Cytosorbents (CTSO) 10-Q 5 May 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	May 01, 2020
Document and Entity Information
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Entity Registrant Name	Cytosorbents Corp
Entity Central Index Key	0001175151
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	true
Trading Symbol	CTSO
Entity Common Stock, Shares Outstanding		36,231,035
Entity Shell Company	false
Entity Emerging Growth Company	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($)	Mar. 31, 2020	Dec. 31, 2019
Current Assets:
Cash and cash equivalents	$ 26,389,021	$ 12,232,418
Grants and accounts receivable, net of allowance for doubtful accounts of $149,841 at March 31, 2020 and $145,313 at December 31, 2019	5,395,510	4,467,087
Inventories	1,967,174	2,113,897
Prepaid expenses and other current assets	3,777,526	2,088,127
Total current assets	37,529,231	20,901,529
Property and equipment, net	1,993,911	1,925,325
Right of use asset	970,182	1,070,762
Other assets	3,733,172	3,484,894
Total Assets	44,226,496	27,382,510
Current Liabilities:
Accounts payable	1,770,440	2,039,222
Current maturities of long-term debt	4,166,667	1,666,666
Lease liability - current portion	442,865	428,083
Accrued expenses and other current liabilities	5,084,308	5,802,296
Total current liabilities	11,464,280	9,936,267
Long term debt, net of current maturities and debt issuance costs	10,921,389	13,385,522
Lease liability, net of current portion	527,317	642,679
Total Liabilities	22,912,986	23,964,468
Commitments and Contingencies (Note 6)
Stockholders' Equity:
Preferred Stock, Par Value $0.001, 5,000,000 shares authorized; -0- shares issued and outstanding at March 31, 2020 and December 31, 2019	0	0
Common Stock, Par Value $0.001, 100,000,000 shares authorized; 36,130,355 and 32,616,107 shares issued and outstanding at March 31, 2020 and December 31, 2019, respectively	36,130	32,616
Additional paid-in capital	212,383,812	191,648,907
Accumulated other comprehensive income	1,135,806	525,978
Accumulated deficit	(192,242,238)	(188,789,459)
Total Stockholders' Equity	21,313,510	3,418,042
Total Liabilities and Stockholders' Equity	$ 44,226,496	$ 27,382,510

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
CONSOLIDATED BALANCE SHEETS
Allowance for doubtful accounts	$ 149,841	$ 145,313
Preferred Stock, Par value	$ 0.001	$ 0.001
Preferred Stock, Shares Authorized	5,000,000	5,000,000
Preferred Stock, Shares Issued	0	0
Preferred Stock, Shares Outstanding	0	0
Common Stock, Par Value	$ 0.001	$ 0.001
Number of common stock authorized	100,000,000	100,000,000
Common Stock, shares issued	36,130,355
Common Stock, shares outstanding	36,130,355	32,616,107

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Revenue:
Total revenue	$ 8,707,310	$ 5,191,629
Cost of revenue	2,384,842	1,738,589
Gross margin	6,322,468	3,453,040
Other expenses:
Research and development	1,965,286	2,418,633
Legal, financial and other consulting	519,002	561,516
Selling, general and administrative	6,316,934	4,758,084
Total expenses	8,801,222	7,738,233
Loss from operations	(2,478,754)	(4,285,193)
Other expense:
Interest expense, net	(305,537)	(205,179)
Loss on foreign currency transactions	(668,488)	(393,455)
Total other expense, net	(974,025)	(598,634)
Loss before benefit from income taxes	(3,452,779)	(4,883,827)
Benefit from income taxes	0	0
Net loss attributable to common shareholders	$ (3,452,779)	$ (4,883,827)
Basic and diluted net loss per common share	$ (0.10)	$ (0.15)
Weighted average number of shares of common stock outstanding	33,981,262	31,931,215
Net loss	$ (3,452,779)	$ (4,883,827)
Other comprehensive income (loss):
Currency translation adjustment	609,828	306,287
Comprehensive loss	(2,842,951)	(4,577,540)
Product
Revenue:
Total revenue	8,155,969	4,576,579
Cyto Sorb Sales
Revenue:
Total revenue	8,155,969	4,509,779
Other Sales
Revenue:
Total revenue	0	66,800
Grant
Revenue:
Total revenue	$ 551,341	$ 615,050

CONSOLIDATED STATEMENT OF CHANG

CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($)	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit	Total
Balance at Dec. 31, 2018	$ 31,774	$ 186,138,466	$ 288,175	$ (169,523,815)	$ 16,934,600
Balance (in shares) at Dec. 31, 2018	31,774,139
Stock based compensation - employees, consultants and directors	$ 0	227,658	0	0	227,658
Other comprehensive income, foreign translation adjustment	0	0	306,287	0	306,287
Proceeds from exercise of stock options	$ 47	236,023	0	0	236,070
Proceeds from exercise of stock options (in shares)	46,734
Cashless exercise of stock options	$ 0	0	0	0	0
Cashless exercise of stock options (in shares)	967
Cashless exercise of warrants	$ 9	(9)	0	0	0
Cashless exercise of warrants (in shares)	9,029
Issuance of restricted stock units	$ 52	425,587	0	0	425,639
Issuance of restricted stock units (in shares)	51,817
Proceeds from exercise of warrants	$ 361	1,768,130	0	0	1,768,491
Proceeds from exercise of warrants (in shares)	360,358
Net loss	$ 0	0	0	(4,883,827)	(4,883,827)
Balance at Mar. 31, 2019	$ 32,243	188,795,855	594,462	(174,407,642)	15,014,918
Balance (in shares) at Mar. 31, 2019	32,243,044
Balance at Dec. 31, 2018	$ 31,774	186,138,466	288,175	(169,523,815)	16,934,600
Balance (in shares) at Dec. 31, 2018	31,774,139
Balance at Dec. 31, 2019	$ 32,616	191,648,907	525,978	(188,789,459)	3,418,042
Balance (in shares) at Dec. 31, 2019	32,616,107
Stock based compensation - employees, consultants and directors	$ 0	729,429	0	0	729,429
Other comprehensive income, foreign translation adjustment	0	0	609,828	0	609,828
Proceeds from exercise of stock options	$ 38	138,392	0	0	138,430
Proceeds from exercise of stock options (in shares)	38,277
Issuance of restricted stock units	$ 55	328,884	0	0	328,939
Issuance of restricted stock units (in shares)	54,734
Issuance of common stock, net of fees incurred	$ 3,421	19,538,200	0	0	$ 19,541,621
Issuance of common stock, net of fees incurred (in shares)	3,421,237				3,627,760
Net loss	$ 0	0	0	(3,452,779)	$ (3,452,779)
Balance at Mar. 31, 2020	$ 36,130	$ 212,383,812	$ 1,135,806	$ (192,242,238)	$ 21,313,510
Balance (in shares) at Mar. 31, 2020	36,130,355

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net loss	$ (3,452,779)	$ (4,883,827)
Adjustments to reconcile net loss to net cash used by operating activities:
Non-cash compensation	477,732	261,747
Depreciation and amortization	181,368	138,175
Amortization of debt costs	35,868	23,754
Bad debt	7,862	14,193
Stock-based compensation	729,429	227,658
Foreign currency transaction loss	668,488	393,455
Changes in operating assets and liabilities:
Grants and accounts receivable	(1,023,329)	611,668
Inventories	134,270	(395,683)
Prepaid expenses and other current assets	87,107	435,423
Accounts payable and accrued expenses	(1,055,356)	(1,064,124)
Net cash used by operating activities	(3,209,340)	(4,237,561)
Cash flows from investing activities:
Purchases of property and equipment	(235,551)	(292,458)
Payments for patent costs	(273,011)	(181,769)
Net cash used by investing activities	(508,562)	(474,227)
Cash flows from financing activities:
Equity contributions - net of fees incurred	17,743,226	0
Proceeds from exercise of stock options	138,430	236,070
Proceeds from exercise of warrants	0	1,768,491
Net cash provided by financing activities	17,881,656	2,004,561
Effect of exchange rates on cash	(7,151)	(14,236)
Net change in cash and cash equivalents	14,156,603	(2,721,463)
Cash and cash equivalents - beginning of period	12,232,418	22,368,837
Cash and cash equivalents - end of period	26,389,021	19,647,374
Supplemental disclosure of cash flow information:
Cash paid during the period for interest	318,879	227,681
Supplemental disclosure of non-cash financing activities
Settlement of accrued bonuses with restricted stock units	328,939	425,639
Equity contribution proceeds in transit	$ 1,798,395	$ 0

BASIS OF PRESENTATION

BASIS OF PRESENTATION	3 Months Ended
	Mar. 31, 2020
BASIS OF PRESENTATION
BASIS OF PRESENTATION	1. BASIS OF PRESENTATION The interim consolidated financial statements of CytoSorbents Corporation (the “Company”) have been prepared in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”). In the opinion of management, the Company has made all necessary adjustments, which include normal recurring adjustments, for a fair statement of the Company’s consolidated financial position and results of operations for the interim periods presented. Certain information and disclosures normally included in the annual consolidated financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. These interim consolidated financial statements should be read in conjunction with the audited consolidated financial statements and accompanying notes for the year ended December 31, 2019 included in the Company’s Annual Report on Form 10-K, as filed with the Securities and Exchange Commission (the “SEC”) on March 5, 2020. The results for the three months ended March 31, 2020 and 2019 are not necessarily indicative of the results to be expected for a full year, any other interim periods or any future year or period. The accompanying consolidated financial statements have been prepared on a going concern basis, which contemplates the realization of assets and satisfaction of liabilities in the normal course of business. As of March 31, 2020, the Company had an accumulated deficit of $192,242,238, which included net losses of $3,452,779 for the three months ended March 31, 2020 and $4,883,827 for the three months ended March 31, 2019. The Company’s losses have resulted principally from costs incurred in the research and development of the Company’s polymer technology, selling, general and administrative expenses and clinical study activities. The Company intends to continue to conduct significant additional research, development, and clinical study activities which, together with expenses incurred for the establishment of manufacturing arrangements and a marketing and distribution presence and other selling, general and administrative expenses, are expected to result in continuing net losses for the foreseeable future. The amount of future losses and when, if ever, the Company will achieve profitability are uncertain. The Company’s ability to achieve profitability will depend, among other things, on successfully completing the development of its technology and commercial products, obtaining additional requisite regulatory approvals in markets not covered by the CE mark previously received for the Company’s CytoSorb product and for potential label extensions of the current CE mark, establishing manufacturing and sales and marketing arrangements with third parties, and raising sufficient funds to finance the Company’s activities. No assurance can be given that the Company’s product development efforts will be successful, that the Company’s current CE mark will enable it to achieve profitability, that additional regulatory approvals in other countries will be obtained, that any of the Company’s products will be manufactured at a competitive cost and will be of acceptable quality, or that the Company will be able to achieve profitability or that profitability, if achieved, can be sustained. These matters raise substantial doubt about the Company’s ability to continue as a going concern. These consolidated financial statements do not include any adjustments related to the outcome of this uncertainty.

PRINCIPAL BUSINESS ACTIVITY AND

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2020
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	2. PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Nature of Business The Company is a leader in critical care immunotherapy using blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world. The Company, through its subsidiary CytoSorbents Medical, Inc. (formerly known as CytoSorbents, Inc.), is engaged in the research, development and commercialization of medical devices with its blood purification technology platform which incorporates a proprietary adsorbent, porous polymer technology. The Company, through its wholly owned European subsidiary, CytoSorbents Europe GmbH, conducts sales and marketing related operations for the CytoSorb device. In March 2016, the Company formed CytoSorbents Switzerland GmbH, a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the second quarter of 2016, provides marketing and direct sales services in Switzerland. In November 2018, the Company formed CytoSorbents Poland Sp. z.o.o., a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the first quarter of 2019, provides marketing and direct sales services in Poland. CytoSorb, the Company’s flagship product, was approved in the European Union (“EU”) in March 2011, and is currently being marketed and distributed in fifty-five countries around the world, as a safe and effective extracorporeal cytokine absorber, designed to reduce the “cytokine storm” that could otherwise cause massive inflammation, organ failure and death in common critical illnesses such as sepsis, burn injury, trauma, lung injury, and pancreatitis. In May 2018, the Company received a label extension for CytoSorb covering use of the device for the removal of bilirubin and myoglobin which allows for the use of the device in the treatment of liver failure and trauma, respectively. CytoSorb is also being used during and after cardiac surgery to remove inflammatory mediators, such as cytokines and free hemoglobin, which can lead to post-operative complications, including multiple organ failure. In April 2020, the Company announced that the United States Food and Drug Administration (the “FDA”) granted Emergency Use Authorization (“EUA”) of CytoSorb for use in critically-ill patients infected with COVID-19. Under the EUA, the Company can make CytoSorb available, through commercial sales, to all hospitals in the United States for use in patients, 18 years of age or older, with confirmed COVID-19 infection who are admitted to the intensive care unit (ICU) with confirmed or imminent respiratory failure who have early acute lung injury or acute respiratory distress syndrome (ARDS), severe disease, or life-threatening illness resulting in respiratory failure, septic shock, and/or multiple organ dysfunction or failure. The EUA will be effective until a declaration is made that the circumstances justifying the EUA have terminated or until revoked by the FDA. In April 2020, we announced that the FDA has granted Breakthrough Designation to CytoSorb for the removal of ticagrelor in a cardiopulmonary bypass circuit during emergent and urgent cardiothoracic surgery. The Breakthrough Devices Program provides for more effective treatment of life-threatening or irreversibly debilitating disease or conditions, in this case the need to reverse the effects of ticagrelor in emergent or urgent cardiac surgery that can otherwise cause a high risk of serious or life-threatening bleeding. Through Breakthrough Designation, FDA will work with CytoSorbents to expedite the development, assessment, and regulatory review of CytoSorb for the removal of ticagrelor, while maintaining statutory standards of regulatory approval (e.g., 510(k), de novo 510(k) or premarket approval ) consistent with the Agency’s mission to protect and promote public health. The technology is based upon biocompatible, highly porous polymer sorbent beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface adsorption. The Company has numerous products under development based upon this unique blood purification technology, which is protected by 21 issued U.S. patents and multiple international patents, with applications pending both in the U.S. and internationally, including HemoDefend, ContrastSorb, DrugSorb, and others. These patents and patent applications are directed to various compositions and methods of use related to our blood purification technologies and are expected to expire between 2020 and 2035, absent any patent term extensions. Management believes that any near term expiring patents will not have a significant impact on our ongoing business. Stock Market Listing On December 17, 2014 the Company’s common stock, par value $0.001 per share, was approved for listing on the Nasdaq Capital Market (“Nasdaq”), and it began trading on Nasdaq on December 23, 2014 under the symbol “CTSO.” Previously, the Company’s common stock traded in the over-the-counter-market on the OTC Bulletin Board. Basis of Consolidation and Foreign Currency Translation The consolidated financial statements include the accounts of CytoSorbents Corporation and its wholly-owned subsidiaries, CytoSorbents Medical, Inc. and CytoSorbents Europe GmbH. In addition, the consolidated financial statements include CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. z.o.o., wholly owned subsidiaries of CytoSorbents Europe GmbH, and CytoSorbents UK Limited, a wholly-owned subsidiary of CytoSorbents Medical, Inc. All significant intercompany transactions and balances have been eliminated in consolidation. Translation gains and losses resulting from the process of remeasuring into the United States Dollar, the foreign currency financial statements of CytoSorbents Europe GmbH, for which the Euro is the functional currency, are included in operations. Foreign currency transaction loss included in net loss amounted to approximately $(668,000) and $(393,000) for the three months ended March 31, 2020 and 2019, respectively. The Company translates assets and liabilities of CytoSorbents Europe GmbH at the exchange rate in effect at the consolidated balance sheet date. The Company translates revenue and expenses at the daily average exchange rates. The Company includes accumulated net translation adjustments in accumulated other comprehensive income (loss) as a component of stockholders’ equity. Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. Grants and Accounts Receivable Grants receivable represent amounts due from U.S. government agencies and are included in Grants and Accounts Receivable. Accounts receivable are unsecured, non-interest bearing customer obligations due under normal trade terms. The Company sells its devices to various hospitals and distributors. The Company performs ongoing credit evaluations of its customers’ financial conditions. Management reviews accounts receivable periodically to determine collectability. Balances that are determined to be uncollectible are written off to the allowance for doubtful accounts. The allowance for doubtful accounts contains a general accrual for estimated bad debts and amounted to approximately $150,000 and $145,000 at March 31, 2020 and December 31, 2019, respectively. Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At March 31, 2020 and December 31, 2019, the Company’s inventory was comprised of finished goods, which amounted to $353,437 and $305,452, respectively; work in process which amounted to $1,394,156 and $1,523,923, respectively; and raw materials, which amounted to $219,581 and $284,522, respectively. Devices used in clinical trials or for research and development purposes are removed from inventory and charged to research and development expenses at the time of their use. Donated devices are removed from inventory and charged to selling, general and administrative expenses. Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation of property and equipment is provided for by the straight-line method over the estimated useful lives of the related assets. Leasehold improvements are amortized over the lesser of their economic useful lives or the term of the related leases. Gains and losses on depreciable assets retired or sold are recognized in the consolidated statements of operations and comprehensive loss in the year of disposal. Repairs and maintenance expenditures are expensed as incurred. Patents Legal costs incurred to establish and successfully defend patents are capitalized. When patents are issued, capitalized costs are amortized on the straight-line method over the related patent term. In the event a patent is abandoned, the net book value of the patent is written off. Impairment or Disposal of Long-Lived Assets The Company assesses the impairment of patents and other long-lived assets under accounting standards for the impairment or disposal of long-lived assets whenever events or changes in circumstances indicate that the carrying value may not be recoverable. For long-lived assets to be held and used, the Company recognizes an impairment loss only if its carrying amount is not recoverable through its undiscounted cash flows and measures the impairment loss based on the difference between the carrying amount and fair value. Revenue Recognition Product Sales : Revenues from sales of products to both direct and distributor/strategic partner customers are recognized at the time when control passes to the customer, in accordance with the terms of their respective contracts. Recognition of revenue occurs as each performance obligation is completed. Grant Income : Revenue from grant income is based on contractual agreements. Certain agreements provide for reimbursement of costs; other agreements provide for reimbursement of costs and an overhead margin and certain agreements are performance based, where revenue is earned based upon the achievement of milestones outlined in the contract. Revenues are recognized when the associated performance obligation is fulfilled. Costs are recorded as incurred. Costs subject to reimbursement by these grants have been reflected as costs of revenue. Research and Development All research and development costs, payments to laboratories and research consultants are expensed when incurred. Advertising Expenses Advertising expenses are charged to activities when incurred. Advertising expenses amounted to approximately $31,500 and $51,800 for the three months ended March 31, 2020 and 2019, respectively, and are included in selling, general, and administrative expenses on the consolidated statements of operations and comprehensive loss. Income Taxes Income taxes are accounted for under the asset and liability method prescribed by accounting standards for accounting for income taxes. Deferred income taxes are recorded for temporary differences between financial statement carrying amounts and the tax basis of assets and liabilities. Deferred tax assets and liabilities reflect the tax rates expected to be in effect for the years in which the differences are expected to reverse. A valuation allowance is provided if it is more likely than not that some or all of the deferred tax asset will not be realized. The Company has provided a valuation allowance against all deferred tax assets. Under Section 382 of the Internal Revenue Code, the net operating losses generated prior to the previously completed reverse merger may be limited due to the change in ownership. Additionally, net operating losses generated subsequent to the reverse merger may be limited in the event of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at March 31, 2020 or December 31, 2019. The Company files tax returns in the U.S. federal and state jurisdictions. The Company utilizes the Technology Business Tax Certificate Transfer Program to sell a portion of its New Jersey Net Operating Loss carry forwards to an industrial company. Each of CytoSorbents Europe GmbH, CytoSorbents Switzerland GmbH, CytoSorbents Poland Sp. Z.o.o. and CytoSorbents UK Limited file an annual corporate tax return, VAT return and a trade tax return in Germany, Switzerland, Poland and the United Kingdom, respectively. Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities. Actual results could differ from these estimates. The valuation of options granted is a significant estimate in these consolidated financial statements. Concentration of Credit Risk The Company maintains cash balances, at times, with financial institutions in excess of amounts insured by the Federal Deposit Insurance Corporation. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of our revenues are from product sales in Germany. Substantially all of our grant and other income are from grant agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of March 31, 2020, one distributor accounted for approximately 10% of outstanding grants and accounts receivable. As of December 31, 2019, no agency, distributor/strategic partners or direct customer represented more than 10% of outstanding grants and accounts receivables. For the three months ended March 31, 2020 and 2019, no agency, distributor, or direct customer represented more than 10% of the Company’s total revenue. Financial Instruments The carrying values of cash and cash equivalents, grants and accounts receivable, accounts payable, notes payable, and other debt obligations approximate their fair values due to their short-term nature. Net Loss Per Common Share Basic earnings per share is computed by dividing loss available to common stockholders by the weighted average number of common shares outstanding during the period. Diluted earnings per common share are computed using the treasury stock method on the basis of the weighted-average number of shares of common stock plus the dilutive effect of potential common shares outstanding during the period. Dilutive potential common shares include outstanding warrants, stock options and restricted shares. The computation of diluted earnings per share does not assume conversion, exercise or contingent exercise of securities that would have an anti-dilutive effect on earnings (See Note 8). Stock-Based Compensation The Company accounts for its stock-based compensation under the recognition requirements of accounting standards for accounting for stock-based compensation, for employees and directors whereby each option granted is valued at fair market value on the date of grant. Under these accounting standards, the fair value of each option is estimated on the date of grant using the Black-Scholes option pricing model. The Company also follows the guidance of accounting standards for accounting for equity instruments that are issued to other than employees for acquiring, or in conjunction with selling, goods or services for equity instruments issued to consultants. Shipping and Handling Costs The cost of shipping product to customers and distributors is typically borne by the customer or distributor. The Company records other shipping and handling costs in cost of revenue. Total freight costs amounted to approximately $133,000 and $146,500, respectively, for the three months ended March 31, 2020 and 2019.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	3 Months Ended
	Mar. 31, 2020
STOCKHOLDERS' EQUITY
STOCKHOLDERS' EQUITY	3. STOCKHOLDERS’ EQUITY Preferred Stock In June 2019, the Company amended and restated its certificate of incorporation. The amended and restated certificate of incorporation authorizes the issuance of up to 5,000,000 shares of “blank check” preferred stock, with such designation rights and preferences as may be determined from time to time by the Board of Directors. Common Stock In June 2019, the Company amended and restated its certificate of incorporation. The amended and restated certificate of incorporation increased the number of shares of common stock from 50,000,000 shares authorized to be issued to 100,000,000 shares. Shelf Registration On July 26, 2018, the Company filed a registration statement on Form S‑3 with the SEC (as amended, the “2018 Shelf”). The 2018 Shelf, which was declared effective on August 7, 2018, enables the Company to offer and sell, in one or more offerings, any combination of common stock, preferred stock, senior or subordinated debt securities, warrants and units, up to a total dollar amount of $150 million. Termination of Controlled Equity Offering Sales Agreement with Cantor Fitzgerald & Co. On May 31, 2019, the Company delivered to Cantor Fitzgerald & Co. (“Cantor”) written notice of termination (the “Termination Notice”) of the Controlled Equity Offering Sales Agreement, dated November 4, 2015, by and between the Company and Cantor, as amended by Amendment No. 1 to Sales Agreement, dated July 26, 2018 (collectively, the “Sales Agreement”). In accordance with Section 13(b) thereof, the Sales Agreement terminated on June 10, 2019, ten (10) days after the delivery of the Termination Notice. As provided in the Sales Agreement, the Sales Agreement terminated without liability of any party to any other party, except that certain provisions of the Sales Agreement identified therein shall remain in full force and effect notwithstanding the termination. Pursuant to the Sales Agreement, the Company offered and sold, from time to time through Cantor, shares of the Company’s common stock. In the aggregate, the Company sold 2,094,140 shares pursuant to the Sales Agreement, at an average selling price of $8.72 per share, generating net proceeds of approximately $17,718,000 from November 4, 2015 through December 31, 2018. There were no sales during the year ended December 31, 2019. Open Market Sale Agreement with Jefferies LLC and B. Riley FBR, Inc. On July 9, 2019 the Company entered into an Open Market Sale Agreement (the “New Sale Agreement”) with Jefferies LLC and B. Riley FBR, Inc. (each an “Agent” and, together, the “Agents”), pursuant to which the Company may sell, from time to time, at its option, shares of the Company’s common stock having an aggregate offering price of up to $25,000,000 through the Agents, as the Company’s sales agents. All shares of the Company’s common stock offered and sold,or to be offered and sold under the New Sale Agreement were or will be issued and sold pursuant to the Company’s 2018 Shelf by methods deemed to be an “at the market offering” as defined in Rule 415(a)(4) promulgated under the Securities Act of 1933, as amended, in block transactions or if specified by the Company, in privately negotiated transactions. On April 20, 2020, the Company and the Agents entered into an amendment to the Sale Agreement (the "Amendment") to provide for an increase in the aggregate offering amount under the Sales Agreement, such that as of April 20, 2020, the Company may offer and sell Shares having an additional aggregate offering price of up to $25 million under the Sale Agreement, as amended by the Amendment (the "Amended Sale Agreement"). Subject to the terms of the Amended Agreement, the Agents are required to use their commercially reasonable efforts consistent with their normal sales and trading practices to sell the shares of the Company’s common stock from time to time, based upon the Company’s instructions (including any price, time or size limits or other customary parameters or conditions the Company may impose). The Company will pay the Agents a commission of up to 3.0% of the gross proceeds from the sale of the shares of the Company’s common stock sold thereunder, if any. The Company has also agreed to provide the Agents with customary indemnification rights. The offering of the shares of the Company’s common stock will terminate upon the earliest of (a) the sale of the maximum number or amount of the shares of the Company’s stock permitted to be sold under the New Sale Agreement and (b) the termination of the New Sale Agreement by the parties thereto. During the year ended December 31, 2019, the Company sold 191,244 shares pursuant to the New Sale Agreement, at an average selling price of $4.11 per share, generating net proceeds of approximately $762,000. During the three months ended March 31, 2020, the Company sold 3,421,237 shares pursuant to the New Sale Agreement, at an average selling price of $5.89 per share, generating net proceeds of approximately $19,542,000. As of March 31, 2020, approximately $1,798,000 of these proceeds were in transit. These proceeds were received in early April 2020. During the period from April 1, 2020 through April 2, 2020, the Company sold 15,279 shares pursuant to the New Sale Agreement, at an average selling price of $8.02 per share, generating net proceeds of approximately $119,000. In the aggregate, the Company has sold 3,627,760 shares pursuant to the New Sale Agreement, at an average selling price of $5.80 per share, generating net proceeds of approximately $20,422,000. Stock-Based Compensation Total share-based employee, director, and consultant compensation for the three months ended March 31, 2020 and 2019 amounted to approximately $729,000 and $228,000, respectively. These amounts are included in the statement of operations under general and administrative expenses. The summary of the stock option activity for the three months ended March 31, 2020 is as follows: Weighted Weighted Average Average Remaining Exercise Price Contractual Shares per Share Life (Years) Outstanding, December 31, 2019 4,218,189 $ 6.16 7.0 Granted 1,446,325 $ 6.03 9.7 Forfeited (2,967) $ 5.52 — Expired (204,405) $ 5.76 — Exercised (38,277) $ 3.62 — Outstanding, March 31, 2020 5,418,865 $ 6.16 7.7 The fair value of each stock option was estimated using the Black Scholes pricing model which takes into account as of the grant date the exercise price (ranging from $5.68 to $6.57 per share) and expected life of the stock option (10 years), the current price of the underlying stock and its expected volatility (69.8 percent), expected dividends (‑0‑ percent) on the stock and the risk free interest rate (ranging from 0.45 to 0.94 percent) for the expected term of the stock option. The intrinsic value is calculated at the difference between the market value as of March 31, 2020 of $7.73 and the exercise price of the shares. Options Outstanding Number Weighted Weighted Range of Outstanding at Average Average Aggregate Exercise March 31, Exercise Remaining Intrinsic Price 2020 Price Life (Years) Value $2.23 - $14.50 5,418,865 $ 6.16 772 $ 8,977,748 Options Exercisable Number Weighted Exercisable at Average Aggregate March 31, Exercise Intrinsic 2020 Price Value 3,258,410 $ 5.90 $ 6,253,699 The summary of the status of the Company’s non-vested options for the three months ended March 31, 2020 is as follows: Weighted Average Grant Date Shares Fair Value Non-vested, December 31, 2019 1,183,790 $ 4.49 Granted 1,446,325 $ 3.69 Forfeited (3,025) $ 3.35 Vested (466,635) $ 4.14 Non-vested, March 31,2020 2,160,455 $ 4.03 As of March 31, 2020, the Company had approximately $3,300,000 of total unrecognized compensation cost related to stock options which will be amortized over approximately 35 months. Change in Control-Based Awards of Restricted Stock Units: The Board of Directors has granted restricted stock units to members of the Board of Directors, to the Company’s executive officers, and to employees of the Company. These restricted stock units will only vest upon a Change in Control of the Company, as defined in the Amended and Restated CytoSorbents Corporation 2014 Long-Term Incentive Plan. The following table is a summary of these restricted stock units: Restricted Stock Units Board of Executive Other Directors Management Employees Total Intrinsic Value December 31, 2019 277,200 604,500 1,205,050 2,086,750 $ 8,033,988 Granted — — 158,700 158,700 Forfeited — — (3,500) (3,500) March 31, 2020 277,200 604,500 1,360,250 2,241,950 $ 17,330,274 Due to the uncertainty over whether these restricted stock units will vest, which only happens upon a Change in Control, no charge for these restricted stock units has been recorded in the consolidated statement of operations for the three months ended March 31, 2020 and 2019. Performance-Based Awards of Restricted Stock Units: Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2017, on February 28, 2018, the Board of Directors granted 146,200 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2017. These awards were valued at approximately $1,148,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2020 and 2019, the Company recorded a charge of approximately $0 and $107,000, respectively, related to these restricted stock unit awards. Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2018, on March 4, 2019 the Board of Directors granted 22,220 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2018. These awards were valued at approximately $179,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2020 and 2019, the Company recorded a charge of approximately $9,000 and $5,000 respectively, related to these restricted stock unit awards. Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2019, on July 22, 2019 the Board of Directors granted 180,300 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2019. These awards were valued at approximately $1,300,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant, one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2020 and 2019, the Company recorded a charge of approximately $103,000 and $0, respectively, related to these restricted stock unit awards. Pursuant to a review of the compensation of the senior management of the Company and managements’ performance in 2019, on February 28, 2020, the Board of Directors granted 168,100 restricted stock units to certain senior managers of the Company in order to settle bonuses accrued as of December 31, 2020. These awards were valued at approximately $1,014,000 at the date of issuance, based upon the market price of the Company’s common stock at the date of the grant, and vest one third on the date of the grant one third on the first anniversary of the date of the grant, and one third on the second anniversary of the date of the grant. For the three months ended March 31, 2020 and 2019, the Company recorded a charge of approximately $366,000 and $0 respectively, related to these restricted stock unit awards. The following table outlines the restricted stock unit activity for the three months ended March 31, 2020: Weighted Average Grant Date Shares Fair Value Non-vested, January 1, 2020 167,872 $ 7.52 Granted 168,100 $ 6.03 Vested (105,968) $ 6.90 Non-vested, March 31, 2020 230,004 $ 6.71 Warrants: As of March 31, 2020, the Company had no warrants outstanding. On December 31, 2019, the Company had warrants outstanding to purchase of 30,000 shares of the Company’s common stock at an exercise price of $9.90. However, these warrants expired January 14, 2020.

REVENUE

REVENUE	3 Months Ended
	Mar. 31, 2020
REVENUE
REVENUE	4. REVENUE The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2020: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ — $ — $ — $ — Germany 4,913,588 — — 4,913,588 All other countries 1,495,806 1,746,575 — 3,242,381 Total product revenue 6,409,394 1,746,575 — 8,155,969 Grant and other income: United States — — 551,341 551,341 Total revenue $ 6,409,394 $ 1,746,575 $ 551,341 $ 8,707,310 The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2019: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 66,800 $ — $ — $ 66,800 Germany 3,098,176 — — 3,098,176 All other countries 816,229 595,374 — 1,411,603 Total product revenue 3,981,205 595,374 — 4,576,579 Grant and other income: United States — — 615,050 615,050 Total revenue $ 3,981,205 $ 595,374 $ 615,050 $ 5,191,629 The Company has two primary revenue streams: (1) sales of the CytoSorb device and related device accessories and (2) grant income from contracts with various agencies of the United States government. Both of these revenue streams are within the scope of this accounting pronouncement. The following is a brief description of each revenue stream. CytoSorb Sales The Company sells its CytoSorb device using both its own sales force (direct sales) and through the use of distributors and/or strategic partners. All sales of the device are outside the United States, as CytoSorb is not yet approved in the United States, other than in respect of the EUA. Direct sales are fulfilled from the Company’s office in Berlin, Germany. Direct sales relate to sales to hospitals located in Germany, Switzerland, Austria, Belgium, Luxembourg, Poland, the Netherlands, Sweden, Denmark and Norway. There are no formal sales contracts with any direct customers relating to product price or minimum purchase requirements. However, there are agreements in place with certain direct customers that provide for either free of charge product or rebate credits based upon achieving minimum purchase levels. The Company records the value of these items earned as a reduction of revenue. These customers submit purchase orders and the order is fulfilled and shipped directly to the customer. Prices to all direct customers are based on a standard price list based on the packaged quantity (6 packs vs 12 packs). Distributor and strategic partner sales make up the remaining product sales. These distributors are located in various countries throughout the world. The Company has a formal written contract with each distributor/strategic partner. These contracts have terms ranging from 1-5 years in length, with three years being the typical term. In addition, certain distributors are eligible for volume discount pricing if their unit sales are in excess of the base requirement per the contract. Each distributor's/strategic partner's contract has minimum annual purchase requirements in order to maintain exclusivity in their respective territories. There is no additional consideration or monetary penalty that would be required to be paid to CytoSorbents if a distributor does not meet the minimum purchase commitments included in the contract, however, at the discretion of the Company, the distributor may lose its exclusive rights in the territory if such commitments are not met. Government Grants The Company has been the recipient of various grant contracts from various agencies of the United States government, primarily the Department of Defense, to perform various research and development activities. These contracts fall into one of the following categories: 1. 2. 3. 4. In summary, the contracts the Company has with customers are the distributor/strategic partner contracts related to CytoSorb product sales, agreements with direct customers related to free-of-charge product and credit rebates based upon achieving minimum purchase levels, and contracts with various government agencies related to the Company’s grants. The Company does not currently incur any outside/third party incremental costs to obtain any of these contracts. The Company does incur internal costs, primarily salary related costs, to obtain the contracts related to the grants. Company employees spend time reviewing the program requirements and developing the budget and related proposal to submit to the grantor agency. There may additionally be travel expenditures involved with meeting with government agency officials during the negotiation of the contract. These internal costs are expensed as incurred. The following table provides information about receivables and contract liabilities from contracts with customers: March 31, 2020 December 31, 2019 Receivables, which are included in grants and accounts receivable $ 2,040,455 $ 2,246,821 Contract liabilities $ 151,772 $ 171,842 Contract liabilities represent the value of free of charge goods and credit rebates earned in accordance with the terms of certain direct customer agreements during the periods ended March 31, 2020 and December 31, 2019, and deferred revenue on distributor/strategic partner contracts. Deferred revenue is the difference between the average selling price anticipated for the year ended 2020 and the actual price invoiced during the three months ended March 31, 2020. At March 31, 2020, deferred revenue amounted to approximately $32,300 and is included in contract liabilities above. There was no deferred revenue liability as of December 31, 2019.

LONG-TERM DEBT, NET

LONG-TERM DEBT, NET	3 Months Ended
	Mar. 31, 2020
LONG-TERM DEBT, NET
LONG-TERM DEBT, NET	5. LONG-TERM DEBT, NET On June 30, 2016, the Company and its wholly-owned subsidiary, CytoSorbents Medical, Inc. (together, the “Borrower”), entered into a Loan and Security Agreement with Bridge Bank, a division of Western Alliance Bank, (the “Bank”), pursuant to which the Company borrowed $10 million in two equal tranches of $5 million (the “Original Term Loans”). On March 29, 2018 (the “Closing Date”), the Original Term Loans were refinanced with the Bank pursuant to an Amended and Restated Loan and Security Agreement by and between the Bank and the Borrower (the “Amended and Restated Loan and Security Agreement”), under which the Bank agreed to loan the Borrower up to an aggregate of $15 million to be disbursed in two tranches (1) one tranche of $10 million (the “Term A Loan”), which was funded on the Closing Date and used to refinance the Original Term Loans, and (2) a second tranche of $5 million which may be disbursed at the Borrower’s sole request prior to March 31, 2019 provided certain conditions are met (the “Term B Loan” and together with the Term A Loan, the “Term Loans”). On July 31, 2019 (the “Settlement Date”), the Borrower entered into the First Amendment to the Amended and Restated Loan and Security Agreement (the “First Amendment”) with the Bank, which amended certain provisions of the Amended and Restated Loan and Security Agreement and the 2018 Success Fee Letter (the “2018 Letter”). In connection with the execution of the First Amendment, the draw period for the Term B Loan was extended to August 15, 2019 and the Company drew down the full $5.0 million Term B Loan on the Settlement Date, bringing the total outstanding debt to $15,000,000 at July 31, 2019. The proceeds of Term Loans were used for general business requirements in accordance with the Amended and Restated Loan and Security Agreement. The outstanding balances on Term Loans bear interest at the prime rate reported in the Wall Street Journal plus 3.66%. This rate was 6.91% at March 31, 2020. On the Closing Date, the Company was required to pay a non-refundable closing fee of $25,000, expenses incurred by the Bank related to the Amended and Restated Loan and Security Agreement of $11,000 and a portion of the final fee for the period the Original Term Loans were outstanding of $85,938. In addition, the Company incurred legal expenses related to the Amended and Restated Loan and Security Agreement of $20,050 and $4,212 related to the First Amendment. As of the Settlement Date, the total unamortized loan costs related to the Term Loans amounted to $90,925. These costs have been presented as a direct deduction from the proceeds of the loan on the consolidated balance sheet in accordance with the provisions of ASC 850. These costs are being amortized over the loan period as a charge to interest expense. For the three months ended March 31, 2020 and 2019, the Company recorded interest expense amounting to $8,524 and $8,129, respectively related to these costs. After accounting for the various costs outlined above, the effective interest rate on the Term A Loan was 9.1% as of March 29, 2018. Under the terms of the First Amendment, commencing on the first calendar day of the calendar month after Term B Loan was made, the Company is required to make monthly payments of interest-only through April 2020. The interest-only period will be further extended through November 2020 provided the Borrower has been compliant with its obligations under the financial covenant revenue test set forth in the Amended and Restated Loan and Security Agreement for all months from the month immediately after the month in which the Term B Loan is funded through March 2020. Since the Company has complied with its obligations under the financial covenant revenue test through March 2020, commencing on November 1, 2020, the Company shall make equal monthly payments of principal of $833,333, together with accrued and unpaid interest. All unpaid principal and accrued and unpaid interest shall be due and payable in full on April 1, 2022. In addition, the Amended and Restated Loan and Security Agreement requires the Company to pay a non-refundable final fee equal to 2.5% of the principal amount of each Term Loan funded upon the earlier of the (i) April 1, 2022 maturity date or (ii) termination of the Term Loan via acceleration or prepayment. This final fee is being accrued and charged to interest expense over the term of the loan. For the three months ended March 31, 2020 and 2019, the Company recorded interest expense of $27,344 and 15,625, respectively, related to the final fee. The Term Loans are evidenced by a secured promissory notes issued to the Bank by the Company. If the Company elects to prepay the Term Loans pursuant to the terms of the Amended and Restated Loan and Security Agreement, it will owe a prepayment fee to the Bank, as follows: (1) for a prepayment made on or after the funding date of a Term Loan through and including the first anniversary of such funding date, an amount equal to 2.0% of the principal amount of such Term Loan prepaid; (2) for a prepayment made after the first anniversary of the funding date of a Term Loan through and including the second anniversary of such funding date, an amount equal to 1.5% of the principal amount of such Term Loan prepaid; and (3) for a prepayment made after the second anniversary of the funding date of a Term Loan through April 1, 2022, an amount equal to 1.0% of the principal amount of such Term Loan prepaid. Events of default which may cause repayment of the Term Loans to be accelerated include, among other customary events of default, (1) non-payment of any obligation when due, (2) the failure to perform any obligation required under the Amended and Restated Loan and Security Agreement and to cure such default within a reasonable time frame, (3) the occurrence of a Material Adverse Event (as defined in the Amended and Restated Loan and Security Agreement), (4) the attachment or seizure of a material portion of the Borrower’s assets if such attachment or seizure is not released, discharged or rescinded within 10 days, and (5) if the Borrower becomes insolvent or starts an insolvency proceeding or if an insolvency proceeding is brought by a third party against the Borrower and such proceeding is not dismissed or stayed within 30 days. The Amended and Restated Loan and Security Agreement includes customary loan conditions, Borrower representations and warranties, Borrower affirmative covenants and Borrower negative covenants for secured transactions of this type. The Company is in substantial compliance with these covenants. The Company’s and CytoSorbents Medical, Inc.’s obligations under the Amended and Restated Loan and Security Agreement are joint and severable and are secured by a first priority security interest in favor of the Bank with respect to the Company’s Shares (as defined in the Amended and Restated Loan and Security Agreement) and the Borrower’s Collateral (as defined in the Amended and Restated Loan and Security Agreement, which definition excludes the Borrower’s intellectual property and other customary exceptions). 2018 Success Fee Letter: Pursuant to the amended 2018 Letter, the Borrower shall pay to the Bank a success fee in the amount equal to 6.37% of the funded amount of the Term B Loan (as defined in the Restated Loan and Security Agreement) (the “Success Fee”) upon the first occurrence of any of the following events: (a) a sale or other disposition by the Borrower of all or substantially all of its assets; (b) a merger or consolidation of the Borrower into or with another person or entity, where the holders of the Borrower’s outstanding voting equity securities as of immediately prior to such merger or consolidation hold less than a majority of the issued and outstanding voting equity securities of the successor or surviving person or entity as of immediately following the consummation of such merger or consolidation; (c) a transaction or a series of related transactions in which any “person” or “group” (within the meaning of Section 13(d) and 14(d)(2) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”) becomes the “beneficial owner” (as defined in Rule 13d-3 under the Exchange Act), directly or indirectly, of a sufficient number of shares of all classes of stock then outstanding of the Borrower ordinarily entitled to vote in the election of directors, empowering such “person” or “group” to elect a majority of the Board of Directors of the Borrower, who did not have such power before such transaction; or (d) the closing price per share for the Company’s common stock on the Nasdaq Capital Market being the greater of (i) 70% or more over $7.05, the closing price of the Company’s common stock on March 29, 2018 (after giving effect to any stock splits or consolidations effected after the date thereof) for five successive business days, or (ii) at least 26.13% more than the average price of Company’s common stock for the 365 day period ending on the date of the funding of the Term B Loan. Long-term debt consists of the following at March 31, 2020: Principal amount $ 15,000,000 Less unamortized debt acquisition costs (68,194) Plus accrued final fee 156,250 Subtotal 15,088,056 Less current maturities (4,166,667) Long-term debt net of current maturities $ 10,921,389 Principal payments of long-term debt are due as follows during the year ended March 31: 2021 $ 4,166,667 2022 10,000,000 2023 833,333 Total $ 15,000,000

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	3 Months Ended
	Mar. 31, 2020
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES	6. COMMITMENTS AND CONTINGENCIES Employment Agreements On July 30, 2019, CytoSorbents Corporation entered into amended and restated executive employment agreements with its principal executives, Dr. Phillip P. Chan, Chief Executive Officer, Vincent Capponi, President and Chief Operating Officer, and Kathleen P. Bloch, Chief Financial Officer. Each of the agreements has an initial term of three years, and was retroactively effective as of January 1, 2019. On April 12, 2020, CytoSorbents Corporation entered into an executive employment agreement with Dr. Ethymios Deliargyris, to start as Chief Medical Officer no later than May 18, 2020, with an initial term that expires on December 31, 2021. After the expiration of the initial terms, the employment agreements will automatically renew for additional terms of one year unless either party provides written notice of non-renewal at least 60 days prior to a renewal. The foregoing employment agreements each provide for base salary and other customary benefits which include participation in group insurance plans, paid time off and reimbursement of certain business related expenses, including travel and continuing educational expenses, as well as bonus and/or equity awards at the discretion of the Board of Directors. In addition, the agreements provide for certain termination benefits in the event of termination without “Cause” or voluntary termination of employment for “Good Reason”, as defined in each agreement. The agreements also provide for certain benefits in the event of a “Change of Control” of the Company, as defined in each agreement. Litigation The Company is from time to time subject to claims and litigation arising out of the ordinary course of business. The Company intends to defend vigorously against any future claims and litigation. The Company is not currently a party to any legal proceedings. Royalty Agreements Pursuant to an agreement dated August 11, 2003, an investor agreed to make a $4 million equity investment in the Company. These amounts were received by the Company in 2003. In connection with this agreement, the Company granted the investor a future royalty of 3% on all gross revenues received by the Company from the sale of its CytoSorb device, which such rights were assigned to an existing investor in 2017. For the three months ended March 31, 2020 and 2019, the Company has recorded royalty costs of approximately $242,000 and $134,000, respectively. License Agreements In March 2006, the Company entered into a license agreement which provides the Company the exclusive right to use its patented technology and proprietary know how relating to adsorbent polymers for a period of 18 years. Under the terms of the agreement, the Company has agreed to pay royalties of 2.5% to 5% on the sale of certain of its products if and when those products are sold commercially for a term not greater than 18 years commencing with the first sale of such product. For the three months ended March 31, 2020 and 2019, per the terms of the license agreement, the Company has recorded royalty costs of approximately $404,000 and $224,000, respectively.

LEASES

LEASES	3 Months Ended
	Mar. 31, 2020
LEASES
LEASES	7. LEASES The Company leases its operating facilities in both the United States and Germany under operating lease agreements. In the United States, in January 2019, the Company entered into an Eighteenth Amendment to Lease with the landlord which became effective February 1, 2019. This amendment expands the Company’s space to 19,920 square feet and extends the term of the lease to May 31, 2020. The Company’s base rent is approximately $32,000 per month. In addition, the Company is obligated to pay monthly operating expenses of approximately $29,000 per month. The amendment also includes a one year renewal option. The base rent for the renewal term will increase by the greater of five percent or the increase in the Consumer Price Index. There were no lease incentives and no initial direct costs were incurred related to this lease amendment. In Germany, the Company leases its operating facility under two operating lease agreements. These leases require combined base rent payments amounting to approximately $8,800 per month. The initial lease term of both leases ends August 31, 2021. In addition, the Company is obligated to monthly operating expenses of approximately $2,900 per month. Both leases have a five year option to renew that would extend the lease term to August 31, 2026. There are no provisions in the leases to increase the base rent during the renewal period. There were no lease incentives and no initial direct costs were incurred related to these leases. Initial Measurement of Right-Of-Use Asset and Lease Liability: Under the provisions of this ASU, the Company has adjusted its consolidated balance sheet at December 31, 2018 to reflect the value of the right-of-use asset and related lease liability. This value was calculated based on the present value of the remaining base rent lease payments. The remaining lease payments include the renewal periods for both facilities as the Company has determined that it is probable that the renewal options will be exercised under each of the lease agreements. The discount rate used was the Company’s incremental borrowing rate, which is 9.16%, as the Company could not determine the rate implicit in the lease. As a result, the value of the right-of-asset and related lease liability is as follows: March 31, December 31, 2020 2019 Right-of-use asset $ 970,182 $ 1,070,762 Total lease liability $ 970,182 $ 1,070,762 Less current portion (442,865) (428,083) Lease liability, net of current portion $ 527,317 $ 642,679 The maturities of the lease liabilities are as follows during the year ended March 31: 2021 $ 442,865 2022 136,098 2023 75,308 2024 82,503 2025 90,385 Thereafter 143,023 Total $ 970,182 For the three months ended March 31, 2020 and 2019, operating cash flows paid in connection with operating leases amounted to approximately $234,000 and $215,000, respectively. As of March 31, 2020 and December 31, 2019, the weighted average remaining lease term was 3.96 years and 4.01 years, respectively.

NET LOSS PER SHARE

NET LOSS PER SHARE	3 Months Ended
	Mar. 31, 2020
NET LOSS PER SHARE
NET LOSS PER SHARE	8. NET LOSS PER SHARE Basic loss per share and diluted loss per share for the three months ended March 31, 2020 and 2019 have been computed by dividing the net loss for each respective period by the weighted average number of shares outstanding during that period. All outstanding options and restricted stock awards representing approximately 7,891,000 and 5,716,000 incremental shares at March 31, 2020 and 2019, respectively, have been excluded from the computation of diluted loss per share as they are anti-dilutive.

SUBSEQUENT EVENTS

SUBSEQUENT EVENTS	3 Months Ended
	Mar. 31, 2020
SUBSEQUENT EVENTS
SUBSEQUENT EVENTS	9. SUBSEQUENT EVENTS During the period from April 1, 2020 through April 2, 2020, the Company sold 15,279 shares pursuant to the New Sale Agreement at an average selling price of $8.02 per share, generating net proceeds of approximately $119,000 (see Note 3). On April 13, 2020, the Company received approximately $1,411,000 in loan proceeds from the Payroll Protection Program (the “PPP”) administered by the Small Business Administration (the “SBA”) of the United States government. This program was established under the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”). On April 29, 2020, following a reassessment of the Company’s current favorable financial and operating position, including cash on hand and access to public capital markets, we repaid the PPP loan. On April 20, 2020, the Company and the Agents entered into the Amendment to provide for an increase in the aggregate offering amount under the New Sale Agreement, such that as of April 20, 2020, the Company may offer and sell Shares having an additional aggregate offering price of up to $25 million under the New Sale Agreement (see Note 3). On April 12, 2020, the Company entered into an executive employment contract with Efthymios N. Deliargyris, MD, FACC, FESC, FSCAI as Chief Medical Officer, to start as Chief Medical Officer no later than May 18, 2020, with an initial term that expires on December 31, 2021. Dr. Deliargyris commenced employment on May 1, 2020 (see Note 6). On May 4, 2020, Vincent J. Capponi was promoted to President and Chief Operating Officer.

PRINCIPAL BUSINESS ACTIVITY A_2

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2020
PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Nature of Business	Nature of Business The Company is a leader in critical care immunotherapy using blood purification technology to treat deadly inflammation in critically-ill and cardiac surgery patients around the world. The Company, through its subsidiary CytoSorbents Medical, Inc. (formerly known as CytoSorbents, Inc.), is engaged in the research, development and commercialization of medical devices with its blood purification technology platform which incorporates a proprietary adsorbent, porous polymer technology. The Company, through its wholly owned European subsidiary, CytoSorbents Europe GmbH, conducts sales and marketing related operations for the CytoSorb device. In March 2016, the Company formed CytoSorbents Switzerland GmbH, a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the second quarter of 2016, provides marketing and direct sales services in Switzerland. In November 2018, the Company formed CytoSorbents Poland Sp. z.o.o., a wholly-owned subsidiary of CytoSorbents Europe GmbH. This subsidiary, which began operations during the first quarter of 2019, provides marketing and direct sales services in Poland. CytoSorb, the Company’s flagship product, was approved in the European Union (“EU”) in March 2011, and is currently being marketed and distributed in fifty-five countries around the world, as a safe and effective extracorporeal cytokine absorber, designed to reduce the “cytokine storm” that could otherwise cause massive inflammation, organ failure and death in common critical illnesses such as sepsis, burn injury, trauma, lung injury, and pancreatitis. In May 2018, the Company received a label extension for CytoSorb covering use of the device for the removal of bilirubin and myoglobin which allows for the use of the device in the treatment of liver failure and trauma, respectively. CytoSorb is also being used during and after cardiac surgery to remove inflammatory mediators, such as cytokines and free hemoglobin, which can lead to post-operative complications, including multiple organ failure. In April 2020, the Company announced that the United States Food and Drug Administration (the “FDA”) granted Emergency Use Authorization (“EUA”) of CytoSorb for use in critically-ill patients infected with COVID-19. Under the EUA, the Company can make CytoSorb available, through commercial sales, to all hospitals in the United States for use in patients, 18 years of age or older, with confirmed COVID-19 infection who are admitted to the intensive care unit (ICU) with confirmed or imminent respiratory failure who have early acute lung injury or acute respiratory distress syndrome (ARDS), severe disease, or life-threatening illness resulting in respiratory failure, septic shock, and/or multiple organ dysfunction or failure. The EUA will be effective until a declaration is made that the circumstances justifying the EUA have terminated or until revoked by the FDA. In April 2020, we announced that the FDA has granted Breakthrough Designation to CytoSorb for the removal of ticagrelor in a cardiopulmonary bypass circuit during emergent and urgent cardiothoracic surgery. The Breakthrough Devices Program provides for more effective treatment of life-threatening or irreversibly debilitating disease or conditions, in this case the need to reverse the effects of ticagrelor in emergent or urgent cardiac surgery that can otherwise cause a high risk of serious or life-threatening bleeding. Through Breakthrough Designation, FDA will work with CytoSorbents to expedite the development, assessment, and regulatory review of CytoSorb for the removal of ticagrelor, while maintaining statutory standards of regulatory approval (e.g., 510(k), de novo 510(k) or premarket approval ) consistent with the Agency’s mission to protect and promote public health. The technology is based upon biocompatible, highly porous polymer sorbent beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface adsorption. The Company has numerous products under development based upon this unique blood purification technology, which is protected by 21 issued U.S. patents and multiple international patents, with applications pending both in the U.S. and internationally, including HemoDefend, ContrastSorb, DrugSorb, and others. These patents and patent applications are directed to various compositions and methods of use related to our blood purification technologies and are expected to expire between 2020 and 2035, absent any patent term extensions. Management believes that any near term expiring patents will not have a significant impact on our ongoing business.
Stock Market Listing	Stock Market Listing On December 17, 2014 the Company’s common stock, par value $0.001 per share, was approved for listing on the Nasdaq Capital Market (“Nasdaq”), and it began trading on Nasdaq on December 23, 2014 under the symbol “CTSO.” Previously, the Company’s common stock traded in the over-the-counter-market on the OTC Bulletin Board.
Basis of Consolidation and Foreign Currency Translation	Basis of Consolidation and Foreign Currency Translation The consolidated financial statements include the accounts of CytoSorbents Corporation and its wholly-owned subsidiaries, CytoSorbents Medical, Inc. and CytoSorbents Europe GmbH. In addition, the consolidated financial statements include CytoSorbents Switzerland GmbH and CytoSorbents Poland Sp. z.o.o., wholly owned subsidiaries of CytoSorbents Europe GmbH, and CytoSorbents UK Limited, a wholly-owned subsidiary of CytoSorbents Medical, Inc. All significant intercompany transactions and balances have been eliminated in consolidation. Translation gains and losses resulting from the process of remeasuring into the United States Dollar, the foreign currency financial statements of CytoSorbents Europe GmbH, for which the Euro is the functional currency, are included in operations. Foreign currency transaction loss included in net loss amounted to approximately $(668,000) and $(393,000) for the three months ended March 31, 2020 and 2019, respectively. The Company translates assets and liabilities of CytoSorbents Europe GmbH at the exchange rate in effect at the consolidated balance sheet date. The Company translates revenue and expenses at the daily average exchange rates. The Company includes accumulated net translation adjustments in accumulated other comprehensive income (loss) as a component of stockholders’ equity.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents.
Grants and Accounts Receivable	Grants and Accounts Receivable Grants receivable represent amounts due from U.S. government agencies and are included in Grants and Accounts Receivable. Accounts receivable are unsecured, non-interest bearing customer obligations due under normal trade terms. The Company sells its devices to various hospitals and distributors. The Company performs ongoing credit evaluations of its customers’ financial conditions. Management reviews accounts receivable periodically to determine collectability. Balances that are determined to be uncollectible are written off to the allowance for doubtful accounts. The allowance for doubtful accounts contains a general accrual for estimated bad debts and amounted to approximately $150,000 and $145,000 at March 31, 2020 and December 31, 2019, respectively.
Inventories	Inventories Inventories are valued at the lower of cost or net realizable value under the first in, first out (FIFO) method. At March 31, 2020 and December 31, 2019, the Company’s inventory was comprised of finished goods, which amounted to $353,437 and $305,452, respectively; work in process which amounted to $1,394,156 and $1,523,923, respectively; and raw materials, which amounted to $219,581 and $284,522, respectively. Devices used in clinical trials or for research and development purposes are removed from inventory and charged to research and development expenses at the time of their use. Donated devices are removed from inventory and charged to selling, general and administrative expenses.
Property and Equipment	Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation of property and equipment is provided for by the straight-line method over the estimated useful lives of the related assets. Leasehold improvements are amortized over the lesser of their economic useful lives or the term of the related leases. Gains and losses on depreciable assets retired or sold are recognized in the consolidated statements of operations and comprehensive loss in the year of disposal. Repairs and maintenance expenditures are expensed as incurred.
Patents	Patents Legal costs incurred to establish and successfully defend patents are capitalized. When patents are issued, capitalized costs are amortized on the straight-line method over the related patent term. In the event a patent is abandoned, the net book value of the patent is written off.
Impairment or Disposal of Long-Lived Assets	Impairment or Disposal of Long-Lived Assets The Company assesses the impairment of patents and other long-lived assets under accounting standards for the impairment or disposal of long-lived assets whenever events or changes in circumstances indicate that the carrying value may not be recoverable. For long-lived assets to be held and used, the Company recognizes an impairment loss only if its carrying amount is not recoverable through its undiscounted cash flows and measures the impairment loss based on the difference between the carrying amount and fair value.
Revenue Recognition	Revenue Recognition Product Sales : Revenues from sales of products to both direct and distributor/strategic partner customers are recognized at the time when control passes to the customer, in accordance with the terms of their respective contracts. Recognition of revenue occurs as each performance obligation is completed. Grant Income : Revenue from grant income is based on contractual agreements. Certain agreements provide for reimbursement of costs; other agreements provide for reimbursement of costs and an overhead margin and certain agreements are performance based, where revenue is earned based upon the achievement of milestones outlined in the contract. Revenues are recognized when the associated performance obligation is fulfilled. Costs are recorded as incurred. Costs subject to reimbursement by these grants have been reflected as costs of revenue.
Research and Development	Research and Development All research and development costs, payments to laboratories and research consultants are expensed when incurred.
Advertising Expenses	Advertising Expenses Advertising expenses are charged to activities when incurred. Advertising expenses amounted to approximately $31,500 and $51,800 for the three months ended March 31, 2020 and 2019, respectively, and are included in selling, general, and administrative expenses on the consolidated statements of operations and comprehensive loss.
Income Taxes	Income Taxes Income taxes are accounted for under the asset and liability method prescribed by accounting standards for accounting for income taxes. Deferred income taxes are recorded for temporary differences between financial statement carrying amounts and the tax basis of assets and liabilities. Deferred tax assets and liabilities reflect the tax rates expected to be in effect for the years in which the differences are expected to reverse. A valuation allowance is provided if it is more likely than not that some or all of the deferred tax asset will not be realized. The Company has provided a valuation allowance against all deferred tax assets. Under Section 382 of the Internal Revenue Code, the net operating losses generated prior to the previously completed reverse merger may be limited due to the change in ownership. Additionally, net operating losses generated subsequent to the reverse merger may be limited in the event of changes in ownership. The Company follows accounting standards associated with uncertain tax positions. The Company had no unrecognized tax benefits at March 31, 2020 or December 31, 2019. The Company files tax returns in the U.S. federal and state jurisdictions. The Company utilizes the Technology Business Tax Certificate Transfer Program to sell a portion of its New Jersey Net Operating Loss carry forwards to an industrial company. Each of CytoSorbents Europe GmbH, CytoSorbents Switzerland GmbH, CytoSorbents Poland Sp. Z.o.o. and CytoSorbents UK Limited file an annual corporate tax return, VAT return and a trade tax return in Germany, Switzerland, Poland and the United Kingdom, respectively.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities. Actual results could differ from these estimates. The valuation of options granted is a significant estimate in these consolidated financial statements.
Concentration of Credit Risk	Concentration of Credit Risk The Company maintains cash balances, at times, with financial institutions in excess of amounts insured by the Federal Deposit Insurance Corporation. Management monitors the soundness of these institutions in an effort to minimize its collection risk of these balances. A significant portion of our revenues are from product sales in Germany. Substantially all of our grant and other income are from grant agencies in the United States. (See Note 4 for further information relating to the Company’s revenue.) As of March 31, 2020, one distributor accounted for approximately 10% of outstanding grants and accounts receivable. As of December 31, 2019, no agency, distributor/strategic partners or direct customer represented more than 10% of outstanding grants and accounts receivables. For the three months ended March 31, 2020 and 2019, no agency, distributor, or direct customer represented more than 10% of the Company’s total revenue.
Financial Instruments	Financial Instruments The carrying values of cash and cash equivalents, grants and accounts receivable, accounts payable, notes payable, and other debt obligations approximate their fair values due to their short-term nature.
Net Loss Per Common Share	Net Loss Per Common Share Basic earnings per share is computed by dividing loss available to common stockholders by the weighted average number of common shares outstanding during the period. Diluted earnings per common share are computed using the treasury stock method on the basis of the weighted-average number of shares of common stock plus the dilutive effect of potential common shares outstanding during the period. Dilutive potential common shares include outstanding warrants, stock options and restricted shares. The computation of diluted earnings per share does not assume conversion, exercise or contingent exercise of securities that would have an anti-dilutive effect on earnings (See Note 8).
Stock-Based Compensation	Stock-Based Compensation The Company accounts for its stock-based compensation under the recognition requirements of accounting standards for accounting for stock-based compensation, for employees and directors whereby each option granted is valued at fair market value on the date of grant. Under these accounting standards, the fair value of each option is estimated on the date of grant using the Black-Scholes option pricing model. The Company also follows the guidance of accounting standards for accounting for equity instruments that are issued to other than employees for acquiring, or in conjunction with selling, goods or services for equity instruments issued to consultants.
Shipping and Handling Costs	Shipping and Handling Costs The cost of shipping product to customers and distributors is typically borne by the customer or distributor. The Company records other shipping and handling costs in cost of revenue. Total freight costs amounted to approximately $133,000 and $146,500, respectively, for the three months ended March 31, 2020 and 2019.

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	3 Months Ended
	Mar. 31, 2020
STOCKHOLDERS' EQUITY
Schedule Of Share Based Compensation Stock Options Activity	The summary of the stock option activity for the three months ended March 31, 2020 is as follows: Weighted Weighted Average Average Remaining Exercise Price Contractual Shares per Share Life (Years) Outstanding, December 31, 2019 4,218,189 $ 6.16 7.0 Granted 1,446,325 $ 6.03 9.7 Forfeited (2,967) $ 5.52 — Expired (204,405) $ 5.76 — Exercised (38,277) $ 3.62 — Outstanding, March 31, 2020 5,418,865 $ 6.16 7.7
Schedule of Share-based Compensation, Shares Authorized under Stock Option Plans, by Exercise Price Range	The intrinsic value is calculated at the difference between the market value as of March 31, 2020 of $7.73 and the exercise price of the shares. Options Outstanding Number Weighted Weighted Range of Outstanding at Average Average Aggregate Exercise March 31, Exercise Remaining Intrinsic Price 2020 Price Life (Years) Value $2.23 - $14.50 5,418,865 $ 6.16 772 $ 8,977,748 Options Exercisable Number Weighted Exercisable at Average Aggregate March 31, Exercise Intrinsic 2020 Price Value 3,258,410 $ 5.90 $ 6,253,699
Schedule Of Non vested Share Activity	The summary of the status of the Company’s non-vested options for the three months ended March 31, 2020 is as follows: Weighted Average Grant Date Shares Fair Value Non-vested, December 31, 2019 1,183,790 $ 4.49 Granted 1,446,325 $ 3.69 Forfeited (3,025) $ 3.35 Vested (466,635) $ 4.14 Non-vested, March 31,2020 2,160,455 $ 4.03
Schedule of Share-based Compensation, Restricted Stock Units Award Activity	The following table is a summary of these restricted stock units: Restricted Stock Units Board of Executive Other Directors Management Employees Total Intrinsic Value December 31, 2019 277,200 604,500 1,205,050 2,086,750 $ 8,033,988 Granted — — 158,700 158,700 Forfeited — — (3,500) (3,500) March 31, 2020 277,200 604,500 1,360,250 2,241,950 $ 17,330,274
Schedule Of Restricted Stock Unit Activity	Weighted Average Grant Date Shares Fair Value Non-vested, January 1, 2020 167,872 $ 7.52 Granted 168,100 $ 6.03 Vested (105,968) $ 6.90 Non-vested, March 31, 2020 230,004 $ 6.71

REVENUE (Tables)

REVENUE (Tables)	3 Months Ended
	Mar. 31, 2020
REVENUE
Schedule of disaggregation of Revenue	The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2020: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ — $ — $ — $ — Germany 4,913,588 — — 4,913,588 All other countries 1,495,806 1,746,575 — 3,242,381 Total product revenue 6,409,394 1,746,575 — 8,155,969 Grant and other income: United States — — 551,341 551,341 Total revenue $ 6,409,394 $ 1,746,575 $ 551,341 $ 8,707,310 The following table disaggregates the Company’s revenue by customer type and geographic area for the three months ended March 31, 2019: United States Distributors/ Government Direct Strategic Partners Agencies Total Product sales: United States $ 66,800 $ — $ — $ 66,800 Germany 3,098,176 — — 3,098,176 All other countries 816,229 595,374 — 1,411,603 Total product revenue 3,981,205 595,374 — 4,576,579 Grant and other income: United States — — 615,050 615,050 Total revenue $ 3,981,205 $ 595,374 $ 615,050 $ 5,191,629
Schedule of contract with Customer, Asset and Liability	March 31, 2020 December 31, 2019 Receivables, which are included in grants and accounts receivable $ 2,040,455 $ 2,246,821 Contract liabilities $ 151,772 $ 171,842

LONG-TERM DEBT, NET (Tables)

LONG-TERM DEBT, NET (Tables)	3 Months Ended
	Mar. 31, 2020
LONG-TERM DEBT, NET
Schedule of Long-term Debt	Long-term debt consists of the following at March 31, 2020: Principal amount $ 15,000,000 Less unamortized debt acquisition costs (68,194) Plus accrued final fee 156,250 Subtotal 15,088,056 Less current maturities (4,166,667) Long-term debt net of current maturities $ 10,921,389
Schedule of Principal payments of long-term debt	Principal payments of long-term debt are due as follows during the year ended March 31: 2021 $ 4,166,667 2022 10,000,000 2023 833,333 Total $ 15,000,000

LEASES (Tables)

LEASES (Tables)	3 Months Ended
	Mar. 31, 2020
LEASES
Schedule Of Right-Of-Asset And Related Lease Liability	As a result, the value of the right-of-asset and related lease liability is as follows: March 31, December 31, 2020 2019 Right-of-use asset $ 970,182 $ 1,070,762 Total lease liability $ 970,182 $ 1,070,762 Less current portion (442,865) (428,083) Lease liability, net of current portion $ 527,317 $ 642,679
Schedule of Maturities of Lease Liabilities	The maturities of the lease liabilities are as follows during the year ended March 31: 2021 $ 442,865 2022 136,098 2023 75,308 2024 82,503 2025 90,385 Thereafter 143,023 Total $ 970,182

BASIS OF PRESENTATION (Details)

BASIS OF PRESENTATION (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
BASIS OF PRESENTATION
Accumulated deficit	$ (192,242,238)		$ (188,789,459)
Net loss	$ (3,452,779)	$ (4,883,827)

PRINCIPAL BUSINESS ACTIVITY A_3

PRINCIPAL BUSINESS ACTIVITY AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019	Dec. 17, 2014
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Common Stock, Par Value	$ 0.001		$ 0.001	$ 0.001
Inventory, Finished Goods, Gross	$ 353,437		$ 305,452
Inventory, Work in Process, Gross	1,394,156		1,523,923
Inventory, Raw Materials, Gross	219,581		$ 284,522
Advertising Expense	31,500	$ 51,800
Cost of Goods and Services Sold	2,384,842	1,738,589
Cargo and Freight
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Cost of Goods and Services Sold	$ 133,000	$ 146,500
Accounts Receivable
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage			10.00%
Accounts Receivable | One Distributor
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	10.00%
Sales Revenue, Net
Principal Business Activity and Summary of Significant Accounting Policies [Line Items]
Concentration Risk, Percentage	10.00%	10.00%

STOCKHOLDERS' EQUITY - Stock op

STOCKHOLDERS' EQUITY - Stock option activity (Details) - $ / shares	Mar. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Shares
Outstanding		4,218,189
Granted		1,446,325
Forfeited		(2,967)
Expired		(204,405)
Exercised		(38,277)
Outstanding	5,418,865	5,418,865	4,218,189
Weighted Average Exercise Price per Share
Outstanding		$ 6.16
Granted		6.03
Forfeited		5.52
Expired		5.76
Exercised		3.62
Outstanding	$ 6.16	$ 6.16	$ 6.16
Weighted Average Remaining Contractual Life (Years)
Outstanding			7 years
Granted		9 years 8 months 12 days
Forfeited		0 years
Expired		0 years
Exercised		0 years
Outstanding	7 years 8 months 12 days

STOCKHOLDERS' EQUITY - Intrinsi

STOCKHOLDERS' EQUITY - Intrinsic value (Details)	3 Months Ended
	Mar. 31, 2020USD ($)$ / sharesshares
Options Exercisable
Number Exercisable at March 31, 2020 | shares	3,258,410
Weighted Average Exercise Price	$ 5.90
Aggregate Intrinsic Value | $	$ 6,253,699
$2.23 - $14.50
Options Outstanding
Range of Exercise Price, Lower Range Limit	$ 2.23
Range of Exercise Price, Upper Range Limit	$ 14.50
Number Outstanding at March 31,2020 | shares	5,418,865
Weighted Average Exercise Price	$ 6.16
Weighted Average Remaining Life (Years)	772 years
Aggregate Intrinsic Value | $	$ 8,977,748

STOCKHOLDERS' EQUITY - Non-vest

STOCKHOLDERS' EQUITY - Non-vested options (Details)	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Shares
Non-vested, December 31, 2019 | shares	1,183,790
Granted | shares	1,446,325
Forfeited | shares	(3,025)
Vested | shares	(466,635)
Non-vested, March 31, 2020 | shares	2,160,455
Weighted Average Grant Date Fair Value
Non-vested, January 1, 2019 | $ / shares	$ 4.49
Granted | $ / shares	3.69
Forfeited | $ / shares	3.35
Vested | $ / shares	4.14
Non-vested, December 31, 2019 | $ / shares	$ 4.03

STOCKHOLDERS' EQUITY - Restrict

STOCKHOLDERS' EQUITY - Restricted stock unit (Details) - Restricted stock	3 Months Ended
	Mar. 31, 2020USD ($)shares
Restricted Stock Units, Beginning Balance	2,086,750
Restricted Stock Units, Intrinsic Value Beginning Balance | $	$ 8,033,988
Restricted Stock Units, Granted	158,700
Restricted Stock Units, Forfeited	(3,500)
Restricted Stock Units, Ending Balance	2,241,950
Restricted Stock Units, Intrinsic Value Ending Balance | $	$ 17,330,274
Board of Directors
Restricted Stock Units, Beginning Balance	277,200
Restricted Stock Units, Granted	0
Restricted Stock Units, Forfeited	0
Restricted Stock Units, Ending Balance	277,200
Executive Management
Restricted Stock Units, Beginning Balance	604,500
Restricted Stock Units, Granted	0
Restricted Stock Units, Forfeited	0
Restricted Stock Units, Ending Balance	604,500
Other Employees
Restricted Stock Units, Beginning Balance	1,205,050
Restricted Stock Units, Granted	158,700
Restricted Stock Units, Forfeited	(3,500)
Restricted Stock Units, Ending Balance	1,360,250

STOCKHOLDERS' EQUITY - Restri_2

STOCKHOLDERS' EQUITY - Restricted stock unit activity (Details) - Restricted stock	3 Months Ended
	Mar. 31, 2020$ / sharesshares
Shares
Non-vested, January 1, 2020 | shares	167,872
Granted | shares	168,100
Vested | shares	(105,968)
Non-vested, March 31, 2020 | shares	230,004
Weighted Average Grant Date Fair Value
Non-vested, January 1, 2019 | $ / shares	$ 7.52
Granted | $ / shares	6.03
Vested | $ / shares	6.90
Non-vested, December 31, 2019 | $ / shares	$ 6.71

STOCKHOLDERS' EQUITY - Addition

STOCKHOLDERS' EQUITY - Additional information (Details) - USD ($)	Apr. 20, 2020	Apr. 01, 2020	Feb. 28, 2020	Jul. 09, 2019	May 31, 2019	Jul. 22, 2019	Mar. 04, 2019	Feb. 28, 2018	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019	Jun. 30, 2019	Jul. 26, 2018
Stockholders Equity [Line Items]
Number of preferred stock authorized									5,000,000		5,000,000
Number of common stock authorized									100,000,000		100,000,000	100,000,000
Number of common stock issued									36,130,355			50,000,000
Number of shares issued									3,627,760
Aggregate registered amount for offerings													$ 150,000,000
Average selling price									$ 5.80
Net proceeds from issuance of stock									$ 20,422,000
Allocated Share-based Compensation Expense									$ 729,000	$ 228,000
Exercise price per share									$ 7.73
Expected life of the stock option									10 years
expected dividends									0.00%
Risk free interest rate, minimum									0.45%
Risk free rate maximum									0.94%
Total unrecognized compensation cost related to stock options									$ 3,300,000
Amortized period									35 months
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested, Number of Shares									466,635
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures									$ 328,939	425,639
Class of Warrant or Right, Outstanding									30,000		0
Class of Warrant or Right, Exercise Price of Warrants or Rights									$ 9.90
Restricted stock
Stockholders Equity [Line Items]
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures									$ 366,000
February 28, 2018 Performance-Based Award [Member] | Restricted stock
Stockholders Equity [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross								146,200
Stock Issued During Period, Value, Restricted Stock Award, Gross								$ 1,148,000
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures									0	107,000
March 4, 2019 Performance-Based Award [Member] | Restricted stock
Stockholders Equity [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross							22,220
Stock Issued During Period, Value, Restricted Stock Award, Gross							$ 179,000
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures									9,000	5,000
July 22, 2019 Performance-Based Award [Member] | Restricted stock
Stockholders Equity [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross						180,300
Stock Issued During Period, Value, Restricted Stock Award, Gross						$ 1,300,000
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures									$ 103,000	0
February 28 2020 Performance Based Award [Member] | Restricted stock
Stockholders Equity [Line Items]
Stock Issued During Period, Shares, Restricted Stock Award, Gross			168,100
Stock Issued During Period, Value, Restricted Stock Award, Gross			$ 1,014,000
Stock Issued During Period, Value, Restricted Stock Award, Net of Forfeitures										$ 0
Cantor Fitzgerald and Co. [Member]
Stockholders Equity [Line Items]
Number of shares issued					2,094,140
Average selling price					$ 8.72
Net proceeds from issuance of stock					$ 17,718,000
Jefferies LLC and B. Riley FBR, Inc [Member]
Stockholders Equity [Line Items]
Number of shares issued									3,421,237		191,244
aggregate offering price				$ 25,000,000
Average selling price									$ 5.89		$ 4.11
Net proceeds from issuance of stock									$ 19,542,000		$ 762,000
Equity proceeds in transit									$ 1,798,000
Commission rate (as a percent)				3.00%
Series A Preferred Stock [Member]
Stockholders Equity [Line Items]
Number of preferred stock authorized												5,000,000
Exercise Price Ranging From 5.68 To 6.57 [Member]
Stockholders Equity [Line Items]
Expected volatility									69.80%
Exercise Price Ranging From 5.68 To 6.57 [Member] | Maximum
Stockholders Equity [Line Items]
Exercise price per share									$ 6.57
Exercise Price Ranging From 5.68 To 6.57 [Member] | Minimum
Stockholders Equity [Line Items]
Exercise price per share									$ 5.68
Subsequent event | Jefferies LLC and B. Riley FBR, Inc [Member]
Stockholders Equity [Line Items]
Number of shares issued		15,279
aggregate offering price	$ 25,000,000	$ 25,000,000
Average selling price		$ 8.02
Net proceeds from issuance of stock		$ 119,000

REVENUE - Revenue by customer t

REVENUE - Revenue by customer type and geographic area (Details) - USD ($)	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Product sales:
Total revenue	$ 8,707,310	$ 5,191,629
Product
Product sales:
Total revenue	8,155,969	4,576,579
Grant
Product sales:
Total revenue	551,341	615,050
United States | Product
Product sales:
Total revenue		66,800
United States | Grant
Product sales:
Total revenue	551,341	615,050
Germany | Product
Product sales:
Total revenue	4,913,588	3,098,176
All Other Countries | Product
Product sales:
Total revenue	3,242,381	1,411,603
Direct
Product sales:
Total revenue	6,409,394	3,981,205
Direct | Product
Product sales:
Total revenue	6,409,394	3,981,205
Direct | United States | Product
Product sales:
Total revenue	0	66,800
Direct | United States | Grant
Product sales:
Total revenue	0	0
Direct | Germany | Product
Product sales:
Total revenue	4,913,588	3,098,176
Direct | All Other Countries | Product
Product sales:
Total revenue	1,495,806	816,229
Distributors/Strategic Partners
Product sales:
Total revenue	1,746,575	595,374
Distributors/Strategic Partners | Product
Product sales:
Total revenue	1,746,575	595,374
Distributors/Strategic Partners | United States | Product
Product sales:
Total revenue	0	0
Distributors/Strategic Partners | United States | Grant
Product sales:
Total revenue	0	0
Distributors/Strategic Partners | Germany | Product
Product sales:
Total revenue	0	0
Distributors/Strategic Partners | All Other Countries | Product
Product sales:
Total revenue	1,746,575	595,374
United States Government Agencies
Product sales:
Total revenue	551,341	615,050
United States Government Agencies | Product
Product sales:
Total revenue	0	0
United States Government Agencies | United States | Product
Product sales:
Total revenue	0	0
United States Government Agencies | United States | Grant
Product sales:
Total revenue	551,341	615,050
United States Government Agencies | Germany | Product
Product sales:
Total revenue	0	0
United States Government Agencies | All Other Countries | Product
Product sales:
Total revenue	$ 0	$ 0

REVENUE - Receivables and contr

REVENUE - Receivables and contract liabilities (Details) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
REVENUE
Receivables, which are included in grants and accounts receivable	$ 2,040,455	$ 2,246,821
Contract liabilities	$ 151,772	$ 171,842

REVENUE - Additional informatio

REVENUE - Additional information (Details)	3 Months Ended
	Mar. 31, 2020USD ($)segment	Dec. 31, 2019USD ($)
Number of primary revenue streams | segment	2
Deferred revenue included in contract liabilities | $	$ 32,300	$ 0
Maximum
Term Of Customer Contracts	5 years
Minimum
Term Of Customer Contracts	1 year

LONG-TERM DEBT, NET - Letter su

LONG-TERM DEBT, NET - Letter success fee (Details) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
LONG-TERM DEBT, NET
Principal amount	$ 15,000,000
Less unamortized debt acquisition costs	(68,194)
Plus accrued final fee	156,250
Subtotal	15,088,056
Less Current maturities	(4,166,667)	$ (1,666,666)
Long-term debt net of current maturities	$ 10,921,389	$ 13,385,522

LONG-TERM DEBT, NET - Principal

LONG-TERM DEBT, NET - Principal payments (Details)	Mar. 31, 2020USD ($)
LONG-TERM DEBT, NET
2021	$ 4,166,667
2022	10,000,000
2023	833,333
Total	$ 15,000,000

LONG-TERM DEBT, NET - Additiona

LONG-TERM DEBT, NET - Additional information (Details) - USD ($)	Jul. 31, 2019	Mar. 31, 2020	Mar. 31, 2019	Sep. 30, 2019	Mar. 29, 2018	Jun. 30, 2016
Debt Issuance Costs, Net		$ 68,194
Non-refundable fee percent		2.50%
Share Price		$ 5.80
Long-term Debt		$ 15,088,056
Term A Loan
Debt Instrument, Interest Rate, Effective Percentage					9.10%
Non refundable Closing Fee
Interest Expense, Debt		8,524	$ 8,129
Non refundable Final Fee
Interest Expense, Debt		$ 27,344	15,625
Western Alliance Bank
Debt Instrument, Face Amount					$ 15,000,000	$ 10,000,000
Term Loan Interest LIBRO Rate Adjusted Monthly		3.66%
Debt Instrument, Interest Rate, Stated Percentage		6.91%
Debt Issuance Costs, Net		$ 90,925
Western Alliance Bank | First Anniversary
Debt Instrument, Periodic Payment			$ 833,333
Percentage Of Prepayment Interest		2.00%
Western Alliance Bank | Second Anniversary
Percentage Of Prepayment Interest		1.50%
Western Alliance Bank | Third Anniversary
Percentage Of Prepayment Interest		1.00%
Western Alliance Bank | Closing Fee
Debt Issuance Costs, Net		$ 25,000
Western Alliance Bank | Bank Related Expenses
Debt Issuance Costs, Net		11,000
Western Alliance Bank | Legal Expenses
Debt Issuance Costs, Net		$ 20,050
Long-term Debt				$ 85,938
Western Alliance Bank | Term A Loan
Debt Instrument, Face Amount					10,000,000	$ 5,000,000
Western Alliance Bank | Term B Loan
Debt Instrument, Face Amount					$ 5,000,000
Repayments of Debt	$ 5,000,000
Long-term Debt	$ 15,000,000
Western Alliance Bank | 2018 Success Fee Letter
Percentage Of Success Fee		6.37%
Share Price		$ 7.05
Number of days for stock price threshold set in success fee letter		5 days
Western Alliance Bank | 2018 Success Fee Letter | Minimum
Percentage of Closing Price on Common Stock		26.13%
Western Alliance Bank | 2018 Success Fee Letter | Maximum
Percentage of Closing Price on Common Stock		70.00%
Western Alliance Bank - First Amendment | Legal Expenses
Debt Issuance Costs, Net		$ 4,212

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details) - USD ($)	Aug. 11, 2003	Mar. 31, 2020	Mar. 31, 2019
Commitments and Contingencies Disclosure [Line Items]
Initial term (in years)		3 years
Term of License Agreement		18 years
Royalty Agreements [Member]
Commitments and Contingencies Disclosure [Line Items]
Future royalty payment percentage on gross revenue	3.00%
Royalty cost		$ 242,000	$ 134,000
Equity investment by an existing investor	$ 4,000,000
License Agreement [Member]
Commitments and Contingencies Disclosure [Line Items]
Royalty rate, lower limit		2.50%
Royalty rate, upper limit		5.00%
Royalty cost		$ 404,000	$ 224,000

LEASES - ROU and Lease liabilit

LEASES - ROU and Lease liability (Details) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
LEASES
Right of use asset	$ 970,182	$ 1,070,762
Total lease liability	970,182	1,070,762
Less current portion	(442,865)	(428,083)
Lease liability, net of current portion	$ 527,317	$ 642,679

LEASES - Maturities of Lease li

LEASES - Maturities of Lease liabilities (Details)	Mar. 31, 2020USD ($)
LEASES
2021	$ 442,865
2022	136,098
2023	75,308
2024	82,503
2025	90,385
Thereafter	143,023
Total	$ 970,182

LEASES - Additional Information

LEASES - Additional Information (Details)	3 Months Ended
	Mar. 31, 2020USD ($)	Mar. 31, 2019USD ($)	Dec. 31, 2019	Feb. 01, 2019ft²	Dec. 31, 2018
Lessee, Operating Lease, Discount Rate					9.16%
Operating Lease, Payments	$ 234,000	$ 215,000
Operating Lease, Weighted Average Remaining Lease Term	3 years 11 months 16 days		4 years 4 days
United States
Area of Land | ft²				19,920
Operating Leases, Rent Expense, Net	$ 32,000
Additional Operating Leases Rent Expense Net	29,000
Germany
Operating Leases, Rent Expense, Net	8,800
Additional Operating Leases Rent Expense Net	$ 2,900

NET LOSS PER SHARE (Details)

NET LOSS PER SHARE (Details) - shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Stock Options and Warrants
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	7,891,000	5,716,000

SUBSEQUENT EVENTS (Details)

SUBSEQUENT EVENTS (Details) - USD ($)	Apr. 20, 2020	Apr. 13, 2020	Apr. 01, 2020	Jul. 09, 2019	Mar. 31, 2020	Dec. 31, 2019
SUBSEQUENT EVENTS [Line Items]
Number of shares issued					3,627,760
Average selling price					$ 5.80
Net proceeds from issuance of stock					$ 20,422,000
Subsequent event
SUBSEQUENT EVENTS [Line Items]
Loan Proceeds From Payroll Protection Program		$ 1,411,000
Jefferies LLC and B. Riley FBR, Inc [Member]
SUBSEQUENT EVENTS [Line Items]
Number of shares issued					3,421,237	191,244
Average selling price					$ 5.89	$ 4.11
Net proceeds from issuance of stock					$ 19,542,000	$ 762,000
Additional aggregate offering price				$ 25,000,000
Jefferies LLC and B. Riley FBR, Inc [Member] | Subsequent event
SUBSEQUENT EVENTS [Line Items]
Number of shares issued			15,279
Average selling price			$ 8.02
Net proceeds from issuance of stock			$ 119,000
Additional aggregate offering price	$ 25,000,000		$ 25,000,000