Annual report pursuant to Section 13 and 15(d)

Annual report pursuant to Section 13 and 15(d)

Revenue Recognition - Disaggregation of Revenue (Details)

v3.10.0.1
Revenue Recognition - Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
3 Months Ended 12 Months Ended
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue $ 76,475 $ 69,097 $ 67,746 $ 63,423 $ 61,422 $ 59,137 $ 62,264 $ 57,428 $ 276,741 $ 240,251 $ 231,808
Clinical Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 241,873 213,097 210,159
Pharma Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 34,868 27,154 21,649
Client direct billing | Clinical Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 164,888 147,726 126,288
Commercial Insurance | Clinical Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 40,360 35,473 52,801
Medicare and Medicaid | Clinical Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 35,566 29,493 30,517
Self-Pay | Clinical Services                      
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]                      
Total Revenue                 $ 1,059 $ 405 $ 553