interpretation and calculation of the provisions of the Tax Act. Due to the timing of the enactment and the complexity involved in applying the provisions of the Tax Act, the Company made reasonable estimates of the effects of the Tax Act in the consolidated financial statements for the year ended December 31, 2017, as permitted under ASU 2018-05 Income Taxes (Topic 740), Amendments to SEC Paragraphs Pursuant to SAB 118.

The remeasurement of the Company’s U.S. deferred taxes due to the reduction in the U.S. federal corporate tax rate resulted in a reduction of deferred tax assets offset by a reduction of the Company’s valuation allowance, resulting in no net income impact during the year ended December 31, 2017. The accounting for these items was completed in the fourth quarter of 2018, the end of the measurement period for purposes of SAB 118, and there were no adjustments related to the provisional items.

Net Income (Loss) Per Share

12 Months Ended

Dec. 31, 2019

Earnings Per Share [Abstract]

Net Income (Loss) Per Share

14. Net Income (Loss) Per Share

A reconciliation of net income (loss) available to common stockholders and the number of shares in the calculation of basic and diluted earnings (loss) per share follows (in thousands, except share and per share amounts):


	Year Ended
	December 31,
	2019		2018		2017
Basic and diluted earnings (loss) per common share:
Numerator:
Net (loss) income	$	(8,569)	$	661	$	(12,452)
Less:
Net income from discontinued operations, net of tax		—		(5,777)		(4)
Deemed dividends on convertible preferred stock		—		(425)		(1,012)
Undistributed earnings to participating securities
Net loss attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)

Denominator:
Weighted-average shares used in computing basic and diluted loss per share attributable to common stockholders		20,735,202		5,539,739		5,677,860
Basic and diluted net earnings (loss) per share attributable to common stockholders	$	(0.41)	$	(1.00)	$	(2.37)

Diluted (loss) income per common share:
Numerator:
Net (loss) income attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)
Adjustments to undistributed earnings of participating securities		—		—		—
Diluted net (loss) income per share attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)

Denominator:
Weighted-average shares used in computing basic net earnings (loss) per share attributable to common stockholder		20,735,202		5,539,739		5,677,860
Add options to purchase common stock		—		—		—
Weighted-average shares used in computing basic net (loss) income per share attributable to common stockholders		20,735,202		5,539,739		5,677,860
Diluted net (loss) income per share attributable to common stockholders	$	(0.41)	$	(1.00)	$	(2.37)

The following weighted-average outstanding shares of potentially dilutive securities were excluded from the computation of diluted net loss per share attributable to common stockholders for the period presented because including them would have been antidilutive:


	Year Ended
	December 31,
	2019	2018	2017
Redeemable convertible preferred stock	—	65,960,205	62,078,914
Options to purchase common stock	13,610,441	6,025,473	339,452
Warrants to purchase common stock	122,882	60,168	14,168
Warrants to purchase convertible preferred stock	—	260,239	—
Total potential dilutive shares	13,733,323	72,306,085	62,432,534

401(k) Plan and ESPP	12 Months Ended
401(k) Plan and ESPP	Dec. 31, 2019
Retirement Benefits [Abstract]
401(k) Plan and ESPP	15. 401(k) Plan and ESPP The Company sponsors a 401(k) defined contribution plan covering all employees. Employer contributions began in 2018 and the Company incurred expenses for the year ended December 31, 2018 of $263,000. For the year ended December 31, 2019 the Company incurred expenses of $355,000. In October 2019, the Board of Directors and stockholders also adopted and approved the 2019 Employee Stock Purchase Plan (the “ESPP”). Following the IPO, the ESPP authorized the issuance of 1,700,000 shares of common stock to purchase rights granted to our employees or to employees of our designated affiliates. As of December 31, 2019, zero shares of common stock have been purchased. The first purchase period will commence on July 31, 2020.

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2019
Related Party Transactions [Abstract]
Related Party Transactions	16. Related Party Transactions In January 2018, the Company executed an agreement with a related party to sell the Eeva business, representing all of the medical device segment. Refer to Note 6. In June 2018, the Company redeemed and retired 1,202,196 Series B convertible preferred stock from a former employee pursuant to their contractual right of first refusal at a purchase price of $2.5 million The excess of the purchase price over the carrying value $(1.73) of $425,000 has been recorded as a dividend in accumulated deficit as of December 31, 2018. Refer to Note 12 for further detail on this transaction.

Unaudited Quarterly Results of Operations Data

12 Months Ended

Dec. 31, 2019

Quarterly Financial Information Disclosure [Abstract]

Unaudited Quarterly Results of Operations Data

17. Unaudited Quarterly Results of Operations Data

The following table sets forth our unaudited quarterly consolidated results of operations for each of the eight quarterly periods in the period ended December 31, 2019. Our unaudited quarterly results of operations have been prepared on the same basis as our audited consolidated financial statements, and we believe they reflect all normal recurring adjustments necessary for the fair statement of our results of operations for these periods. This information should be read in conjunction with our consolidated financial statements and related notes included elsewhere in this Annual Report. Our historical operating data may not be indicative of our future performance.


	Three Months Ended
	Mar. 31,		Jun. 30,		Sep. 30,		Dec. 31,		Mar. 31,		Jun. 30,		Sep. 30,		Dec. 31,
	2018		2018		2018		2018		2019		2019		2019		2019
	(in thousands)
Revenue	$	22,258	$	26,157	$	27,798	$	29,187	$	47,197	$	56,168	$	61,196	$	65,122
Cost of services		18,324		21,119		22,751		23,772		37,233		44,716		48,876		53,353
Gross profit		3,934		5,038		5,047		5,415		9,964		11,452		12,320		11,769
Operating expenses:
Sales and marketing		1,763		1,731		1,648		2,143		2,346		3,117		3,183		3,255
General and administrative		4,016		3,624		3,986		3,975		4,508		5,981		6,068		7,370
Total operating expenses		5,779		5,355		5,634		6,118		6,854		9,098		9,251		10,625
(Loss) income from operations		(1,845)		(317)		(587)		(703)		3,110		2,354		3,069		1,144
Interest expense, net		(88)		(344)		(27)		(38)		(38)		(128)		(28)		136
Convertible preferred stock warrant valuation adjustment		(184)		(459)		(918)		(1,383)		(551)		(642)		(11,226)		(5,757)
Total other expense, net		(272)		(803)		(945)		(1,421)		(589)		(770)		(11,254)		(5,621)
(Loss) income from continuing operations, before tax		(2,117)		(1,120)		(1,532)		(2,124)		2,521		1,584		(8,185)		(4,477)
Benefit (provision) for income taxes		546		289		395		547		—		(64)		(25)		77
Net (loss) income from continuing operations		(1,571)		(831)		(1,137)		(1,577)		2,521		1,520		(8,210)		(4,400)
Net income from discontinued operations, net of taxes		5,724		—		1		52		—		—		—		—
Net (loss) income	$	4,153	$	(831)	$	(1,136)	$	(1,525)	$	2,521	$	1,520	$	(8,210)	$	(4,400)
Net (loss) income attributable to common stockholders	$	(1,571)	$	(1,255)	$	(1,136)	$	(1,577)	$	31	$	—	$	(8,210)	$	(4,400)
Net loss per share attributable to common stockholders:
Basic and Diluted
Continuing operations	$	(0.28)	$	(0.22)	$	(0.20)	$	(0.31)	$	0.01	$	—	$	(1.10)	$	(0.07)
Discontinued operations		1.01		—		—		0.01		—		—		—		—
Total net loss per share attributable to common stockholders basic and diluted	$	0.73	$	(0.22)	$	(0.20)	$	(0.30)	$	0.01	$	-	$	(1.10)	$	(0.07)
Weighted-average shares used in computing net (loss) earnings per share:
Basic and Diluted		5,690,083		5,693,169		5,627,656		5,151,859		15,120,928		5,172,209		7,472,469		64,192,100

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2019

Accounting Policies [Abstract]

Basis of Presentation

The accompanying consolidated financial statements include those of the Company and its wholly owned subsidiary, Fertility Authority LLC. Effective June 2018, the Company legally dissolved the Fertility Authority LLC legal entity. All intercompany balances and transactions have been eliminated in consolidation. The consolidated financial statements and accompanying notes were prepared in accordance with accounting principles generally accepted in United Sates (“U.S. GAAP”).

Segment Information

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision maker (“CODM”), or decision-making group, in making decisions on how to allocate resources and assess performance. Following the divestiture of Eeva, the Company operates and manages in one operating segment, providing fertility and pharmacy benefits solutions. The Company defines its CODM as its Chief Executive Officer and its President, Chief Financial and Operating Officer. All long-lived assets are located in the United States and all revenue is attributed to the United States. Since the Company operates in one operating segment, all required financial segment information can be found in the consolidated financial statements.

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP generally requires management to make estimates and assumptions that affect the reported amount of certain assets, liabilities, revenue, and expenses, and the related disclosure of contingent assets and liabilities. Specific accounts that require management estimates include accrued receivables, accrued claims payable, allowance for doubtful accounts, accrued rebates, convertible preferred stock warrant liabilities and stock-based compensation. Management bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.

Cash and Cash Equivalents

Revenue Recognition

The Company applies the following five-step model to recognize revenue from contracts with clients:

Identification of the contract, or contracts, with a client

Identification of the performance obligations in the contract

Determination of the transaction price

Allocation of the transaction price to the performance obligations in the contract

Recognition of revenue when, or as, a performance obligation is satisfied

Fertility Benefits Revenue

Pharmacy Benefits Revenue

Accrued Receivable and Accrued Claims Payable

Accounts Receivable and Allowance for Doubtful Accounts


	Years Ended December 31, 2019 and 2018
December 31, 2019	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
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.

Cost of Services

Fertility Benefit Services

Pharmacy Benefit Services

Vendor rebates

Concentration of Credit Risk and Off-Balance-Sheet Risk

Financial instruments that potentially subject the Company to concentrations of credit risk consists primarily of cash and cash equivalents and accounts receivable.

Impairment of Long-Lived Assets

Property and Equipment

Goodwill and Intangible Assets

Convertible Preferred Stock Warrants

Stock-Based Compensation

Common Stock Valuation

the Company’s financial performance

the rights, preferences and privileges of the convertible preferred stock relative to those of the common stock; and

general economic and financial conditions, and the trends specific to the markets in which the Company operates

Income Taxes

The amount of deferred tax provided is calculated using tax rates enacted at the balance sheet date. The impact of tax law changes is recognized in periods when the change is enacted.

Fair Value of Financial Instruments and Fair Value Measurements

Level 1—Quoted prices in active markets for identical assets and liabilities.

Level 3—Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.

Net Income (Loss) per Share Attributable to Common Stockholders

Net (Loss) Income per Share Attributable to Common Stockholders

Recently Adopted Accounting Pronouncements and Accounting Pronouncements Issued but Not Yet Adopted

Recently Adopted Accounting Pronouncements

Accounting Pronouncements Issued but Not Yet Adopted

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2019

Accounting Policies [Abstract]

Schedule of accounts receivable and allowance for doubtful accounts


	Years Ended December 31, 2019 and 2018
December 31, 2019	Balance at Beginning of Period		Charged to Revenue		Charged to Costs and Expenses		Write-offs		Utilization		Balance at End of Period
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

Revenue (Tables)

12 Months Ended

Dec. 31, 2019

Revenue from Contract with Customer [Abstract]

Schedule of disaggregation of revenue


	Year Ended
	December 31,
	2019		2018
Revenue
Fertility benefit services revenue	$	189,618	$	99,786
Pharmacy benefit services revenue		40,065		5,614
Total revenue	$	229,683	$	105,400

Fair Value Measurement (Tables)

12 Months Ended

Dec. 31, 2019

Fair Value Disclosures [Abstract]

Schedule of liabilities measured at fair value on a recurring basis

December 31, 2019

Total

Level 1

Level 2

Level 3

Liabilities:

Convertible preferred stock warrant liability

—

Total

—


	December 31, 2018
	Total		Level 1		Level 2		Level 3
Liabilities:
Convertible preferred stock warrant liability	$	4,589	$	—	$	—	$	4,589
Total	$	4,589	$	—	$	—	$	4,589

Schedule of changes in the estimated fair value using unobservable inputs


	Convertible
	Preferred Stock
	Warrants
Balance as of December 31, 2018	$	4,589
Changes in estimate fair value of warrants		18,176
Conversion of convertible preferred stock warrants to common stock warrants upon IPO		(22,765)
Balance at December 31, 2019	$	—

Divestitures (Tables)

12 Months Ended

Dec. 31, 2019

Discontinued Operations and Disposal Groups [Abstract]

Summary of the operating results and consolidated statement of cash flows from discontinued operations


	Year Ended
	December 31,
	2019		2018		2017
Revenue		—		—	$	328
Cost of service		—		—		59
Gross profit		—		—		269
Operating expenses:
Research and development		—		—		241
General and administration		—		—		21
Total operating expenses		—		—		262
Income from discontinued operations		—		—		7
Gain on sale of discontinued operations	$	—	$	7,554	$	—
Income from discontinued operations, before taxes		—		7,554		7
Provision for income taxes		—		(1,777)		(3)
Net income from discontinued operations, net of taxes	$	—	$	5,777	$	4


	Year Ended
	December 31,
	2019		2018		2017
OPERATING ACTIVITIES
Depreciation expense		—		—		18
Deferred license revenue		—		—		(73)

INVESTING ACTIVITIES
Deferred consideration		—		200		—
Proceeds from sale of business, net of costs		200		2,481		—

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3A
-URI http://asc.fasb.org/extlink&oid=109226691&loc=SL51724579-110230

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109222650&loc=d3e1474-107760

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5D
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721677-107760

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 45
-Paragraph 11
-URI http://asc.fasb.org/extlink&oid=109222160&loc=SL51721533-107759

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 3A
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721659-107760

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 4B
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721665-107760

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 360
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109226691&loc=d3e2941-110230

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5C
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721675-107760

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721683-107760

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 1
-URI http://asc.fasb.org/extlink&oid=109222650&loc=d3e1361-107760

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5A
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721671-107760

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 5B
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721673-107760

Reference 13: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
-SubTopic 20
-Section 50
-Paragraph 4A
-URI http://asc.fasb.org/extlink&oid=109222650&loc=SL51721663-107760

+ Details

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2019

Property, Plant and Equipment [Abstract]

Schedule of Property and equipment


	Estimated
	Useful Life	December 31,
	(in years)	2019		2018

Machinery and equipment	3-5	$	13	$	13
Computers and software	3		1,353		798
Leasehold improvements	lease term		2,391		346
Furniture and fixtures	7		459		102
			4,216		1,259
Less: accumulated depreciation			(1,133)		(483)
Total property and equipment, net		$	3,083	$	776

Intangible Assets, Net (Tables)

12 Months Ended

Dec. 31, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of intangible assets


	Estimated
	Useful Life	December 31,
	(in years)	2019		2018
Trademarks	8	$	4,000	$	4,000
Physician Network	6		3,500		3,500
Website	5		2,000		2,000
			9,500		9,500
Less: accumulated amortization			(7,125)		(5,641)
Total intangible assets, net		$	2,375	$	3,859

Schedule of future amortization expense of other intangible assets


Year ending December 31:
2020	$	1,162
2021		614
2022		500
Thereafter		99
Total	$	2,375

Accrued Expenses and Other Current Liabilities (Tables)

12 Months Ended

Dec. 31, 2019

Accrued Liabilities and Other Liabilities [Abstract]

Schedule of accrued expenses and other current liabilities


	December 31,
	2019		2018

Accrued claims payable	$	9,795	$	6,656
Accrued compensation		2,559		1,490
Accrued commission		1,216		966
Professional fees		1,315		274
Other		1,890		396
Total accrued expenses and other current liabilities	$	16,775	$	9,782

Convertible Preferred Stock Warrants (Tables)

12 Months Ended

Dec. 31, 2019

Warrants and Rights Note Disclosure [Abstract]

Schedule of preferred stock warrant liabilities


Rollforward of warrants and fair value	Warrants	Liability
		(in thousands)
Total warrants and liability as of December 31, 2018	2,019,245	$	4,589
Revaluation of remaining warrants			18,176
Conversion of preferred stock warrants to common stock warrants	(2,019,245)		(22,765)
Total warrants and liability as of December 31, 2019	—	$	—

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2019

Commitments and Contingencies Disclosure [Abstract]

Schedule of contractual obligations


	Operating
Year Ending December 31:	Lease
2020	$	885
2021		1,286
2022		1,286
2023		1,286
2024		1,326
Thereafter		6,213
Total	$	12,282

Stockholders' Equity (Deficit) (Tables)

12 Months Ended

Dec. 31, 2019

Equity [Abstract]

Schedule of common stock reserved for future issuance


	December 31,	December 31,
	2019	2018

Convertible preferred stock	-	65,428,088
Warrants in Series B convertible preferred stock issued and outstanding	-	2,019,245
Common stock warrants	1,607,864	140,394
Shares available for grants under stock option plan	3,124,254	143,710
Options issued and outstanding under stock plan	15,721,085	15,932,040
Total common stock reserved for future issuance	20,453,203	83,663,477

Summary of stock option activity


					Weighted
	Shares		Weighted		Average
	Available		Average		Remaining	Aggregate
	for	Number of	Exercise		Contractual	Intrinsic
	Future Grant	Shares	Price		Life (Years)	Value
						(In thousands)
Balances at December 31, 2018	143,710	15,932,040	$	1.00	8.5	$	33,886
Additional shares authorized for grant	9,708,653	—		—
Options granted	(7,069,628)	7,069,628		2.68
Options exercised	—	(6,490,059)		0.64
Options forfeited	500,882	(500,882)		1.34
Options cancelled	289,642	(289,642)		0.61
Shares expired due to termination of 2008 Plan	(449,005)
Balances at December 31, 2019	3,124,254	15,721,085	$	2.44	8.4	$	165,906

Options exercisable at December 31, 2018		7,499,936	$	0.95	8.2	$	16,096

Options vested and expected to vest at December 31, 2019		15,721,085		2.44	8.4	$	165,906

Options exercisable at December 31, 2019		4,349,090	$	0.96	7.4	$	52,367

Schedule of assumptions used in the option-pricing model for options granted


	Year Ended December 31
	2019	2018
Expected term (in years)	5.63 - 6.28	5.38 - 6.10
Risk-free interest rate	1.5% - 2.5%	2.6% - 3.1%
Expected volatility	48.6% - 49.0%	48.1% - 48.9%
Expected dividend rate	—	—

Summary of stock based compensation expense for employees


	Year Ended
	December 31
	2019		2018
Cost of services	$	537	$	96
Selling and marketing		900		366
General and administrative		3,624		2,535
Total stock-based compensation expense	$	5,061	$	2,997

Schedule of assumptions to determine the fair value of common stock warrants



		2018
Contractual remaining life (years)		1
Risk-free interest rate		2.4%
Expected volatility		48.6%
Expected dividend yield		—

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Composition of the income tax (benefit) provision


	December 31,
	2019		2018		2017
Current
Federal	$	—	$	(1,446)	$	(3)
State		12		(331)		—
Total Current		12		(1,777)		(3)
Deferred:
Federal		—		—		—
State		—		—		—
Total Deferred		—		—		—
Total provision/(benefit) from Income taxes	$	12	$	(1,777)	$	(3)

Reconciliation of the statutory income tax rate to the effective tax rate


	December 31,
	2019		2018		2017
Income tax provision at statutory rate	21	%	21	%	34	%
State income taxes, net of federal benefit	6		5		4
Share-based compensation	56		(2)		(1)
Warrant valuation	(45)		(10)		—
Change in valuation allowance	(35)		13		63
Effect of tax legislation	—		—		(97)
State rate change	—		2		—
Other	(3)		(3)		(3)
Effective tax rate	—	%	26	%	—	%

Components of net deferred tax assets and liabilities


	December 31,
	2019		2018
Deferred tax assets:
Net operating loss carryforwards	$	24,104	$	22,446
Capitalized start‑up costs		13		15
Research and development credits		1,039		1,059
Accruals and reserves		2,860		1,895
Property and equipment		103		37
Intangibles		624		375
Total deferred tax assets		28,743		25,827
Valuation allowance		(28,743)		(25,781)
Deferred tax assets after valuation allowance	$	—	$	46
Deferred tax liabilities:
Deferred gain		—		(46)
Total deferred tax liabilities		—		(46)
Net deferred tax assets	$	—	$	—

Reconciliation of unrecognized tax benefits


	December 31,
	2019		2018		2017
Balance at the beginning of the year	$	397	$	397	$	397
Reductions based upon tax positions related to the current year		(7)		—		—
Balance at the end of the year	$	390	$	397	$	397

Net Income (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 2019

Earnings Per Share [Abstract]

Reconciliation of net income loss available to common stockholders


	Year Ended
	December 31,
	2019		2018		2017
Basic and diluted earnings (loss) per common share:
Numerator:
Net (loss) income	$	(8,569)	$	661	$	(12,452)
Less:
Net income from discontinued operations, net of tax		—		(5,777)		(4)
Deemed dividends on convertible preferred stock		—		(425)		(1,012)
Undistributed earnings to participating securities
Net loss attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)

Denominator:
Weighted-average shares used in computing basic and diluted loss per share attributable to common stockholders		20,735,202		5,539,739		5,677,860
Basic and diluted net earnings (loss) per share attributable to common stockholders	$	(0.41)	$	(1.00)	$	(2.37)

Diluted (loss) income per common share:
Numerator:
Net (loss) income attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)
Adjustments to undistributed earnings of participating securities		—		—		—
Diluted net (loss) income per share attributable to common stockholders	$	(8,569)	$	(5,541)	$	(13,468)

Denominator:
Weighted-average shares used in computing basic net earnings (loss) per share attributable to common stockholder		20,735,202		5,539,739		5,677,860
Add options to purchase common stock		—		—		—
Weighted-average shares used in computing basic net (loss) income per share attributable to common stockholders		20,735,202		5,539,739		5,677,860
Diluted net (loss) income per share attributable to common stockholders	$	(0.41)	$	(1.00)	$	(2.37)

Antidilutive securities excluded from computation of earnings per share


	Year Ended
	December 31,
	2019	2018	2017
Redeemable convertible preferred stock	—	65,960,205	62,078,914
Options to purchase common stock	13,610,441	6,025,473	339,452
Warrants to purchase common stock	122,882	60,168	14,168
Warrants to purchase convertible preferred stock	—	260,239	—
Total potential dilutive shares	13,733,323	72,306,085	62,432,534

Unaudited Quarterly Results of Operations Data (Tables)

12 Months Ended

Dec. 31, 2019

Quarterly Financial Information Disclosure [Abstract]

Schedule of quarterly consolidated results of operations


	Three Months Ended
	Mar. 31,		Jun. 30,		Sep. 30,		Dec. 31,		Mar. 31,		Jun. 30,		Sep. 30,		Dec. 31,
	2018		2018		2018		2018		2019		2019		2019		2019
	(in thousands)
Revenue	$	22,258	$	26,157	$	27,798	$	29,187	$	47,197	$	56,168	$	61,196	$	65,122
Cost of services		18,324		21,119		22,751		23,772		37,233		44,716		48,876		53,353
Gross profit		3,934		5,038		5,047		5,415		9,964		11,452		12,320		11,769
Operating expenses:
Sales and marketing		1,763		1,731		1,648		2,143		2,346		3,117		3,183		3,255
General and administrative		4,016		3,624		3,986		3,975		4,508		5,981		6,068		7,370
Total operating expenses		5,779		5,355		5,634		6,118		6,854		9,098		9,251		10,625
(Loss) income from operations		(1,845)		(317)		(587)		(703)		3,110		2,354		3,069		1,144
Interest expense, net		(88)		(344)		(27)		(38)		(38)		(128)		(28)		136
Convertible preferred stock warrant valuation adjustment		(184)		(459)		(918)		(1,383)		(551)		(642)		(11,226)		(5,757)
Total other expense, net		(272)		(803)		(945)		(1,421)		(589)		(770)		(11,254)		(5,621)
(Loss) income from continuing operations, before tax		(2,117)		(1,120)		(1,532)		(2,124)		2,521		1,584		(8,185)		(4,477)
Benefit (provision) for income taxes		546		289		395		547		—		(64)		(25)		77
Net (loss) income from continuing operations		(1,571)		(831)		(1,137)		(1,577)		2,521		1,520		(8,210)		(4,400)
Net income from discontinued operations, net of taxes		5,724		—		1		52		—		—		—		—
Net (loss) income	$	4,153	$	(831)	$	(1,136)	$	(1,525)	$	2,521	$	1,520	$	(8,210)	$	(4,400)
Net (loss) income attributable to common stockholders	$	(1,571)	$	(1,255)	$	(1,136)	$	(1,577)	$	31	$	—	$	(8,210)	$	(4,400)
Net loss per share attributable to common stockholders:
Basic and Diluted
Continuing operations	$	(0.28)	$	(0.22)	$	(0.20)	$	(0.31)	$	0.01	$	—	$	(1.10)	$	(0.07)
Discontinued operations		1.01		—		—		0.01		—		—		—		—
Total net loss per share attributable to common stockholders basic and diluted	$	0.73	$	(0.22)	$	(0.20)	$	(0.30)	$	0.01	$	-	$	(1.10)	$	(0.07)
Weighted-average shares used in computing net (loss) earnings per share:
Basic and Diluted		5,690,083		5,693,169		5,627,656		5,151,859		15,120,928		5,172,209		7,472,469		64,192,100

Business and Basis of Presentation - Description of Business (Details) - segment	1 Months Ended	12 Months Ended
	Mar. 31, 2015	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Number of operating segments	2	1	1	1

Business and Basis of Presentation - Reverse Stock Split (Details)	Oct. 14, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Reverse stock split ratio	0.22000264

Business and Basis of Presentation - Initial Public Offering (Details) - USD ($) $ / shares in Units, $ in Thousands		12 Months Ended
	Oct. 29, 2019	Dec. 31, 2019	Sep. 30, 2018
Subsidiary, Sale of Stock [Line Items]
Share price (in dollars per share)			$ 1.49
Underwriters’ discounts and commissions		$ 5,900
Offering costs		3,700
Reclassification of temporary equity to permanent equity		106,237
Additional Paid in Capital
Subsidiary, Sale of Stock [Line Items]
Reclassification of temporary equity to permanent equity		$ 106,230
Common Stock
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)		6,700,000
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering (in shares)		65,428,088
Reclassification of temporary equity to permanent equity		$ 7
IPO
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	6,700,000
Share price (in dollars per share)	$ 13.00
Net proceeds after deducting underwriters’ discounts, commissions, and offering costs	$ 77,500
Underwriters’ discounts and commissions	5,900
Offering costs	$ 3,700
Conversion of Convertible Preferred Stock to Common Stock upon initial public offering (in shares)	65,428,088
Conversion basis (in shares)	1
IPO \| Additional Paid in Capital
Subsidiary, Sale of Stock [Line Items]
Reclassification of temporary equity to permanent equity	$ 106,200
IPO \| Common Stock
Subsidiary, Sale of Stock [Line Items]
Reclassification of temporary equity to permanent equity	$ 7
Selling Shareholders, Including Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	4,800,000
Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Number of shares issued and sold (in shares)	1,500,000

Business and Basis of Presentation - Segment Information (Details) - segment	1 Months Ended	12 Months Ended
	Mar. 31, 2015	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]
Number of operating segments	2	1	1	1

Summary of Significant Accounting Policies - Revenue Recognition (Details)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Contract term	3 years
Contract termination, notice period, low end of range	30 days
Contract termination, notice period, high end of range	90 days

Summary of Significant Accounting Policies - Accrued Receivable and Accrued Claims Payable (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Accrued receivables	$ 16,000	$ 9,500
Accrued claims payable	9,795	6,656
Unbilled receivables	$ 8,500	$ 3,600

Summary of Significant Accounting Policies - Accounts and Receivable and Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	$ 3,486	$ 1,090
Charged to Revenue	7,742	3,414
Charged to Costs and Expenses	1,606	824
Write-offs	(10)	(239)
Utilization	(6,504)	(1,603)
Balance at End of Period	6,320	3,486
Allowance for doubtful accounts
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	1,175	590
Charged to Costs and Expenses	1,606	824
Write-offs	(10)	(239)
Balance at End of Period	2,771	1,175
Allowance for service changes and cancellations
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	2,311	500
Charged to Revenue	7,742	3,414
Utilization	(6,504)	(1,603)
Balance at End of Period	$ 3,549	$ 2,311

Summary of Significant Accounting Policies - Cost of Services (Details)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Contract Term, Clinics, Low End of Range	1 year
Contract Term, Clinics, High End of Range	2 years

Summary of Significant Accounting Policies - Concentration of Credit Risk (Details) - Institution	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Concentration Risk [Line Items]
Number of financial institutions where substantially all of the cash is maintained	1
Accounts Receivable \| Credit Concentration Risk
Concentration Risk [Line Items]
Concentration risk (as a percent)	31.00%	48.00%
Accounts Receivable \| Credit Concentration Risk \| Largest customer
Concentration Risk [Line Items]
Concentration risk (as a percent)	17.00%	25.00%
Accounts Receivable \| Credit Concentration Risk \| Second largest customer
Concentration Risk [Line Items]
Concentration risk (as a percent)	14.00%	13.00%
Accounts Receivable \| Credit Concentration Risk \| Third largest customer
Concentration Risk [Line Items]
Concentration risk (as a percent)		10.00%

Summary of Significant Accounting Policies - Impairment of Long-Lived Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Impairment or Disposal of Tangible Assets Disclosure [Abstract]
Impairments	$ 0	$ 0

Summary of Significant Accounting Policies - Goodwill and Other Intangibles (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($) segment	Dec. 31, 2018 USD ($) segment	Dec. 31, 2017 USD ($) segment
Goodwill and Intangible Asset Impairment [Abstract]
Number of reporting units \| segment	1	1	1
Impairment of goodwill or intangible assets \| $	$ 0	$ 0	$ 0

Summary of Significant Accounting Policies - Stock-Based Compensation - General Information (Details)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected dividend rate (as a percent)	0.00%	0.00%

Summary of Significant Accounting Policies - Stock-Based Compensation - ASU 2016-09 (Details) $ in Thousands	Jan. 01, 2018 USD ($)
Accounting Standards Update 2016-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Impact of adoption of 2016- 09	$ (213)

Summary of Significant Accounting Policies - Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Unrecognized Tax Benefits, Income Tax Penalties and Interest Accrued [Abstract]
Accrued interest or penalties	$ 0	$ 0	$ 0
Unrecognized Tax Benefits, Income Tax Penalties and Interest Expense [Abstract]
Income tax penalties and interest expense	$ 0	$ 0	$ 0

Summary of Significant Accounting Policies - Accounting Pronouncements - General Information (Details)	Dec. 31, 2019
Accounting Standards Update 2014-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Retrospective
Accounting Standards Update 2015-17
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2018
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Prospective
Accounting Standards Update 2016-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2018
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Prospective
Accounting Standards Update 2016-15
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2018
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2017-04
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2018
Change in Accounting Principle, Accounting Standards Update, Early Adoption	true
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Prospective
Accounting Standards Update 2017-01
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2017-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2018
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2018-07
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 01, 2019
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Accounting Standards Update 2016-02
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	false
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false
Change in Accounting Principle, Accounting Standards Update, Transition Option Elected	Modified Retrospective
Accounting Standards Update 2016-13
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted	false
Change in Accounting Principle, Accounting Standards Update, Early Adoption	false

Summary of Significant Accounting Policies - Accounting Pronouncements - Adjustments (Details) $ in Thousands	Jan. 01, 2018 USD ($)
Accounting Standards Update 2016-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Impact of adoption of 2016- 09	$ (213)

Revenue - Disaggregated Revenue (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Revenues [Abstract]
Revenue	$ 65,122	$ 61,196	$ 56,168	$ 47,197	$ 29,187	$ 27,798	$ 26,157	$ 22,258	$ 229,683	$ 105,400	$ 48,584
Fertility benefit services revenue
Revenues [Abstract]
Revenue									189,618	99,786
Pharmacy benefit services revenue
Revenues [Abstract]
Revenue									$ 40,065	$ 5,614

Revenue - Concentration of Major Clients (Details) - Sales Revenue, Net - Customer Concentration Risk	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Concentration Risk [Line Items]
Concentration risk (as a percent)	41.00%	48.00%
Client 1
Concentration Risk [Line Items]
Concentration risk (as a percent)	16.00%	24.00%
Client 2
Concentration Risk [Line Items]
Concentration risk (as a percent)	15.00%	14.00%
Client 3
Concentration Risk [Line Items]
Concentration risk (as a percent)	10.00%	10.00%

Fair Value Measurement - Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Financial Liabilities Fair Value Disclosure [Abstract]
Convertible preferred stock warrant liability		$ 4,589
Recurring
Financial Liabilities Fair Value Disclosure [Abstract]
Convertible preferred stock warrant liability	$ 4,589
Total	4,589
Recurring \| Level 3
Financial Liabilities Fair Value Disclosure [Abstract]
Convertible preferred stock warrant liability	4,589
Total	$ 4,589

Fair Value Measurement - Unobservable Input Reconciliation (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2019 USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at beginning of period	$ 4,589
Changes in estimate fair value of warrants	18,176
Conversion of convertible preferred stock warrants to common stock warrants upon IPO	$ (22,765)
Fair Value, Recurring Basis, Unobservable Input Reconciliation, Liability, Gain (Loss), Statement of Income	us-gaap:FairValueAdjustmentOfWarrants

Fair Value Measurement - Transfers (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Fair Value Measurement
Transfer of assets from Level 1 to Level 2	$ 0	$ 0
Transfer of assets from Level 2 to Level 1	0	0
Transfer of liabilities from Level 1 to Level 2	0	0
Transfer of liabilities from Level 2 to Level 1	0	0
Transfer of assets, Level 3, net	0	0
Transfer of liabilities, Level 3, net	$ 0	$ 0

Property and Equipment, Net - Useful Lives (Details)	12 Months Ended
Property and Equipment, Net - Useful Lives (Details)	Dec. 31, 2019
Machinery and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful life	3 years
Machinery and equipment \| Maximum
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful life	5 years
Computers and software
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful life	3 years
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful life	7 years
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, estimated useful life	lease term

Property and Equipment, Net - Tabular Disclosure (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment, Net, by Type [Abstract]
Property and equipment, gross	$ 4,216	$ 1,259
Less: accumulated depreciation	(1,133)	(483)
Total property and equipment, net	3,083	776
Machinery and equipment
Property, Plant and Equipment, Net, by Type [Abstract]
Property and equipment, gross	13	13
Computers and software
Property, Plant and Equipment, Net, by Type [Abstract]
Property and equipment, gross	1,353	798
Furniture and fixtures
Property, Plant and Equipment, Net, by Type [Abstract]
Property and equipment, gross	459	102
Leasehold improvements
Property, Plant and Equipment, Net, by Type [Abstract]
Property and equipment, gross	$ 2,391	$ 346

Property and Equipment, Net - Depreciation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Depreciation, Depletion and Amortization [Abstract]
Depreciation expense	$ 650	$ 400	$ 76

Divestitures - General Information (Details) - Eeva Business - Discontinued Operations, Disposed of by Sale - Investor $ in Thousands	Jan. 18, 2018 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration	$ 7,900
Cash consideration	3,000
Liability forgiveness	4,900
Deferred considerations	$ 300

Divestitures - Balance Sheet (Details) - Eeva Business - Discontinued Operations, Disposed of by Sale $ in Thousands	Dec. 31, 2018 USD ($)
Discontinued operations, assets
Assets	$ 200
Discontinued operations, liabilities
Liabilities	$ 0

Divestitures - Operating Results (Details) - USD ($) $ in Thousands	3 Months Ended			12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Mar. 31, 2018	Dec. 31, 2018	Dec. 31, 2017
Discontinued Operation, Income (Loss) from Discontinued Operation Disclosures [Abstract]
Net income from discontinued operations, net of taxes	$ 52	$ 1	$ 5,724	$ 5,777	$ 4
Eeva Business \| Discontinued Operations, Disposed of by Sale
Discontinued Operation, Gain (Loss) on Disposal of Discontinued Operation, Net of Tax [Abstract]
Gain on sale of discontinued operations				7,554
Discontinued Operation, Income (Loss) from Discontinued Operation Disclosures [Abstract]
Income from discontinued operations, before taxes				7,554
Provision for income taxes				(1,777)
Net income from discontinued operations, net of taxes				$ 5,777
Eeva Business \| Discontinued Operations, Held-for-sale
Disposal Group, Including Discontinued Operation, Income Statement Disclosures [Abstract]
Revenue					328
Cost of service					59
Gross profit					269
Research and development					241
General and administration					21
Total operating expenses					262
Income from discontinued operations					7
Discontinued Operation, Income (Loss) from Discontinued Operation Disclosures [Abstract]
Income from discontinued operations, before taxes					7
Provision for income taxes					(3)
Net income from discontinued operations, net of taxes					$ 4

Divestitures - Cash Flows (Details) - Eeva Business - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Discontinued Operations, Disposed of by Sale
Net Cash Provided by (Used in) Discontinued Operations [Abstract]
Deferred consideration		$ 200
Proceeds from sale of business, net of costs	$ 200	$ 2,481
Discontinued Operations, Held-for-sale
Net Cash Provided by (Used in) Discontinued Operations [Abstract]
Depreciation expense			$ 18
Deferred license revenue			$ (73)

Intangible Assets, Net - Useful Lives (Details)	12 Months Ended
Intangible Assets, Net - Useful Lives (Details)	Dec. 31, 2019
Trademarks
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible asset, estimated useful life	8 years
Physician network
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible asset, estimated useful life	6 years
Website
Finite-Lived Intangible Assets [Line Items]
Finite-lived intangible asset, estimated useful life	5 years

Intangible Assets, Net - Tabular Disclosure (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets, Net [Abstract]
Intangible assets, gross	$ 9,500	$ 9,500
Less: accumulated amortization	(7,125)	(5,641)
Total intangible assets, net	2,375	3,859
Trademarks
Finite-Lived Intangible Assets, Net [Abstract]
Intangible assets, gross	4,000	4,000
Physician network
Finite-Lived Intangible Assets, Net [Abstract]
Intangible assets, gross	3,500	3,500
Website
Finite-Lived Intangible Assets, Net [Abstract]
Intangible assets, gross	$ 2,000	$ 2,000

Intangible Assets, Net - Amortization Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 1.5	$ 1.5	$ 1.5

Intangible Assets, Net - Future Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
2020	$ 1,162
2021	614
2022	500
Thereafter	99
Total intangible assets, net	$ 2,375	$ 3,859

Accrued Expenses and Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Accrued Liabilities, Current [Abstract]
Accrued claims payable	$ 9,795	$ 6,656
Accrued compensation	2,559	1,490
Accrued commission	1,216	966
Professional fees	1,315	274
Other	1,890	396
Total accrued expenses and other current liabilities	$ 16,775	$ 9,782

Debt - Term Loan (Details) - USD ($) $ in Thousands	1 Months Ended		12 Months Ended
Debt - Term Loan (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Nov. 30, 2015	Dec. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Loss on debt extinguishment			$ 88
Accretion of the debt discount			75	$ 200
Secured Debt \| Term Loan
Debt Instrument [Line Items]
Principal amount		$ 8,000
Interest rate (as a percent)		7.50%
Principal balance repurchased	$ 2,900
Final balloon payment	$ 640
Early payment penalty fee (as a percent)	1.00%
Early payment penalty fee amount	$ 15,000
Unamortized debt discount	$ 88,000
Loss on debt extinguishment			88,000
Interest expense			163
Accretion of the debt discount			$ 75
Final payment fee (as a percent)		8.00%
Secured Debt \| Term Loan \| Repaid on or before first anniversary
Debt Instrument [Line Items]
Early payment penalty fee (as a percent)		3.00%
Secured Debt \| Term Loan \| Repaid on or before second anniversary
Debt Instrument [Line Items]
Early payment penalty fee (as a percent)		2.00%
Secured Debt \| Term Loan \| Repaid after second anniversary before maturity date
Debt Instrument [Line Items]
Early payment penalty fee (as a percent)		1.00%
Secured Debt \| Term Loan \| London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Variable rate spread (as a percent)		7.30%

Debt - Revolving Line of Credit (Details) $ in Thousands	1 Months Ended	12 Months Ended
Debt - Revolving Line of Credit (Details) $ in Thousands	Jun. 30, 2018 USD ($) installment	Dec. 31, 2019 USD ($)	Dec. 31, 2018 USD ($)
Short-term Debt [Line Items]
Short term debt			$ 253
Line of Credit \| Silicon Valley Bank Revolving Line of Credit
Short-term Debt [Line Items]
Maximum borrowing capacity	$ 15,000
Advance rate upon which the borrowing capacity is based (as a percent)	80.00%
Threshold period of accounts receivable aging	90 days
Unrestricted cash balance to determine threshold for interest rate	$ 5,000
Minimum revenue targets (as a percent)	75.00%
Short term debt		$ 0	$ 253
Interest expense		$ 213
Commitment fee	$ 225
Frequency of commitment fee	annual
Commitment fee, number of installments \| installment	3
Commitment fee, installment amount	$ 75,000
Commitment fee, amount paid	$ 75,000
Line of Credit \| Silicon Valley Bank Revolving Line of Credit \| Unrestricted cash balance greater than 5 million, interest accrues
Short-term Debt [Line Items]
Interest rate (as a percent)	4.75%
Line of Credit \| Silicon Valley Bank Revolving Line of Credit \| Unrestricted cash balance less than 5 million, interest accrues
Short-term Debt [Line Items]
Interest rate (as a percent)	4.75%
Line of Credit \| Silicon Valley Bank Revolving Line of Credit \| Prime Rate \| Unrestricted cash balance greater than 5 million, interest accrues
Short-term Debt [Line Items]
Variable rate spread (as a percent)	0.00%
Line of Credit \| Silicon Valley Bank Revolving Line of Credit \| Prime Rate \| Unrestricted cash balance less than 5 million, interest accrues
Short-term Debt [Line Items]
Variable rate spread (as a percent)	0.50%

Convertible Preferred Stock Warrants - General Information (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Dec. 31, 2019	Oct. 29, 2019	Dec. 31, 2018	Sep. 30, 2018
Class of Warrant or Right [Line Items]
Share price (in dollars per share)				$ 1.49
Convertible preferred stock warrant liability			$ 4,589
IPO
Class of Warrant or Right [Line Items]
Share price (in dollars per share)		$ 13.00
Warrants to purchase common stock
Class of Warrant or Right [Line Items]
Warrants exercised (in shares)	482,661
Warrants exercised, shares issued (in shares)	441,307
Warrants to purchase common stock \| Weighted Average
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.59
Warrants to purchase convertible preferred stock
Class of Warrant or Right [Line Items]
Warrants outstanding (in shares)	0		2,019,245
Shares issued upon the exercise of warrants (in shares)	2,019,245		2,019,245
Warrants exercised, shares issued (in shares)	441,307
Exercise price (in dollars per share)	$ 1.73	$ 1.73	$ 1.73
Convertible preferred stock warrant liability	$ 0		$ 4,589
Warrants to purchase convertible preferred stock \| Weighted Average
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.59

Convertible Preferred Stock Warrants - Warrants Issued (Details) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Warrants to purchase convertible preferred stock
Class of Warrant or Right [Line Items]
Warrants issued (in shares)	0	0

Convertible Preferred Stock Warrants - Fair Value Measurement Inputs and Valuation Techniques (Details) - Warrants to purchase convertible preferred stock	Dec. 31, 2018 Y $ / shares
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, price (in dollars per share) \| $ / shares	$ 2.27
Warrants, valuation technique	us-gaap:ValuationTechniqueOptionPricingModelMember
Measurement Input, Expected Term
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input \| Y	2
Measurement Input, Option Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	0.43
Measurement Input, Risk Free Interest Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	0.023

Convertible Preferred Stock Warrants - Roll Forward (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Class of Warrant or Right [Line Items]
Total liability, beginning of period				$ 4,589					$ 4,589
Revaluation of remaining warrants	$ 5,757	$ 11,226	$ 642	$ 551	$ 1,383	$ 918	$ 459	$ 184	$ 18,176	$ 2,944	$ 714
Total liability, end of period					$ 4,589					$ 4,589
Warrants to purchase convertible preferred stock
Class of Warrant or Right [Line Items]
Total warrants, beginning of period (in shares)				2,019,245					2,019,245
Revaluation of remaining warrants (in shares)									0
Conversion of preferred stock warrants to common stock warrants (in shares)									(2,019,245)
Total warrants, end of period (in shares)	0				2,019,245				0	2,019,245
Total liability, beginning of period				$ 4,589					$ 4,589
Revaluation of remaining warrants									18,176
Conversion of preferred stock warrants to common stock warrants									(22,765)
Total liability, end of period	$ 0				$ 4,589				$ 0	$ 4,589

Commitments and Contingencies - Sublease (Details) - Corporate Offices, Sublease $ in Millions	Sep. 30, 2019 USD ($) ft²
Operating Leased Assets [Line Items]
Leased space (in square feet) \| ft²	25,212
Operating lease, sublease, base rent per annum, through year five	$ 1.3
Operating lease, sublease, base rent per annum, after year five	$ 1.4

Commitments and Contingencies - Operating Lease Commitments (Details) $ in Thousands	Dec. 31, 2019 USD ($)
Operating Leases, Future Minimum Payments Due, Rolling Maturity [Abstract]
2020	$ 885
2021	1,286
2022	1,286
2023	1,286
2024	1,326
Thereafter	6,213
Total	$ 12,282

Commitments and Contingencies - Rent Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Rent expense	$ 1,165	$ 878	$ 650

Commitments and Contingencies - Arbitration and Litigation (Details) - Second Amended Demand for Arbitration, Vendor - claim	Jul. 31, 2019	Apr. 03, 2019
Loss Contingency, Quantities [Abstract]
Loss contingency, claims dismissed, number	2
Loss contingency, pending claims, number		4

Stockholders' Equity (Deficit) - Common Stock Reserved for Future Issuance (Details) - shares	Dec. 31, 2019	Dec. 31, 2018
Class of Stock [Line Items]
Total common stock reserved for future issuance	20,453,203	83,663,477
Options issued and outstanding under stock plan	15,721,085	15,932,040
Options to purchase common stock
Class of Stock [Line Items]
Shares available for grants under stock option plan	3,124,254	143,710
Warrants to purchase convertible preferred stock
Class of Stock [Line Items]
Total common stock reserved for future issuance		2,019,245
Warrants to purchase common stock
Class of Stock [Line Items]
Total common stock reserved for future issuance	1,607,864	140,394
Redeemable convertible preferred stock
Class of Stock [Line Items]
Total common stock reserved for future issuance		65,428,088

Stockholders' Equity (Deficit) - Treasury Stock (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		12 Months Ended
	Aug. 31, 2019	Sep. 30, 2018	Dec. 31, 2019	Dec. 31, 2018
Equity, Class of Treasury Stock [Line Items]
Shares repurchased (in shares)	26,659	589,320
Purchase price (in dollars per share)	$ 6.91	$ 2.04
Repurchase of common stock		$ 1,200	$ 185	$ 1,205
Share price (in dollars per share)		$ 1.49
Treasury stock (in shares)			615,980	589,320
Accumulated Deficit
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock		$ 321	$ 60	$ 321
Treasury Stock
Equity, Class of Treasury Stock [Line Items]
Repurchase of common stock		$ 884,000	$ 125	$ 884

Stockholders' Equity (Deficit) - 2019 Equity Incentive Plan (Details) - 2019 Equity Incentive Plan	Oct. 31, 2019 shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Maximum number of shares (in shares)	19,198,875
Maximum number of shares, new shares (in shares)	2,640,031
Maximum number of shares, additional shares (in shares)	16,558,844

Stockholders' Equity (Deficit) - Stock Incentive Plan (Details)	12 Months Ended
	Dec. 31, 2019 plan shares	Dec. 31, 2018 plan shares
Share-based Compensation Arrangement by Share-based Payment Award, Additional General Disclosures [Abstract]
Number of stock-based compensation plans \| plan	2	2
Incentive stock options and non-statutory stock options, exercise price to fair value of common stock, maximum (as a percent)	100.00%	100.00%
Shareholder stock options, exercise price to fair value of common stock, maximum (as a percent)	110.00%	110.00%
Unvested shares subject to repurchase (in shares) \| shares	0	0
Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award, Additional General Disclosures [Abstract]
Vesting period	4 years	4 years
Term of award	10 years	10 years

Stockholders' Equity (Deficit) - Stock Options - Shares Available for Future Grant (Details) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Additional General Disclosures [Abstract]
Shares expired due to termination of 2008 Plan (in shares)	(449,005)
Options to purchase common stock
Share-based Compensation Arrangement by Share-based Payment Award, Additional General Disclosures [Abstract]
Shares available for future grant (in shares)	3,124,254	143,710
Additional shares authorized for grant (in shares)	9,708,653

Stockholders' Equity (Deficit) - Stock Options - Activity (Details) - USD ($) $ / shares in Units, $ in Thousands		12 Months Ended
	Oct. 29, 2019	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Balance at beginning of period (in shares)		15,932,040
Options granted (in shares)		7,069,628
Options exercised (in shares)	(1,311,944)	(6,490,059)
Options forfeited (in shares)		(500,882)
Options cancelled (in shares)		(289,642)
Balance at end of period (in shares)		15,721,085	15,932,040
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Balance at beginning of period (in dollars per share)		$ 1.00
Options granted (in dollars per share)		2.68	$ 1.14
Options exercised (in dollars per share)	$ 0.94	0.64
Options forfeited (in dollars per share)		$ 1.34
Options cancelled (in dollars per share)		0.61
Balance at end of period (in dollars per share)		$ 2.44	$ 1.00
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Weighted average remaining contractual life (years)		8 years 4 months 24 days	8 years 6 months
Aggregate intrinsic value		$ 165,906	$ 33,886
Options exercisable, number of shares (in shares)		4,349,090	7,499,936
Options exercisable, weighted average exercise price (in dollars per share)		$ 0.96	$ 0.95
Options exercisable, weighted average remaining contractual life (years)		7 years 4 months 24 days	8 years 2 months 12 days
Options exercisable, aggregate intrinsic value		$ 52,367	$ 16,096
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest [Abstract]
Options vested and expected to vest, number of shares (in shares)		15,721,085
Options vested and expected to vest, weighted average exercise price (in dollars per share)		$ 2.44
Options vested and expected to vest, weighted average remaining contractual life (years)		8 years 4 months 24 days
Options vested and expected to vest, aggregate intrinsic value		$ 165,906

Stockholders' Equity (Deficit) - Stock Options - Intrinsic Value of Options Exercised (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Total intrinsic value of options exercised	$ 50,846	$ 59,000

Stockholders' Equity (Deficit) - Stock Options - Granted (Details) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Options granted (in dollars per share)	$ 2.68	$ 1.14

Stockholders' Equity (Deficit) - Stock Options - Vested (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Fair value of options to purchase common stock vested	$ 2.8	$ 3.7

Stockholders' Equity (Deficit) - Stock Options - Initial Public Offering (Details) - $ / shares		12 Months Ended
	Oct. 29, 2019	Dec. 31, 2019
Equity [Abstract]
Options exercised (in shares)	1,311,944	6,490,059
Options exercised (in dollars per share)	$ 0.94	$ 0.64

Stockholders' Equity (Deficit) - Stock Options - Fair Value Assumptions (Details) - Options to purchase common stock	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected dividend rate (as a percent)	0.00%	0.00%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected term (in years)	5 years 7 months 17 days	5 years 4 months 17 days
Risk-free interest rate (as a percent)	1.50%	2.60%
Expected volatility (as a percent)	48.60%	48.10%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected term (in years)	6 years 3 months 11 days	6 years 1 month 6 days
Risk-free interest rate (as a percent)	2.50%	3.10%
Expected volatility (as a percent)	49.00%	48.90%

Stockholders' Equity (Deficit) - Share Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 5,061	$ 2,997
Cost of services
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	537	96
Selling and marketing
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	900	366
General and administrative
Share-based Payment Arrangement, Additional Disclosure [Abstract]
Stock-based compensation expense	$ 3,624	$ 2,535

Stockholders' Equity (Deficit) - Cost Not Yet Recognized (Details) $ in Millions	12 Months Ended
	Dec. 31, 2019 USD ($)
Cost not yet recognized
Compensation cost not yet recognized	$ 19.3
Options to purchase common stock
Cost not yet recognized
Weighted-average remaining recognition period	3 years 1 month 6 days

Stockholders' Equity (Deficit) - Common Stock Warrants (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Jun. 30, 2016	Feb. 29, 2016
Class of Warrant or Right [Line Items]
Stock-based compensation expense		$ 5,061	$ 2,997
Warrants to purchase common stock
Class of Warrant or Right [Line Items]
Warrants exercised (in shares)	482,661
Warrants exercised, shares issued (in shares)	441,307
Warrants cancelled (in shares)		69,114
Stock-based compensation expense			$ 259	$ 259
Warrants to purchase common stock \| Weighted Average
Class of Warrant or Right [Line Items]
Exercise price (in dollars per share)	$ 1.59	$ 1.59
Warrants to purchase common stock, issued February 2016
Class of Warrant or Right [Line Items]
Shares issued upon the exercise of warrants (in shares)						71,280
Exercise price (in dollars per share)						$ 0.86
Warrants to purchase common stock, issued June 2016
Class of Warrant or Right [Line Items]
Shares issued upon the exercise of warrants (in shares)					69,114
Exercise price (in dollars per share)					$ 1.41

Stockholders' Equity (Deficit) - Fair Value Measurement Inputs and Valuation Techniques (Details) - Warrants to purchase common stock	Dec. 31, 2018 Y
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, valuation technique	us-gaap:ValuationTechniqueOptionPricingModelMember
Measurement Input, Expected Term
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	1
Measurement Input, Risk Free Interest Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	0.024
Measurement Input, Option Volatility
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	0.486
Measurement Input, Expected Dividend Rate
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Warrants, measurement input	0

Income Taxes - Provision (Benefit) (Details) - USD ($) $ in Thousands	3 Months Ended							12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Expense (Benefit), Continuing Operations [Abstract]
(Benefit) provision for income taxes	$ (77)	$ 25	$ 64	$ (547)	$ (395)	$ (289)	$ (546)	$ 12	$ (1,777)	$ (3)

Income Taxes - Composition of Income Tax (Benefit) Provision (Details) - USD ($) $ in Thousands	3 Months Ended							12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Current Federal, State and Local, Tax Expense (Benefit) [Abstract]
Federal									$ (1,446)	$ (3)
State								$ 12	(331)
Total Current								12	(1,777)	(3)
Total provision/(benefit) from Income taxes	$ (77)	$ 25	$ 64	$ (547)	$ (395)	$ (289)	$ (546)	$ 12	$ (1,777)	$ (3)

Income Taxes - Reconciliation of Statutory Income Tax Rate (Details)		12 Months Ended
	Dec. 31, 2017	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Effective Income Tax Rate Reconciliation, Percent [Abstract]
Income tax provision at statutory rate (as a percent)	35.00%	21.00%	21.00%	34.00%
State income taxes, net of federal benefit (as a percent)		6.00%	5.00%	4.00%
Share-based compensation (as a percent)		56.00%	(2.00%)	(1.00%)
Warrant valuation (as a percent)		(45.00%)	(10.00%)
Change in valuation allowance (as a percent)		(35.00%)	13.00%	63.00%
Effect of tax legislation (as a percent)				(97.00%)
State rate change (as a percent)			2.00%
Other (as a percent)		(3.00%)	(3.00%)	(3.00%)
Effective tax rate (as a percent)		0.00%	26.00%	0.00%

Income Taxes - Net Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2019	Dec. 31, 2018
Deferred Tax Assets, Gross [Abstract]
Net operating loss carryforwards	$ 24,104	$ 22,446
Capitalized start‑up costs	13	15
Research and development credits	1,039	1,059
Accruals and reserves	2,860	1,895
Property and equipment	103	37
Intangibles	624	375
Total deferred tax assets	28,743	25,827
Valuation allowance	(28,743)	(25,781)
Deferred tax assets after valuation allowance		46
Deferred Tax Liabilities, Gross [Abstract]
Deferred gain		(46)
Total deferred tax liabilities		(46)
Net deferred tax assets	$ 0	$ 0

Income Taxes - Valuation Allowance (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Valuation Allowance [Abstract]
Increase (decrease) in valuation allowance	$ 2.9	$ (1.1)

Income Taxes - Net Operating Loss Carryforwards (Details) $ in Millions	Dec. 31, 2019 USD ($)
Domestic Tax Authority
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	$ 92
State and Local Jurisdiction
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	$ 71

Income Taxes - Tax Credit Carryforwards (Details) $ in Thousands	Dec. 31, 2019 USD ($)
Domestic Tax Authority
Tax Credit Carryforward [Line Items]
Tax credit carryforwards	$ 729
State and Local Jurisdiction
Tax Credit Carryforward [Line Items]
Tax credit carryforwards	$ 830

Income Taxes - Unrecognized Tax Benefits - Roll Forward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Balance at the beginning of the year	$ 397	$ 397	$ 397
Reductions based upon tax positions related to the current year	(7)	0	0
Balance at the end of the year	$ 390	$ 397	$ 397

Income Taxes - Unrecognized Tax Benefits - Additional Information (Details) $ in Thousands	Dec. 31, 2019 USD ($)
Income Tax Uncertainties [Abstract]
Unrecognized tax benefits that would impact effective tax rate	$ 0

Income Taxes - Tax Cuts and Jobs Act (Details)		12 Months Ended
Income Taxes - Tax Cuts and Jobs Act (Details)	Dec. 31, 2017	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Corporate statutory tax rate (as a percent)	35.00%	21.00%	21.00%	34.00%

Net Income (Loss) Per Share - Reconciliation (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Net Income (Loss) Available to Common Stockholders, Basic [Abstract]
Net (loss) income	$ (4,400)	$ (8,210)	$ 1,520	$ 2,521	$ (1,525)	$ (1,136)	$ (831)	$ 4,153	$ (8,569)	$ 661	$ (12,452)
Less: Income from discontinued operations, net of income tax					(52)	(1)		(5,724)		(5,777)	(4)
Less: Deemed dividends on convertible preferred stock										(425)	(1,012)
Net loss attributable to common stockholders - basic	(4,400)	(8,210)		31	(1,577)	(1,136)	(1,255)	(1,571)	$ (8,569)	$ (5,541)	$ (13,468)
Weighted Average Number of Shares Outstanding, Basic [Abstract]
Weighted-average shares used in computing basic loss per share attributable to common stockholders (in shares)									20,735,202	5,539,739	5,677,860
Earnings Per Share, Basic [Abstract]
Basic net earnings (loss) per share attributable to common stockholders (in shares)									$ (0.41)	$ (1.00)	$ (2.37)
Net Income (Loss) Available to Common Stockholders, Diluted [Abstract]
Net loss attributable to common stockholders - basic	$ (4,400)	$ (8,210)		$ 31	$ (1,577)	$ (1,136)	$ (1,255)	$ (1,571)	$ (8,569)	$ (5,541)	$ (13,468)
Diluted net (loss) income per share attributable to common stockholders									$ (8,569)	$ (5,541)	$ (13,468)
Weighted Average Number of Shares Outstanding, Diluted [Abstract]
Weighted-average shares used in computing basic loss per share attributable to common stockholders (in shares)									20,735,202	5,539,739	5,677,860
Weighted-average shares used in computing diluted net (loss) income per share attributable to common stockholders									20,735,202	5,539,739	5,677,860
Earnings Per Share, Diluted [Abstract]
Diluted net (loss) income per share attributable to common stockholders (in dollars per share)									$ (0.41)	$ (1.00)	$ (2.37)

Net Income (Loss) Per Share - Potentially Dilutive Securities (Details) - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total potential dilutive shares (in shares)	13,733,323	72,306,085	62,432,534
Redeemable convertible preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total potential dilutive shares (in shares)		65,960,205	62,078,914
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total potential dilutive shares (in shares)	13,610,441	6,025,473	339,452
Warrants to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total potential dilutive shares (in shares)	122,882	60,168	14,168
Warrants to purchase convertible preferred stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total potential dilutive shares (in shares)		260,239

401(k) Plan and ESPP - 401(k) Plan (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Defined Contribution Plan [Abstract]
Defined contribution plan expenses	$ 263	$ 355

401(k) Plan and ESPP - Employee Stock Purchase Plan (Details) - shares	12 Months Ended
	Dec. 31, 2019	Oct. 29, 2019	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized for issuance (in shares)	20,453,203		83,663,477
Shares purchased (in shares)	0
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized for issuance (in shares)		1,700,000

Related Party Transactions (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2018	Sep. 30, 2018
Related Party Transaction [Line Items]
Repurchase of Preferred Stock (in shares)		1,202,196
Difference between the purchase price and the carrying value		$ 425
Share price (in dollars per share)			$ 1.49
Series B Preferred Stock
Related Party Transaction [Line Items]
Share price (in dollars per share)	$ 1.73
Former employee \| Series B Preferred Stock
Related Party Transaction [Line Items]
Repurchase of Preferred Stock (in shares)	1,202,196
Purchase price	$ 2,500
Difference between the purchase price and the carrying value	$ 425

Unaudited Quarterly Results of Operations Data (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Selected Quarterly Financial Information [Abstract]
Revenue	$ 65,122	$ 61,196	$ 56,168	$ 47,197	$ 29,187	$ 27,798	$ 26,157	$ 22,258	$ 229,683	$ 105,400	$ 48,584
Cost of services	53,353	48,876	44,716	37,233	23,772	22,751	21,119	18,324	184,178	85,966	41,184
Gross profit	11,769	12,320	11,452	9,964	5,415	5,047	5,038	3,934	45,505	19,434	7,400
Operating expenses:
Sales and marketing	3,255	3,183	3,117	2,346	2,143	1,648	1,731	1,763	11,901	7,285	4,258
General and administrative	7,370	6,068	5,981	4,508	3,975	3,986	3,624	4,016	23,927	15,601	14,147
Total operating expenses	10,625	9,251	9,098	6,854	6,118	5,634	5,355	5,779	35,828	22,886	18,405
(Loss) income from operations	1,144	3,069	2,354	3,110	(703)	(587)	(317)	(1,845)	9,677	(3,452)	(11,005)
Interest expense, net	136	(28)	(128)	(38)	(38)	(27)	(344)	(88)	(58)	(497)	(740)
Convertible preferred stock warrant valuation adjustment	(5,757)	(11,226)	(642)	(551)	(1,383)	(918)	(459)	(184)	(18,176)	(2,944)	(714)
Total other expense, net	(5,621)	(11,254)	(770)	(589)	(1,421)	(945)	(803)	(272)	(18,234)	(3,441)	(1,454)
(Loss) income from operations	(4,477)	(8,185)	1,584	2,521	(2,124)	(1,532)	(1,120)	(2,117)	(8,557)	(6,893)	(12,459)
Benefit (provision) for income taxes	77	(25)	(64)		547	395	289	546	(12)	1,777	3
Net (loss) income from continuing operations	(4,400)	(8,210)	1,520	2,521	(1,577)	(1,137)	(831)	(1,571)	(8,569)	(5,116)	(12,456)
Net income from discontinued operations, net of taxes					52	1		5,724		5,777	4
Net (loss) income	(4,400)	(8,210)	$ 1,520	2,521	(1,525)	(1,136)	(831)	4,153	(8,569)	661	(12,452)
Net loss attributable to common stockholders	$ (4,400)	$ (8,210)		$ 31	$ (1,577)	$ (1,136)	$ (1,255)	$ (1,571)	$ (8,569)	$ (5,541)	$ (13,468)
Basic and Diluted
Continuing operations (in dollars per share)	$ (0.07)	$ (1.10)		$ 0.01	$ (0.31)	$ (0.20)	$ (0.22)	$ (0.28)	$ (0.41)	$ (1.00)	$ (2.37)
Discontinued operations (in dollars per share)					0.01			1.01		1.04
Total net loss per share attributable to common stockholders basic and diluted (in dollars per share)	$ (0.07)	$ (1.10)		$ 0.01	$ (0.30)	$ (0.20)	$ (0.22)	$ 0.73	$ (0.41)	$ 0.04	$ (2.37)
Weighted-average shares used in computing net (loss) earnings per share:
Basic and Diluted (in shares)	64,192,100	7,472,469	5,172,209	15,120,928	5,151,859	5,627,656	5,693,169	5,690,083	20,735,202	5,539,739	5,677,860