SEC Filing | Biocept Inc.

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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 10-Q

☒	QUARTERLY REPORT UNDER SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended March 31, 2022

☐	TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from to .

Commission file number: 001-36284

Biocept, Inc.

(Exact name of registrant as specified in its charter)

Delaware

80-0943522

(State or other jurisdiction of

incorporation or organization)

(I.R.S. Employer

Identification No.)

9955 Mesa Rim Road, San Diego, California

(Address of principal executive offices)

92121

(Zip Code)

(858) 320-8200

(Registrant’s telephone number, including area code)

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

Securities registered pursuant to Section 12(b) of the Act:


Title of each class	Trading Symbol(s)	Name of each exchange on which registered
Common Stock, par value $.0001 per share	BIOC	The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes ☒ No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined by Rule 12b-2 of the Exchange Act). Yes ☐ No ☒

As of May 16, 2022, there were 16,922,868 shares of the Registrant’s common stock outstanding.

BIOCEPT, INC.

FORM 10-Q

FOR THE QUARTERLY PERIOD ENDED

March 31, 2022

INDEX

		Page

IMPORTANT NOTE REGARDING FORWARD-LOOKING STATEMENTS		3

PART I.	FINANCIAL INFORMATION	6

Item 1.	Financial Statements	6

	Condensed Balance Sheets as of December 31, 2021 and March 31, 2022 (Unaudited)	6

	Condensed Statements of Operations and Comprehensive (Loss)/Income for the three months ended March 31, 2021 and 2022 (Unaudited)	7

	Condensed Statements of Shareholders’ Equity for the three months ended March 31, 2021 and 2022 (unaudited)	8

	Condensed Statements of Cash Flows for the three months ended March 31, 2021 and 2022 (Unaudited)	9

	Notes to Condensed Financial Statements (Unaudited)	10

Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	22

Item 3.	Quantitative and Qualitative Disclosures about Market Risk	31

Item 4.	Controls and Procedures	31

PART II.	OTHER INFORMATION	33

Item 1.	Legal Proceedings	33

Item 1A.	Risk Factors	33

Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	64

Item 3.	Defaults Upon Senior Securities	64

Item 4.	Mine Safety Disclosures	64

Item 5.	Other Information	64

Item 6.	Exhibits	65

IMPORTANT NOTE REGARDING FORWARD-LOOKING STATEMENTS

This Quarterly Report on Form 10-Q, or Quarterly Report, contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements included or incorporated by reference in this Quarterly Report other than statements of historical fact, are forward-looking statements. You can identify these and other forward-looking statements by the use of words such as “may,” “will,” “could,” “anticipate,” “expect,” “intend,” “believe,” “continue,” “plan,” “estimate,” “potentially,” “predict,” “should” or the negative of such terms, or other comparable terminology. Forward-looking statements also include the assumptions underlying or relating to such statements.

Forward-looking statements may include, but are not limited to, statements about:

•

the performance of our products, assays and services;

•

the ability of our products, assays and services to become a key component of the standard of care for personalized cancer treatment;

•

our ability to generate revenue , grow our business and increase sales of our products, assays and services;

•

our ability to develop and commercialize new products, diagnostic assays, services and enhance our current products, assays and services and future products, assays, and services;

•

our plans to launch a series of cancer diagnostic assays for different predictive biomarkers;

•

our ability to effectively compete with other products, diagnostic assays, methods and services that now exist or may hereafter be developed;

•

our ability to expand our international business and commercialize our products and assays in other countries;

•

market adoption of our products and assays and our ability to successfully complete clinical utility studies;

•

our ability to obtain coverage and adequate reimbursement from governmental and other third-party payers for assays and services;

•

our expectations regarding our material cash requirements, contractual obligations and commitments and the use of our existing cash;

•

our ability to enter into and leverage agreements with commercialization partners for the sales, marketing and commercialization of our current products, assays and services, and our planned future products, assays and services;

•

our ability to satisfy any applicable United States and international regulatory requirements with respect to products, assays and services;

•

our ability to obtain or maintain patents or other appropriate protection for the intellectual property utilized in our current and planned products, assays and services;

•

effects of the COVID-19 pandemic on our business;

•

our estimates regarding the period of time for which our current capital resources will be sufficient to fund our continued operations;

•

our expectations and estimates regarding our future use of cash, expenses and costs and needs for additional financing; and

•

our ability to maintain a strong internal control environment and remediate internal control deficiencies.

Our actual results could differ materially from those anticipated in these forward-looking statements as a result of various factors, including those set forth in this report under the “Management’s Discussion and Analysis” and “Risk Factors” headings, which include but are not limited to the following factors:

•

we may be unable to increase sales of our current products, assays and services or successfully develop and commercialize other products, assays and services;

•

we may be unable to execute our sales and marketing strategy for our products and diagnostic assays and may be unable to gain acceptance in the market and generate sufficient revenue;

•

we may be unable to develop products, assays and services to keep pace with rapid advances in technology, medicine and science;

•

our current products, assays and services and our planned future products, assays and services may not continue to perform as expected;

•

our sole laboratory facility may become damaged or inoperable, or we may be required to vacate the facility;

•

the impact of the COVID-19 pandemic on our business;

•

the decline of our RT-PCR COVID-19 testing business revenues;

•

we may be unable to compete successfully with our competitors and increase or sustain our revenues;

•

medical oncologists, neuro-oncologists, surgical oncologists, urologists, pulmonologists, pathologists and other physicians may decide not to order our current or planned future assays, and laboratory supply distributors and their customers may decide not to order our current or planned future products;

•

we may be unable to identify collaborators willing to work with us to conduct clinical utility studies, or the results of those studies may not demonstrate that an assay provides clinically meaningful information and value;

•

we may lose key members of our executive management team;

•

we may be unable to retain and recruit personnel with the requisite technical skills;

•

we may fail to continue to attract, hire and retain a sufficient number of qualified sales professionals;

•

we may experience delays in transmitting claims to payers;

•

we may encounter manufacturing delays;

•

we may become exposed to business, regulatory, political, operational, financial and economic risks associated with doing business outside of the United States;

•

general economic and business conditions may have a negative impact on our business;

•

our business may be effected by healthcare policy changes;

•

hospitals or other clients may not pay our invoices or third-party payers may not provide coverage and reimbursement or may breach, rescind or modify their contracts or reimbursement policies or delay payments;

•

our products and assays may not receive favorable treatment, clearance or marketing authorization from the U.S. Food and Drug Administration, or FDA;

•

the FDA may begin requiring approval or clearance for our current products and assays and our planned future products and assays;

•

we may become required to conduct additional clinical studies or trials before continuing to offer assays that we have developed or may develop as laboratory developed tests;

•

we may be unable to obtain and maintain effective patent and proprietary rights for our products and services;

•

we may be unable to protect our intellectual property throughout the world; and

•

we may fail to maintain proper and effective internal control over financial reporting.

Moreover, we operate in an evolving environment. New risk factors and uncertainties emerge from time to time and it is not possible for us to predict all risk factors and uncertainties, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements. Readers are cautioned not to place undue reliance on forward-looking statements. The forward-looking statements speak only as of the date on which they are made, and we undertake no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they are made except as required by law. Readers should, however, review the factors and risks we describe in the reports we file from time to time with the SEC. In addition, statements that “we believe” and similar statements reflect our beliefs and opinions on the relevant subject. These statements are based upon information available to us as of the date the statement is made, and while we believe such information forms a reasonable basis for such statements, such information may be limited or incomplete, and our statements should not be read to indicate that we have conducted an exhaustive inquiry into, or review of, all potentially available relevant information. These statements are inherently uncertain, and you are cautioned not to unduly rely upon these statements.

PART I. FINANCIAL INFORMATION

Item 1. Financial Statements

Biocept, Inc.
Condensed Balance Sheets
(In thousands, except share and per share data)

	December 31,			March 31,
	2021			2022
Assets				(unaudited)
Current assets:
Cash	$	28,864		$	27,566
Accounts receivable, net		13,786			16,351
Inventories, net		2,651			3,221
Prepaid expenses and other current assets		391			446
Total current assets		45,692			47,584
Fixed assets, net		2,401			2,380
Lease right-of-use assets - operating		9,026			8,892
Lease right-of-use assets - finance		2,842			2,617
Other non-current assets		456			471
Total assets	$	60,417		$	61,944

Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable	$	7,246			8,076
Accrued liabilities		3,018			4,550
Current portion of lease liabilities - operating		426			449
Current portion of lease liabilities - finance		1,083			1,021
Total current liabilities		11,773			14,096
Non-current portion of lease liabilities - operating		9,736			9,598
Non-current portion of lease liabilities - finance		1,428			1,221
Total liabilities		22,937			24,915
Commitments and contingencies (see Note 10)
Shareholders’ equity:
Preferred stock, $0.0001 par value, 5,000,000 shares authorized; 2,106 shares and 2,090 shares issued and outstanding at December 31, 2021 and March 31, 2022, respectively.		—			—
Common stock, $0.0001 par value, 150,000,000 shares authorized; 16,849,805 shares and 16,850,161 shares issued and outstanding at December 31, 2021 and March 31, 2022, respectively.		2			2
Additional paid-in capital		303,829			306,146
Accumulated deficit		(266,351	)		(269,119	)
Total shareholders’ equity		37,480			37,029
Total liabilities and shareholders’ equity	$	60,417		$	61,944

The accompanying notes are an integral part of these unaudited condensed financial statements.

Biocept, Inc.
Condensed Statements of Operations and Comprehensive Loss
(In thousands, except shares and per share data)
(Unaudited)

	For the Three Months Ended March 31,
	2021			2022
Net revenues	$	17,756		$	19,945
Costs and expenses:
Cost of revenues		9,006			10,335
Research and development expenses		1,043			1,851
General and administrative expenses		3,120			6,806
Sales and marketing expenses		1,923			3,660
Total costs and expenses		15,092			22,652
(Loss)/Income from operations		2,664			(2,707	)
Other income/(expense):
Interest expense, net		(65	)		(61	)
Total other income/(expense):		(65	)		(61	)
(Loss)/income before income taxes		2,599			(2,768	)
Income tax expense		—			—
Net (loss)/income and comprehensive (loss)income		2,599			(2,768	)
Net (loss)/income attributable to common shareholders	$	2,599		$	(2,768	)
Weighted-average shares outstanding used in computing net (loss)income per share attributable to common shareholders:
Basic		13,400,007			16,849,964
Diluted		13,667,716			16,849,964
Net (loss)/income per common share:
Basic	$	0.19		$	(0.16	)
Diluted	$	0.19		$	(0.16	)

The accompanying notes are an integral part of these unaudited condensed financial statements.

Biocept, Inc.
Condensed Statements of Stockholder's Equity
(In thousands, except for shares)
(Unaudited)
	Common Stock				Series A Convertible Preferred Stock					Additional		Accumulated
	Shares		Amount		Shares			Amount		Paid-in Capital		Deficit			Total
Balance at December 31, 2021		16,849,805	$	2		2,106		$	—	$	303,829	$	(266,351	)	$	37,480
Stock-based compensation expense		—		—		—			—		2,317		—			2,317
Shares issued upon conversion of preferred stock		356		—		(16	)		—		—		—			—
Net loss		—		—		—			—		—		(2,768	)		(2,768	)
Balance at March 31, 2022		16,850,161	$	2		2,090		$	—	$	306,146	$	(269,119	)	$	37,029

	Common Stock				Series A Convertible Preferred Stock				Additional		Accumulated
	Shares		Amount		Shares		Amount		Paid-in Capital		Deficit			Total
Balance at December 31, 2020		13,397,041	$	1		2,111	$	—	$	287,218	$	(263,527	)	$	23,692
Stock-based compensation expense		—		—		—		—		460		—			460
Shares issued upon exercise of common stock warrants		5,304		—		—		—		19		—			19
Shares issued upon conversion of preferred stock		23		—		—		—		—		—			—
Shares issued upon exercise of options		194		—		—		—		1		—			1
Net Income		—		—		—		—		—		2,599			2,599
Balance at March 31, 2021		13,402,562	$	1		2,111	$	—	$	287,698	$	(260,928	)	$	26,771

The accompanying notes are an integral part of these unaudited condensed financial statements.

Biocept, Inc.
Condensed Statements of Cash Flows
(in thousands)
(Unaudited)
	For the Three Months Ended March 31,
	2021			2022
Cash Flows from Operating Activities
Net Income(loss )	$	2,599		$	(2,768	)
Adjustments to reconcile net income (loss) to net cash used in operating activities:
Depreciation and amortization		366			405
Amortization of right-of-use assets		362			414
Inventory reserve		(9	)		78
Stock-based compensation		460			2,317
Loss (gain) on disposal of fixed assets		4			—
Increase/(decrease) in cash resulting from changes in:
Accounts receivable, net		(2,998	)		(2,564	)
Inventory		(1,320	)		(648	)
Prepaid expenses and other current assets		1,454			(49	)
Other non-current assets		(13	)		(16	)
Accounts payable		(333	)		375
Accrued liabilities		272			1,524
Net cash (used in)/provided by operating activities		844			(932	)
Cash Flows from Investing Activities:
Purchases of fixed assets		(712	)		(98	)
Net cash used in investing activities		(712	)		(98	)
Cash Flows from Financing Activities:
Proceeds from exercise of common stock warrants		18			—
Proceeds from exercise of overallotment warrants		1			—
Payments on finance leases		(321	)		(268	)
Net cash used in financing activities		(302	)		(268	)
Net decrease in Cash		(170	)		(1,298	)
Cash at Beginning of Period		14,368			28,864
Cash at End of Period		14,198			27,566
Supplemental Disclosures of Cash Flow Information:
Interest	$	65		$	61

Non-cash Investing and Financing Activities:

Fixed assets purchased totaling approximately $894,000 during the three months ended March 31, 2021, were recorded as finance lease obligations and excluded from cash purchases in the Company’s statements of cash flows (see Note 6). There were no financed fixed asset purchases for the three months ending March 31, 2022.

The amount of unpaid fixed assets excluded from cash purchases in the Company’s statements of cash flows were approximately $319,000 at March 31, 2021 and $60,000 at March 31, 2022.

The accompanying notes are an integral part of these unaudited condensed financial statements.

BIOCEPT, INC.

NOTES TO CONDENSED FINANCIAL STATEMENTS

(Unaudited)

1. The Company, Business Activities and Basis of Presentation

The Company and Business Activities

The Company was founded in California in May 1997 and is a molecular oncology diagnostics company that develops and commercializes proprietary clinical diagnostic laboratory assays designed to identify rare tumor cells and cell-free tumor DNA from blood and cerebrospinal fluid, or CSF. The identification of tumor cells and cell-free tumor DNA in CSF has become the Company’s principal development focus following its early commercial expansion into CSF in 2020.

The Company operates a clinical laboratory that is CLIA-certified (under the Clinical Laboratory Improvement Amendment of 1988) and CAP-accredited (by the College of American Pathologists), and manufactures cell enrichment and extraction microfluidic channels, related equipment and certain reagents to perform the Company’s diagnostic assays in a facility located in San Diego, California. CLIA certification and accreditation are required before any clinical laboratory may perform testing on human specimens for the purpose of obtaining information for the diagnosis, prevention, treatment of disease, or assessment of health. The assays the Company offers are classified as laboratory developed tests under the CLIA regulations.

In July 2013, the Company effected a reincorporation to Delaware by merging itself with and into Biocept, Inc., a Delaware corporation, which had been formed to be and was a wholly owned subsidiary of the Company since July 23, 2013.

The COVID-19 pandemic continues to evolve, and the extent to which COVID-19 may impact the Company’s business will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as the ultimate geographic spread of the disease, the duration of the pandemic, the emergence and impact of variants, vaccinations, government funding for COVID-19 testing, travel restrictions and social distancing in the United States and other countries, business closures or business disruptions, and the effectiveness of actions taken in the United States and other countries to contain and treat the disease. The Company experienced increased revenue levels in 2021 and 2022 related to its COVID-19 testing business.

Basis of Presentation

The accompanying unaudited condensed financial statements and notes are prepared in accordance with accounting principles generally accepted in the United States of America, or GAAP, and on the basis that the Company will continue as a going concern (see Note 2). The accompanying unaudited condensed financial statements and notes do not include any adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of liabilities that may result from the possible inability of the Company to continue as a going concern.

The unaudited condensed financial statements included in this Form 10-Q have been prepared in accordance with the U.S. Securities and Exchange Commission, or SEC, instructions for Quarterly Reports on Form 10-Q. Accordingly, the condensed financial statements are unaudited and do not contain all the information required by GAAP to be included in a full set of financial statements. The balance sheet at December 31, 2021 has been derived from the audited financial statements at that date but does not include all of the information and footnotes required by GAAP for a complete set of financial statements. The audited financial statements for the year ended December 31, 2021, filed with the SEC with our Annual Report on Form 10-K on April 5, 2022 include a summary of our significant accounting policies and should be read in conjunction with this Form 10-Q. In the opinion of management, all material adjustments necessary to present fairly the results of operations for such periods have been included in this Form 10-Q. All such adjustments are of a normal recurring nature. The results of operations for interim periods are not necessarily indicative of the results of operations for the entire year.

A novel strain of coronavirus, or COVID-19, continues to spread and severely impact the economy of the United States and other countries around the world. Since March 2020, federal, state and local governmental policies and initiatives designed to reduce the transmission of COVID-19 have resulted in, among other things, a significant reduction in physician office visits, the cancellation of elective medical procedures, customers closing or severely curtailing their operations (voluntarily or in response to government orders), and the adoption of work-from-home policies, all of which have had, and the Company believes will continue to have, an impact on the Company’s results of operations, financial position, and cash flows. Additionally, beginning during the second quarter of 2020, the Company experienced growing demand for COVID-19 molecular and antibody testing services and has expanded its capacity in order to satisfy such demand. As a result, operating results for the three months ended March 31, 2022 may not be indicative of the results that may be expected for the full year or in the future.

Significant Accounting Policies

During the three months ended March 31, 2022, there were no changes to our significant accounting policies as described in our Annual Report on Form 10-K for the fiscal year ended December 31, 2021.

Revenue Recognition and Accounts Receivable

The Company's commercial revenues are generated from diagnostic services provided to patient’s physicians and billed to third-party insurance payers such as managed care organizations, Medicare and Medicaid and patients for any deductibles, coinsurance or copayments that may be due. The Company recognizes revenue in accordance with ASC 606, Revenue from Contracts with Customers, or ASC 606, which requires that an entity recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled to in exchange for those goods or services.

Contracts

For its commercial revenues, while the Company markets directly to physicians and other healthcare providers, the Company provides services that benefit the patient. Patients do not typically enter into direct agreements with the Company; however, a patient’s insurance coverage requirements would dictate whether or not any portion of the cost of the tests would be patient responsibility. Accordingly, the Company establishes contracts with commercial insurers in accordance with customary business practices, as follows:

•

Approval of a contract is established via the order and accession, which are submitted by the patient’s physician.

•

The Company is obligated to perform its diagnostic services upon receipt of a sample from a physician, and the patient and/or applicable payer are obligated to reimburse the Company for services rendered based on the patient’s insurance benefits.

•

Payment terms are a function of a patient’s existing insurance benefits, including the impact of coverage decisions with the Centers for Medicare & Medicaid Services, or CMS, and applicable reimbursement contracts established between the Company and payers, unless the patient is a self-pay patient, whereby the Company bills the patient directly after the services are provided.

•

Once the Company delivers a patient’s assay result to the ordering physician, the contract with a patient has commercial substance, as the Company is legally able to collect payment and bill an insurer and/or patient, regardless of payer contract status or patient insurance benefit status.

•

Consideration associated with commercial revenues is considered variable and constrained until fully adjudicated, with net revenues recorded to the extent that it is probable that a significant reversal will not occur.

The Company’s development services revenues are supported by contractual agreements and generated from assay development services provided to entities, such as pharma or biotech organizations, as well as certain other diagnostic services provided to physicians, and revenues are recognized upon delivery of the performance obligations in the contract.

Performance Obligations

A performance obligation is a promise in a contract to transfer a distinct good or service, or a bundle of goods or services, to the customer. For its commercial and development services revenues, the Company’s contracts have a single performance obligation, which is satisfied upon rendering of services, which culminates in the delivery of a patient’s assay result(s) to the ordering physician or entity. The duration of time between accession receipt and delivery of a valid assay result to the ordering physician or entity is typically less than two weeks, and for our RT-PCR COVID-19 testing, typically 48 hours or less. Accordingly, the Company elected the practical expedient and therefore, does not disclose the value of unsatisfied performance obligations.

Transaction Price

The transaction price is the amount of consideration that the Company expects to collect in exchange for transferring promised goods or services to a customer, excluding amounts collected on behalf of third parties, such as sales taxes. The consideration expected from a contract with a customer may include fixed amounts, variable amounts, or both. The Company’s gross commercial revenues billed, and corresponding gross accounts receivable, are subject to estimated deductions for such allowances and reserves to arrive at reported net revenues, which relate to differences between amounts billed and corresponding amounts estimated to be subsequently collected and is deemed to be variable although the variability is not explicitly stated in any contract. Rather, the implied variability is due to several factors, such as the payment history or lack thereof for third-party payers, reimbursement rate changes for contracted and non-contracted

payers, any patient co-payments, deductibles or compliance incentives, the existence of secondary payers and claim denials. The Company estimates the amount of variable consideration using the most likely amount approach to estimating variable consideration for third-party payers, including direct patient bills, whereby the estimated reimbursement for services is established by payment histories on CPT codes for each payer, or similar payer types. When no payment history is available, the value of the account is estimated at Medicare rates, with additional other payer-specific reserves taken as appropriate. Collection periods for billings on commercial revenues range from less than 30 days to several months, depending on the contracted or non-contracted nature of the payer, among other variables. The estimates of amounts that will ultimately be realized from commercial diagnostic services for non-contracted payers require significant judgment by management.

The Company limits the amount of variable consideration included in the transaction price to the unconstrained portion of such consideration. Revenue is recognized up to the amount of variable consideration that is not subject to a significant reversal until additional information is obtained or the uncertainty associated with the additional payments or refunds is subsequently resolved. Differences between original estimates and subsequent revisions, including final settlements, represent changes in the estimate of variable consideration and are included in the period in which such revisions are made. The Company monitors its estimates of transaction price to depict conditions that exist at each reporting date. If the Company subsequently determines that it will collect more consideration than it originally estimated for a contract with a customer, it will account for the change as an increase in the estimate of the transaction price in the period identified as an increase to revenue. Similarly, if the Company subsequently determines that the amount it expects to collect from a customer is less than it originally estimated, it will generally account for the change as a decrease in the estimate of the transaction price as a decrease to revenue, provided that such downward adjustment does not result in a significant reversal of cumulative revenue recognized. Further, although the Company believes that its estimate for contractual allowances and other reserves is appropriate, it is possible that the Company will experience an impact on cash collections as a result of the impact of the COVID-19 pandemic.

Allocate Transaction Price

For the Company’s commercial revenues, the entire transaction price is allocated to the single performance obligation contained in a contract with a customer. For the Company’s development services revenues, the contracted transaction price is allocated to each single performance obligation contained in a contract with a customer as performed.

Point-in-time Recognition

The Company’s single performance obligation is satisfied at a point in time, and that point in time is defined as the date a patient’s successful assay result is delivered to the patient’s ordering physician or entity. The Company considers this date to be the time at which the patient obtains control of the promised diagnostic assay service.

Contract Balances

The timing of revenue recognition, billings and cash collections results in accounts receivable recorded in the Company’s condensed balance sheets. Generally, billing occurs subsequent to delivery of a patient’s test result to the ordering physician or entity, resulting in an account receivable.

Practical Expedients

The Company does not adjust the transaction price for the effects of a significant financing component, as at contract inception, the Company expects the collection cycle to be one year or less.

The Company expenses sales commissions when incurred because the amortization period is one year or less, which are recorded within sales and marketing expenses.

The Company incurs certain other costs that are incurred regardless of whether a contract is obtained. Such costs are primarily related to legal services and patient communications. These costs are expensed as incurred and recorded within general and administrative expenses.

Disaggregation of Revenue and Concentration of Risk

The composition of the Company’s net revenues recognized during the three months ended March 31, 2021 and 2022, disaggregated by source and nature, are as follows:

	For the Three Months Ended March 31,
	2021		2022
Net revenues from non-contracted payers	$	6,314	$	7,262
Net revenues from contracted payers*		11,341		12,645
Net commercial revenues		17,655		19,907
Development services revenues		39		38
Kits and Specimen Collection Tubes (SCTs)		62		—
Total net revenues	$	17,756	$	19,945

*Includes Medicare, Medicare Advantage and CARES Act as reimbursement amounts are fixed.

Revenues for the three months ended March 31, 2021 and 2022 included $17.7 million and $19.9 million, respectively, in commercial test revenues, including $16.8 million and $18.6 million of revenues attributable to RT-PCR COVID-19 testing. During the three months ended March 31, 2022, no additional account receivable reserves were required, and the Company had approximately $0.6 million in account receivable recoveries for aged receivable balances reserved in prior periods.

	For the Three Months Ended March 31,
	2021		2022
Net commercial revenues	$	17,655	$	19,907
Development services revenues		39		38
Kits and Blood Collection Tubes (BCT)		62		—
Total net revenues	$	17,756	$	19,945

At March 31, 2021 and March 31, 2022, unbilled account receivables totaled approximately $4.3 million and $2.7 million, respectively.

Concentrations of credit risk with respect to revenues are primarily limited to geographies to which the Company provides a significant volume of its services, and to specific third-party payers of the Company’s services such as Medicare, insurance companies, and other third-party payers. The Company’s client base consists of many geographically dispersed clients diversified across various customer types.

The Company's third-party payers that represent more than 10% of total net revenues in any period presented, as well as their related net revenue amount as a percentage of total net revenues, during the three months ended March 31, 2021, and 2022 were as follows:

	For the Three Months Ended March 31,
	2021	2022
Medicare and Medicare Advantage/CARES Act	35%	43%
Blue Cross Blue Shield	30%	16%
Kaiser Permanente	3%	14%

The Company's third-party payers that represent more than 10% of total net accounts receivable, and their related net accounts receivable balance as a percentage of total net accounts receivable, at December 31, 2021 and March 31, 2022 were as follows:

	December 31,	March 31,
	2021	2022
Medicare and Medicare Advantage/CARES Act	31%	36%
Blue Cross Blue Shield	19%	16%

Recent Accounting Pronouncements

None.

2. Liquidity

As of March 31, 2022, cash totaled $27.6 million and the Company had an accumulated deficit of $269.1 million. For the year ended December 31, 2021 and the three months ended March 31, 2022, the Company incurred a net loss of $2.8 million and $2.8 million, respectively, and had cash generated from operations of $0.8 million and cash used in operations of $0.9 million for the quarters ended March 31, 2021 and 2022, respectively. At March 31, 2022, the Company had aggregate net interest-bearing indebtedness of $2.2 million related to financed capital leases, of which $1.0 million was due within one year, in addition to $13.1 million of other non-interest-bearing current liabilities.

The Company has historically funded its operations primarily through sales of its equity securities. For the year ended December 31, 2021, revenue from the Company’s COVID-19 testing business provided an increase level of cash flow. During the quarter ended March 31, 2022, net revenues were approximately $19.9 million compared with approximately $17.8 million for the same period in the prior year, and the Company had a net loss of $2.8 million and net cash used in operations of $0.9 million. The Company believes that based on its current and planned cash usage, along with current and projected COVID-19 testing revenues, its cash balances will support operations through at least 12 months following the issuance of the accompanying unaudited condensed financial statements. As such, the Company determined that it is not probable based on projected cash flows that substantial doubt about the Company’s ability to continue as a going concern exists for the one-year period following the date that the financial statements for the three months ended March 31, 2022 were issued. The Company’s determination was based on estimates regarding expected COVID-19 testing volumes for which the Company is currently seeing a reduced demand and expect this trend to continue absent a negative and sustained turn in the course of the pandemic. The Company used all information currently available to make this determination.

The Company’s principal uses of cash have included cash used in operations, payments relating to purchases of property and equipment and repayments of borrowings. The Company expects that the principal uses of cash in the future will be for continuing operations, marketing activities, funding of research and development, capital expenditures, and general working capital requirements. The Company will need to generate significant growth in net revenues to achieve and sustain income from operations.

In order to meet its long-term operating requirements beyond the next twelve months, the Company will need, among other things, additional capital resources. Until the Company can generate significant cash from operations, including assay revenues, management’s plans to obtain such resources for the Company include proceeds from offerings of the Company’s equity securities or debt, cash received from the exercise of outstanding common stock warrants, or transactions involving product development, technology licensing or collaboration. The Company cannot provide any assurances that such additional funds will be available on reasonable terms, or at all.

3. Sales of Equity Securities

As part of a warrant repricing and exchange transaction, in January 2020, the Company issued an aggregate of 692,725 new warrants in exchange for the exercise of certain warrants issued by the Company in February 2019 and March 2019 for an aggregate of 692,725 shares of common stock and received net proceeds of approximately $2.3 million. As a result of the warrant repricing, the exercise price of warrants to purchase an aggregate of 89,657 shares of common stock issued by the Company in January 2018 was adjusted from $4.05 to $3.495 per share. In January 2020, the Company issued 192,750 shares of common stock pursuant to the partial exercise of the underwriters’ overallotment option from the Company’s December 2019 public offering. The net proceeds to the Company from the overallotment closing was approximately $700,000. The warrants issued in connection with the warrant repricing and exchange transaction were considered inducement warrants and are classified in equity. In addition, the modification expense associated with the change in fair value due to the repricing of February and March 2019 warrants is recorded as inducement expense, which was approximately $191,000. The fair value of the warrants issued was approximately $1.9 million. The fair value of the inducement warrants and warrant modification of $2.1 million was expensed as warrant inducement expense during the year ended December 31, 2021.

On May 12, 2021, the Company entered into a Controlled Equity Offering^SM Sales Agreement (the “Sales Agreement”) with Cantor Fitzgerald & Co. (the “Sales Agent”), under which the Company may issue and sell from time to time up to $25,000,000 of its common stock through or to the Sales Agent, as sales agent or principal. The issuance and sale of these shares under the Sales Agreement, if any, is subject to the continued effectiveness of the Company’s shelf registration statement on Form S-3, filed with the SEC on April 24, 2020. Sales of the Company’s common stock, under the Sales Agreement are made at market prices by any method that is deemed to be an “at the market offering” as defined in Rule 415(a)(4) under the Securities Act of 1933, as amended. Each time the Company wishes to issue and sell common stock under the Sales Agreement, it notifies the Sales Agent of the number of shares to be issued, the dates on which such sales are anticipated to be made and any minimum price below which sales may not be made. Once the Company has so instructed the Sales Agent, unless the Sales Agent declines to accept the terms of the notice, the Sales Agent has agreed to use its commercially reasonable efforts consistent with its normal trading and sales practices to sell such shares up to the amount specified on such terms.

The obligations of the Sales Agent under the Sales Agreement to sell the Company’s common stock are subject to a number of conditions that the Company must meet. The offering of common stock pursuant to the Sales Agreement will terminate upon the earlier of (1) the sale of all common stock subject to the Sales Agreement and (2) termination of the Sales Agreement as permitted therein. The Sales Agreement may be terminated by the Company at any time upon ten days’ notice. The Sales Agent may terminate the Sales Agreement at any time upon ten days’ prior notice. The Sales Agent is entitled to compensation from the Company at a fixed commission rate equal to 3.0% of the gross sales price per share of any common stock sold under the Sales Agreement.

During 2021, we received net proceeds of $14.1 million from the sale of our common stock and issued 3,428,680 shares of our common stock at a weighted average purchase price of $4.31 pursuant to the Sales Agreement. As of March 31, 2022, $10.2 million of our common stock remained available for sale under the sales agreement.

4. Fair Value Measurement

The estimated nonrecurring fair value measurements associated with fixed asset purchases recorded as right-of-use asset finance lease obligations totaling approximately $0.9 million for the three months ended March 31, 2021 were calculated as the present value of the lease payments based on contractual payment amounts and estimated market rates. There were no fixed asset purchases recorded as right-of-use assets for the three months ended March 31, 2022

Upon adoption of guidance in ASC Topic 842 Leases, the estimated fair value of the right-of-use operating lease asset was recorded based on the present value of future lease payments based on contractual payment amounts and estimated market rates in effect.

Other Fair Value Measurements

As of the closing of the Company’s January 2020 warrant repricing and exchange transaction, the estimated grant date fair value of approximately $2.80 per share associated with the warrants to purchase up to 692,725 shares of common stock issued in the transaction, or a total of approximately $1.9 million, was recorded as a warrant inducement expense with an offset to additional paid-in capital. All warrants issued in this warrant inducement transaction have an exercise price of $3.495 per share, became exercisable beginning 6 months from issuance and expire 5.5 years from the date of issuance. The fair value of the warrants was estimated using a Black-Scholes model with the following assumptions:


Beginning stock price	$	3.00
Exercise price	$	3.495
Expected dividend yield		0.00	%
Discount rate-bond equivalent yield		1.66	%
Expected life (in years)		5.50
Expected volatility		150.33	%

In addition to the inducement warrants issued in the Company’s January 2020 warrant repricing and exchange transaction, the Company adjusted the exercise prices of the February 2019 and March 2019 warrants from $12.00 and $12.50, respectively, to $3.495 to induce exercise of these warrants. This price modification triggered the requirement for modification accounting of these warrants. Based on the applicable guidance, the modification required the Company to value the modified February 2019 and March 2019 warrants immediately prior to the modification of the exercise price and immediately following the modification and record the difference between the resulting two values as warrant inducement expense.

The estimated fair value prior to modification of the February 2019 and March 2019 warrants was approximately $2.70 per share, whereas the estimated fair value of the February 2019 warrants increased to $2.90 due to the adjustment of the exercise price, and the estimated fair value of the March 2019 warrants increased to $3.00 per share. There were 216,725 February 2019 warrants and 476,000 March 2019 warrants eligible for this price modification and the resulting modification expense recorded as warrant inducement expenses were $60,000 and $130,000, respectively.

5. Balance Sheet Details

The following provides certain balance sheet details:

	December 31,		March 31,
	2021		2022
			(unaudited)
Inventories
Raw materials	$	2,303	$	2,735
Subassemblies		294		414
Finished goods		54		72
	$	2,651	$	3,221
Fixed Assets
Machinery and equipment	$	3,063	$	3,079
Furniture and office equipment		161		161
Computer equipment and software		2,931		2,931
Leasehold improvements		634		634