MiMedx (MDXG) 10-Q 4 Aug 20 2020 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2020	Jul. 28, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2020
Document Transition Report	false
Entity File Number	001-35887
Entity Registrant Name	MIMEDX GROUP, INC.
Entity Incorporation, State or Country Code	FL
Entity Tax Identification Number	26-2792552
Entity Address, Address Line One	1775 West Oak Commons Ct NE
Entity Address, City or Town	Marietta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30062
City Area Code	770
Local Phone Number	651-9100
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		110,291,863
Entity Central Index Key	0001376339
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 48,189	$ 69,069
Accounts receivable, net	30,097	32,327
Inventory, net	10,565	9,104
Prepaid expenses	2,850	6,669
Income tax receivable	10,700	18
Other current assets	5,191	6,058
Total current assets	107,592	123,245
Property and equipment, net	10,820	12,328
Right of use asset	2,911	3,397
Goodwill	19,976	19,976
Intangible assets, net	7,386	7,777
Other assets	2,227	443
Total assets	150,912	167,166
Current liabilities:
Accounts payable	11,946	8,710
Accrued compensation	20,784	21,302
Accrued expenses	25,768	32,161
Current portion of long term debt	3,750	3,750
Other current liabilities	1,415	1,399
Total current liabilities	63,663	67,322
Long term debt, net	61,472	61,906
Other liabilities	2,917	3,540
Total liabilities	128,052	132,768
Commitments and contingencies (Note 13)
Stockholders' equity:
Preferred stock; $.001 par value; 5,000,000 shares authorized; 0 issued and 0 outstanding at June 30, 2020 and 0 issued and 0 outstanding at December 31, 2019	0	0
Common stock; $.001 par value; 150,000,000 shares authorized; 112,703,926 issued and 110,291,404 outstanding at June 30, 2020 and 112,703,926 issued and 110,818,649 outstanding at December 31, 2019	113	113
Additional paid-in capital	151,625	147,231
Treasury stock at cost; 2,412,522 shares at June 30, 2020 and 1,885,277 shares at December 31, 2019	(13,451)	(10,806)
Accumulated deficit	(115,427)	(102,140)
Total stockholders' equity	22,860	34,398
Total liabilities and stockholders' equity	$ 150,912	$ 167,166

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Jun. 30, 2020	Dec. 31, 2019
Stockholders' equity:
Preferred stock par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	5,000,000	5,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares issued (in shares)	112,703,926	112,703,926
Common stock, shares outstanding (in shares)	110,291,404	110,818,649
Treasury stock, shares (in shares)	2,412,522	1,885,277

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Income Statement [Abstract]
Net sales	$ 53,647	$ 67,437	$ 115,383	$ 133,992
Cost of sales	8,198	9,749	18,223	17,167
Gross profit	45,449	57,688	97,160	116,825
Operating expenses:
Selling, general and administrative	37,329	50,641	84,270	101,503
Investigation, restatement and related	11,446	21,025	27,038	39,132
Research and development	2,259	2,828	4,910	5,730
Amortization of intangible assets	271	267	542	500
Impairment of intangible assets	0	0	0	446
Operating loss	(5,856)	(17,073)	(19,600)	(30,486)
Other (expense) income, net
Interest expense, net	(2,574)	(269)	(4,961)	(58)
Other (expense) income, net	(9)	174	(3)	145
Loss before income tax provision	(8,439)	(17,168)	(24,564)	(30,399)
Income tax provision (expense) benefit	(27)	(42)	11,277	(84)
Net loss	$ (8,466)	$ (17,210)	$ (13,287)	$ (30,483)
Net loss per common share - basic (in dollars per share)	$ (0.08)	$ (0.16)	$ (0.12)	$ (0.29)
Net loss per common share - diluted (in dollars per share)	$ (0.08)	$ (0.16)	$ (0.12)	$ (0.29)
Weighted average shares outstanding - basic (in shares)	108,119,461	106,942,429	108,081,625	106,885,893
Weighted average shares outstanding - diluted (in shares)	108,119,461	106,942,429	108,081,625	106,885,893

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Treasury Stock	Deficit
Balance (in shares) at Dec. 31, 2018		112,703,926		3,605,263
Balance, beginning of period at Dec. 31, 2018	$ 49,655	$ 113	$ 164,744	$ (38,642)	$ (76,560)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	6,513		6,513
Exercise of stock options (in shares)				(150,000)
Exercise of stock options	108		(1,343)	$ 1,451
Issuance of restricted stock (in shares)				(2,853,235)
Issuance of restricted stock	0		(35,740)	$ 35,740
Restricted stock cancellation/forfeited (in shares)				191,953
Restricted stock cancellation/forfeited	0		2,124	$ (2,124)
Shares repurchased for tax withholding (in shares)				361,053
Shares repurchased for tax withholding	(1,109)			$ (1,109)
Net loss	(30,483)				(30,483)
Balance (in shares) at Jun. 30, 2019		112,703,926		1,155,034
Balance, end of period at Jun. 30, 2019	24,684	$ 113	136,298	$ (4,684)	(107,043)
Balance (in shares) at Mar. 31, 2019		112,703,926		3,832,013
Balance, beginning of period at Mar. 31, 2019	38,352	$ 113	166,296	$ (38,224)	(89,833)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	3,499		3,499
Exercise of stock options (in shares)				(150,000)
Exercise of stock options	108		(1,343)	$ 1,451
Issuance of restricted stock (in shares)				(2,601,930)
Issuance of restricted stock	0		(32,715)	$ 32,715
Restricted stock cancellation/forfeited (in shares)				50,572
Restricted stock cancellation/forfeited	0		561	$ (561)
Shares repurchased for tax withholding (in shares)				24,379
Shares repurchased for tax withholding	(65)			$ (65)
Net loss	(17,210)				(17,210)
Balance (in shares) at Jun. 30, 2019		112,703,926		1,155,034
Balance, end of period at Jun. 30, 2019	24,684	$ 113	136,298	$ (4,684)	(107,043)
Balance (in shares) at Dec. 31, 2019		112,703,926		1,885,277
Balance, beginning of period at Dec. 31, 2019	34,398	$ 113	147,231	$ (10,806)	(102,140)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	3,781		3,781
Exercise of stock options (in shares)				(220,300)
Exercise of stock options	298		(1,658)	$ 1,956
Restricted stock cancellation/forfeited (in shares)				285,611
Restricted stock cancellation/forfeited	0		2,124	$ (2,124)
Shares repurchased for tax withholding (in shares)				461,934
Shares repurchased for tax withholding	(2,330)		147	$ (2,477)
Net loss	(13,287)				(13,287)
Balance (in shares) at Jun. 30, 2020		112,703,926		2,412,522
Balance, end of period at Jun. 30, 2020	22,860	$ 113	151,625	$ (13,451)	(115,427)
Balance (in shares) at Mar. 31, 2020		112,703,926		2,163,066
Balance, beginning of period at Mar. 31, 2020	30,339	$ 113	149,765	$ (12,578)	(106,961)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	1,866		1,866
Exercise of stock options (in shares)				(50,000)
Exercise of stock options	0		(444)	$ 444
Restricted stock cancellation/forfeited (in shares)				42,613
Restricted stock cancellation/forfeited	0		378	$ (378)
Shares repurchased for tax withholding (in shares)				256,843
Shares repurchased for tax withholding	(879)		60	$ (939)
Net loss	(8,466)				(8,466)
Balance (in shares) at Jun. 30, 2020		112,703,926		2,412,522
Balance, end of period at Jun. 30, 2020	$ 22,860	$ 113	$ 151,625	$ (13,451)	$ (115,427)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Cash flows from operating activities:
Net loss	$ (13,287)	$ (30,483)
Adjustments to reconcile net loss to net cash flows used in operating activities:
Share-based compensation	7,783	6,513
Depreciation	2,928	3,340
Amortization of intangible assets	542	500
Amortization of deferred financing costs	1,441	116
Bad debt expense	234	0
Non-cash lease expenses	486	492
Reserve for inventory obsolescence	(217)	500
Loss on fixed asset disposal	1	313
Impairment of intangible assets	0	1,258
Increase (decrease) in cash resulting from changes in:
Accounts receivable	1,996	0
Inventory	(1,243)	534
Prepaid expenses	3,819	4,125
Income tax receivable	(10,682)	(80)
Other current assets	821	(1,527)
Accounts payable	3,236	(4,072)
Accrued compensation	(518)	(3,814)
Accrued expenses	(12,109)	10,975
Other liabilities	(609)	(1,820)
Net cash flows used in operating activities	(15,378)	(13,130)
Cash flows from investing activities:
Purchases of equipment	(1,421)	(899)
Principal payments from note receivable	0	389
Patent application costs	(151)	(253)
Net cash flows used in investing activities	(1,572)	(763)
Cash flows from financing activities:
Proceeds from term loan	10,000	72,750
Repayment of term loan	(11,875)	0
Deferred financing cost	(23)	(6,045)
Stock repurchased for tax withholdings on vesting of restricted stock	(2,330)	(1,109)
Proceeds from exercise of stock options	298	108
Net cash flows (used in) provided by financing activities	(3,930)	65,704
Net change in cash	(20,880)	51,811
Cash and cash equivalents, beginning of period	69,069	45,118
Cash and cash equivalents, end of period	$ 48,189	$ 96,929

Nature of Business

Nature of Business	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business MiMedx Group, Inc. (together with its subsidiaries, except where the context otherwise requires, “ MiMedx ,” or the “ Company ”) is an advanced wound care and emerging therapeutic biologics company, developing and distributing human placental tissue allografts with patent-protected processes for multiple sectors of healthcare. The Company derives its products from human placental tissues processed using proprietary processing methodologies. The Company’s mission is to offer products and tissues to help the body heal itself. All of the Company’s products are regulated by the United States Food and Drug Administration (“ FDA ”). MiMedx is the leading supplier of human placental allografts, which are human tissues that are transplanted from one person (a donor) to another person (a recipient). The Company operates in one business segment, Regenerative Biomaterials, which includes the design, manufacture, and marketing of products and tissue processing services for the wound care, burn, surgical, orthopedic, spine, sports medicine, ophthalmic and dental sectors of healthcare. Its biomaterial platform technologies include AmnioFix®, EpiFix®, EpiCord®, AmnioCord® and AmnioFill® brands. AmnioFix and EpiFix are tissue allografts derived from amnion and chorion layers of human placental membrane; EpiCord and AmnioCord are tissue allografts derived from umbilical cord tissue. AmnioFill is a placental connective tissue matrix, derived from the placental disc and other placental tissue. The Company’s business model is focused primarily on the United States of America but the Company is exploring potential future international expansion opportunities. Effect of COVID-19 Pandemic On March 11, 2020, the World Health Organization designated the outbreak of a novel strain of coronavirus (“ COVID-19 ”) as a global pandemic (the “ Pandemic ” or “ COVID-19 Pandemic ”).The COVID-19 Pandemic and associated governmental and societal responses have affected the Company’s business, results of operations and financial condition. The continuation or additional waves of the outbreak of COVID-19 or the outbreak of other health epidemics could harm the Company’s operations and increase the Company’s costs and expenses in numerous ways. The ultimate impact of the COVID-19 Pandemic is highly uncertain and subject to change. The Company does not yet know the full extent of delays or impacts on the business, clinical trials, healthcare systems or the global economy as a whole, or how long such effects will endure. The effects of the COVID-19 Pandemic or other health epidemics could continue to have an adverse impact on the Company’s business, results of operations and financial condition. On March 27, 2020, the Coronavirus Aid, Relief and Economic Security Act (the “ CARES Act ”) was signed into law. The CARES Act includes provisions relating to refundable payroll tax credits, deferment of employer portion of certain payroll taxes, loans, and grants to certain businesses, net operating loss carryback periods, alternative minimum tax credit refunds, modifications to the net interest deduction limitations and technical corrections to tax depreciation methods for qualified improvement property. As a result of the CARES Act, the Company expects a federal tax refund of approximately $11.3 million and has recognized as an income tax benefit of the same amount. The income tax benefit was recognized due to the release of a previously-recorded valuation allowance.

Significant Accounting Policies

Significant Accounting Policies	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Please see Note 3 to the Company’s Consolidated Financial Statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019 and filed with the Securities and Exchange Commission (“ SEC ”) on July 6, 2020 (the “ 2019 Form 10-K ”) for a description of all significant accounting policies. Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) from interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and six months ended June 30, 2020 and 2019 , are not necessarily indicative of the results that may be expected for the fiscal year. The balance sheet as of December 31, 2019 , was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2019 Form 10-K. Use of Estimates The unaudited condensed consolidated financial statements have been prepared in accordance with GAAP. Conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited condensed consolidated financial statements and the reported unaudited condensed consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment and intangible assets, estimates for contingent liabilities, the measurement of right-of-use assets and lease liabilities, management’s assessment of the Company’s ability to continue as a going concern, estimates of fair value of share-based payments and valuation of deferred tax assets. Principles of Consolidation The unaudited condensed consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. Cash and Cash Equivalents Cash and cash equivalents include cash and Federal Deposit Insurance Corporation (“ FDIC ”) insured certificates of deposit held at various banks with an original maturity of three months or less. Accounts Receivable Accounts receivable represent amounts due from customers for which revenue has been recognized. Generally, the Company does not require collateral or any other security to support its receivables. The allowance for doubtful accounts is the Company’s best estimate of the amount of probable credit losses in the Company’s existing receivables. The Company determines the allowance based on factors such as historical collection experience, customers’ current creditworthiness, customer concentrations, age of accounts receivable and general economic conditions that may affect customers’ ability to pay. The Company’s allowance for doubtful accounts was $0.2 million and $0 as of June 30, 2020 and December 31, 2019 , respectively. Notes Receivable Notes receivable represent formal payment agreements with customers which generally arise in situations where amounts shipped and billed have aged significantly as well as the promissory note issued by Stability Biologics, LLC (“ Stability ’’) as part of the divestiture of Stability in 2017. The promissory note from Stability was paid in full in the three months ended September 30, 2019. The Company’s notes receivable are included in other current and long-term assets in the unaudited condensed consolidated balance sheets and were valued taking into consideration cost of the market participant inputs, market conditions, liquidity, operating results and other qualitative factors. Inventories Inventories are valued at the lower of cost or net realizable value, using the first-in, first-out (“ FIFO ”) method. Inventory is tracked through raw material, work-in-process, and finished good stages as the product progresses through various production steps and stocking locations. Labor and overhead costs are absorbed through the various production processes until the work order closes. Historical yields and normal capacities are utilized in the calculation of production overhead rates. Reserves for inventory obsolescence are utilized to account for slow-moving inventory as well as inventory no longer needed due to diminished market demand. Revenue Recognition The Company sells its products primarily to individual customers and independent distributors (collectively referred to as “ customers ”). During the six months ended June 30, 2019, the Company’s control environment was such that it created uncertainty surrounding all of its customer arrangements, which required consideration related to the proper revenue recognition under the applicable literature. The control environment allowed for the existence of extra-contractual or undocumented terms or arrangements initiated by or agreed to by the Company and former members of Company management at the outset of the transactions (side agreements). Concessions were also agreed to subsequent to the initial sale (e.g. sales above established customer credit limits extended and unusually long payment terms, return or exchange rights, and contingent payment obligations) that called into question the ability to recognize revenue at the time that product was shipped to a customer. As a result, the Company’s application of the applicable revenue recognition guidance varies for the three and six months ended June 30, 2020 as compared to the three and six months ended June 30, 2019 . Additionally, the Company changed its pattern of revenue recognition effective October 1, 2019. The application of the relevant revenue recognition guidance and the pattern of revenue recognition are further discussed below for each period presented. Three and Six Months Ended June 30, 2019 The Company follows Accounting Standards Codification (“ ASC ”) Topic 606, Revenue from Contracts with Customers (“ ASC 606” ) which establishes principles for reporting information about the nature, amount, timing and uncertainty of revenue and cash flows arising from the entity’s contracts to provide goods or services to customers. The core principle requires an entity to recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration that it expects to be entitled to receive in exchange for those goods or services recognized as performance obligations are satisfied. The Company’s inability to fulfill these criteria (the “ Step 1 Criteria ”) was due to uncertainties of contractual adjustments with customers created by a combination of an inappropriate tone at the top and extra-contractual arrangements. Consequently, the Company concluded that it did not meet the Step 1 Criteria upon shipment of the product. Subsequent to the shipment of product, uncertainties surrounding contractual adjustment were not resolved until either: (1) the customer returned the product prior to payment; or (2) the Company received payment from the customer. At that point, the Company determined that an accounting contract existed and the performance obligations of the Company to deliver product and the customer to pay for the product were satisfied. The Company determined the transaction price of its contracts to equal the amount of consideration received from customers less the amount expected to be refunded or credited to customers, which is recognized as a refund liability that is updated at the end of each reporting period for changes in circumstances. The refund liability is included within accrued expenses in the unaudited condensed consolidated balance sheet. Transition and the Six Months Ended June 30, 2020 Beginning October 1, 2019, for all new customer arrangements, the Company determined adequate measures were in place to understand the terms of its contracts with customers. As such, beginning October 1, 2019, the Company concluded that the criteria under ASC 606 would be met prior to shipment of product to the customer or implantation of the products on consignment. For all customer transactions concluded to meet the Step 1 Criteria, the Company then assessed the remaining criteria of ASC 606 to determine the proper timing of revenue recognition. For the remaining customer arrangements at September 30, 2019 (the “ Remaining Contracts ”), the Company concluded that due to the uncertainty that extracontractual arrangement may continue the Step 1 Criteria would not be satisfied until the Company receives payment from the customer. At that point, the Company determined that an accounting contract would exist and the performance obligations of the company to deliver product and the customer to pay for the product would be satisfied. As of June 30, 2020, upon reassessment, the Company concluded that the Step 1 Criteria continued not to be met with respect to the Remaining Contracts due to the same circumstances described above. The amount of sales related to these Remaining Contracts which have not been recognized as of June 30, 2020 was $2.8 million . This amount is not recognized on the unaudited condensed consolidated balance sheet as of June 30, 2020. In addition, the Company continued to defer the cost of sales for the Remaining Contracts for which revenue recognition criteria have not been met. These amounts were recorded within other current assets on the condensed consolidated balance sheet in the amount of $0.4 million and $1.3 million as of June 30, 2020 and December 31, 2019, respectively. A rollforward of this activity from December 31, 2019 to June 30, 2020, along with the deferred cost of sales associated with such unrecognized sales, is presented in the following table (amounts in thousands): Amounts Invoiced and Not Collected Deferred Cost of Sales Amounts as of December 31, 2019 $ 9,006 $ 1,261 Revenue recognized related to amounts invoiced and not collected at September 30, 2019: Cash collected during the six months ended June 30, 2020 related to the Remaining Contracts (6,201 ) (868 ) Amounts as of June 30, 2020 $ 2,805 $ 393 Under ASC 606, the Company recognizes revenue following the five-step model: (i) identify the contracts with a customer (the Step 1 Criteria); (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. As noted above, during the third quarter of 2019, the Company determined that they had met the Step 1 Criteria. The Company also determined that the performance obligation was met upon delivery of the product to the customer, or at the time the product is implanted for products on consignment, at which point the Company determined it will collect the consideration it is entitled to in exchange for the product transferred to the customer. As a result, the Company recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) the performance obligation is satisfied, generally upon shipment of the product to the customer. The nature of the Company’s contracts gives rise to certain types of variable consideration, including rebates and other discounts. The Company includes estimated amounts of variable consideration in the transaction price to the extent that it is probable there will not be a significant reversal of revenue. Estimates are based on historical or anticipated performance. The Company does have consignment agreements with several customers and distributors which allow the Company to better market its products by moving them closer to the end user. In these cases, the Company determined that it has fulfilled its performance obligation once control of the product has been delivered to the customer, which occurs simultaneously with the product being implanted. The Company acts as the principal in all of its customer arrangements and therefore records revenue on a gross basis. Shipping is considered immaterial in the context of the overall customer arrangement, and damages or loss of goods in transit are rare. Therefore, shipping is not deemed a separately recognized performance obligation. The Company maintains a returns policy that allows its customers to return product that is consigned, damaged or non-conforming, ordered in error, or due to a recall. The estimate of the provision for returns is based upon historical experience with actual returns. The Company’s payment terms for customers are typically 30 to 60 days from receipt of title of the goods. GPO Fees The Company sells to Group Purchasing Organization (“ GPO ”) members who transact directly with the Company at GPO-agreed pricing. GPOs are funded by administrative fees that are paid by the Company. These fees are set as a percentage of the purchase volume, which is typically 3% of sales made to the GPO members. The Company presents the administrative fees paid to GPOs as a reduction of revenues because the benefit received by the Company in exchange for the GPO fees is not sufficiently separable from the GPO member’s purchase of the Company’s products. Cost of Sales Cost of sales includes all costs directly related to bringing the Company’s products to their final selling destination. Amounts include direct and indirect costs to manufacture products including raw materials, personnel costs and direct overhead expenses necessary to convert collected tissues into finished goods, product testing costs, quality assurance costs, facility costs associated with the Company’s manufacturing and warehouse facilities, depreciation, freight charges, costs to operate equipment and other shipping and handling costs for products shipped to customers. Leases The Company determines if an arrangement is, or contains, a lease at inception. Right-of-use assets and the related liabilities result from operating leases which were included in Right of use asset, Other current liabilities and Other liabilities, respectively. Operating lease assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Operating lease assets and liabilities are recognized at the lease commencement date based on the estimated present value of lease payments over the lease term. The lease term used in the calculation includes options to extend or terminate the lease when the exercise of such options are reasonably certain. The Company uses its estimated incremental borrowing rate in determining the present value of lease payments. Variable components of the lease payments such as fair market value adjustments, utilities, and maintenance costs are expensed as incurred and not included in determining the present value of lease liabilities. As an accounting policy election, the Company excludes short-term leases having initial terms of 12 months or fewer. Lease expense is recognized on a straight-line basis over the lease term. See Note 6, “ Leases ” for further information regarding lease obligations. Patent Costs The Company incurs certain legal and related costs in connection with patent applications for tissue-based products and processes. The Company capitalizes such costs to be amortized over the expected life of the patent to the extent that an economic benefit is anticipated from the resulting patent or alternative future use is available to the Company and are included in Intangible Assets in the Condensed Consolidated Balance Sheets. The Company capitalized approximately $0.2 million and $0.3 million of patent costs during the first six months of 2020 and 2019 , respectively . Treasury Stock The Company accounts for the purchase of treasury stock under the cost method. Treasury stock which is reissued for the exercise of option grants and the issuance of restricted stock grants is accounted for on a FIFO basis. Recently Issued and Adopted Accounting Standards In June 2016, the FASB issued Accounting Standards Updated (“ ASU ”) 2016-13, “ Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments ,” that introduces a new model for recognizing credit losses on financial instruments based on an estimate of current expected credit losses. This includes accounts receivable, trade receivables, loans, held-to-maturity debt securities, net investments in leases and certain off-balance sheet credit exposures. The guidance also modifies the impairment model for available-for-sale debt securities. The ASU is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2019. The Company adopted this ASU on January 1, 2020 using a modified retrospective transition method which requires a cumulative-effect adjustment to the opening balance of retained earnings to be recognized on the date of adoption with no change to financial results reported in prior periods. The cumulative effect adjustment recorded on January 1, 2020 is not material. The adoption of this ASU did not have a significant impact on the Company’s consolidated financial statements and related disclosures. All other ASUs issued and not yet effective for the six months ended June 30, 2020 , and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s financial position or results of operations.

Liquidity and Capital Resources

Liquidity and Capital Resources Liquidity and Capital Resources	6 Months Ended
	Jun. 30, 2020
Liquidity and Capital Resources [Abstract]
Liquidity and Capital Resources	Liquidity and Capital Resources Working Capital As of June 30, 2020 , the Company had $48.2 million of cash and cash equivalents. The Company reported total current assets of $107.6 million and current liabilities of $63.7 million as of June 30, 2020 , yielding working capital of $43.9 million as of June 30, 2020 . Overall Liquidity and Capital Resources The Company’s largest cash requirement for the six months ended June 30, 2020 was cash for general working capital needs. In addition, the Company’s other cash requirements included capital expenditures and investigation and restatement expenses. The Company funded its cash requirements through its existing cash reserves, and the BT Term Loan (as defined below) that closed in June 2019. The Company believes that its anticipated cash from operating and financing activities and existing cash and cash equivalents will enable the Company to meet its operational liquidity needs and fund its planned investing activities for the next 12 months from the date of the issuance of these condensed consolidated financial statements. Issuance of $100 Million of Series B Convertible Preferred Stock On July 2 , 2020, the Company issued $100 million of the Company’s Series B Convertible Preferred Stock, par value $0.001 per share (the “ Series B Preferred Stock ”) to an affiliate of EW Healthcare Partners and to certain funds managed by Hayfin Capital Management LLP pursuant to a Securities Purchase Agreement with Falcon Fund 2 Holding Company, L.P., an affiliate of EW Healthcare Partners, and certain funds managed by Hayfin Capital Management LLP , dated as of June 30 , 2020 (the “ Securities Purchase Agreement ”), for an aggregate purchase price of $100 million (the “ Preferred Stock Transaction ”). The Series B Preferred Stock pays a 4.0% cumulative dividend per annum (the “ Discounted Dividend Rate ”) prior to the quarterly dividend payment ending on June 30, 2021, and a 6.0% cumulative dividend per annum (the “ Perpetual Dividend Rate ”) thereafter. $75 million Loan Facility with Hayfin On July 2, 2020, the Company executed a Loan Agreement with, among others, Hayfin Services LLP, an affiliate of Hayfin Capital Management LLP (the “ Hayfin Loan Agreement ”), which funded on July 2, 2020 (the “Hayfin Loan Transaction”) and provided the Company with a senior secured term loan in an aggregate amount of $50 million (the “ Hayfin Term Loan ”) and an additional $25 million delayed draw term loan (the “ DD TL ”) in the form of a committed but undrawn facility that is available for drawdown until June 30, 2021. The Hayfin Term Loan and the DD TL mature on July 2, 2025 (the “Maturity Date”). The Hayfin Term Loan and the DD TL have no fixed amortization (i.e., they are interest only through the Maturity Date). Borrowings under the Hayfin Loan Agreement bear interest at a rate equal to LIBOR (subject to a floor of 1.5% ) plus a margin of 6.75% . The margin will be eligible to step down to 6.5% or 6.0% based on future Total Net Leverage levels, as defined in the Hayfin Loan Agreement. The Company paid an upfront commitment fee of 2% of the aggregate of the Hayfin Term Loan and the DD TL. The DD TL is subject to an additional commitment fee of 1% of the amount undrawn. The Hayfin Loan Agreement also contains certain affirmative covenants that impose certain reporting and/or performance obligations on the Company and its subsidiaries, including (i) Maximum Total Net Leverage of 5.0 x through December 31, 2020, stepping down to 4.5 x through June 30, 2021, and to 4.0 x thereafter until the Maturity Date; (ii) Cap on Cash Netting for the purposes of calculating Total Net Leverage set at $10,000,000 ; (iii) a limit of 3.5 x Total Net Leverage, tested prior to any draw downs under the DD TL; and (iv) Minimum Liquidity of $10,000,000 , tested monthly (with each of Maximum Total Net Leverage, Cap on Cash Netting and Minimum Liquidity defined in the Hayfin Loan Agreement). Repayment and Termination of BT Loan Agreement On July 2, 2020, the Company repaid the remaining $72.0 million of principal and accrued interest and fees of $0.1 million under the loan agreement, dated as of June 10, 2019, by and among the Company, the subsidiaries of the Company as guarantors party thereto from time to time, the lenders party thereto from time to time, and Blue Torch Finance LLC (“ Blue Torch ”), as administrative agent and collateral agent, as amended by that certain First Amendment thereto, dated as of April 22, 2020 (the “ BT Loan Agreement ”), and terminated the BT Loan Agreement. As a result of the early termination of the BT Loan Agreement, the Company also incurred a prepayment premium of $1.4 million , which it paid with a portion of the proceeds from the Preferred Stock Transaction and the Hayfin Loan Transaction, as described above. For more information regarding the Preferred Stock Transaction, the Hayfin Loan Transaction, and the repayment of the BT Term Loan refer to Item 9B of the 2019 Form 10-K.

Inventory

Inventory	6 Months Ended
	Jun. 30, 2020
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following (in thousands): June 30, 2020 December 31, 2019 Raw materials $ 417 $ 318 Work in process 3,716 4,299 Finished goods 6,934 5,206 Inventory, gross 11,067 9,823 Reserve for obsolescence (502 ) (719 ) Inventory, net $ 10,565 $ 9,104

Property and Equipment

Property and Equipment	6 Months Ended
	Jun. 30, 2020
Property, Plant and Equipment [Abstract]
Property and Equipment	Property and Equipment Property and equipment consisted of the following (in thousands): June 30, 2020 December 31, 2019 Leasehold improvements $ 5,689 $ 5,321 Laboratory and clean room equipment 15,379 14,894 Furniture and equipment 15,335 15,118 Construction in progress 1,150 972 Property and equipment, gross 37,553 36,305 Less accumulated depreciation (26,733 ) (23,977 ) Property and equipment, net $ 10,820 $ 12,328 Depreciation expense for the six months ended June 30, 2020 and 2019 , was $2.9 million and $3.3 million , respectively, and $1.4 million and $1.6 million for the three months ended June 30, 2020 and 2019 , respectively. These costs are allocated among cost of sales, research and development and selling, general and administrative expenses.

Leases (Notes)

Leases (Notes)	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Leases	Leases The Company has operating leases primarily for corporate offices, vehicles, and certain equipment. Such leases do not require any contingent rental payments, impose any financial restrictions, or contain any residual value guarantees. The Company determines if an arrangement is or contains a lease at inception. The Company does not have any leases classified as financing leases. Operating lease cost for the three and six months ended June 30, 2020 and 2019 was $0.3 million and $0.7 million , and $0.4 million and $0.8 million , respectively, and was recorded in Selling, general, and administrative expenses. Interest on lease obligations for the three and six months ended June 30, 2020 and 2019 was $0.1 million and $0.2 million , and $0.1 million and $0.3 million , respectively. Cash paid for amounts included in the measurement of operating lease liabilities for the three and six months ended June 30, 2020 and 2019 was $0.4 million and $0.8 million , and $0.4 million and $0.9 million , respectively. The amortization of leased assets for the three and six months ended June 30, 2020 and 2019 was $0.2 million and $0.5 million , respectively. Supplemental balance sheet information related to operating leases is as follows (amounts in thousands, except lease term and discount rate): June 30, 2020 December 31, 2019 Assets Right of use asset $ 2,911 $ 3,397 Liabilities Short term lease liability $ 1,220 $ 1,168 Long term lease liability 2,295 2,919 Weighted-average remaining lease term (years) 2.6 3.1 Weighted-average discount rate 11.5 % 11.5 % Maturities of operating leases liabilities are as follows (amounts in thousands): Year ending December 31, Maturities 2020 (excluding the six months ended June 30, 2020) $ 776 2021 1,528 2022 1,552 2023 196 2024 — Thereafter — Total lease payments 4,052 Less: imputed interest (537 ) Total lease liability $ 3,515

Intangible Assets

Intangible Assets	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets	Intangible Assets Intangible assets are summarized as follows (in thousands): June 30, 2020 December 31, 2019 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Licenses $ 1,414 $ (1,267 ) $ 147 $ 1,414 $ (1,200 ) $ 214 Patents and know how 9,226 (5,395 ) 3,831 9,099 (5,070 ) 4,029 Customer and supplier relationships 3,761 (2,552 ) 1,209 3,761 (2,417 ) 1,344 Non-compete agreements 120 (83 ) 37 120 (68 ) 52 Total amortized intangible assets $ 14,521 $ (9,297 ) $ 5,224 $ 14,394 $ (8,755 ) $ 5,639 Unamortized intangible assets Trade names and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in process 1,154 1,154 1,130 1,130 Total intangible assets $ 16,683 $ 7,386 $ 16,532 $ 7,777 Amortization expense for the three and six months ended June 30, 2020 and 2019 , was $0.3 million and $0.5 million , respectively. Patents and patents in process related write-downs due to abandonment for the three and six months ended June 30, 2019 was $0.0 million and $0.8 million , respectively. These write-down were recorded as a component of Selling, general and administrative expense. The Company incurred impairment losses related to customer relationships which were determined to be unrecoverable of $0.0 million and $0.5 million for the three and six months ended June 30, 2019, respectively. There were no impairments or write-downs due to abandonments during the three or six months ended June 30, 2020 . Expected future amortization of intangible assets as of June 30, 2020 , is as follows (in thousands): Year ending December 31, Estimated Amortization Expense 2020 (excluding the six months ended June 30, 2020) $ 544 2021 1,023 2022 921 2023 921 2024 921 Thereafter 894 $ 5,224

Accrued Expenses (Notes)

Accrued Expenses (Notes)	6 Months Ended
	Jun. 30, 2020
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): June 30, 2020 December 31, 2019 Legal costs $ 15,067 $ 12,202 Settlement costs 5,784 5,931 Pricing adjustment settlement with Veterans Affairs — 6,894 Estimated returns 1,431 2,581 External commissions 1,635 1,722 Accrued clinical trials 647 1,076 Other 1,204 1,755 Total $ 25,768 $ 32,161

Long Term Debt Long Term Debt

Long Term Debt Long Term Debt	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Long-Term Debt	Long Term Debt On June 10, 2019, the Company entered into the BT Loan Agreement, pursuant to which the full amount was borrowed and funded (the “ BT Term Loan ”). The proceeds from the BT Term Loan were used (i) for working capital and general corporate purposes and (ii) to pay transaction fees, costs and expenses incurred in connection with the BT Term Loan and the related transactions. The BT Term Loan would have matured on June 20, 2022 and was repayable in quarterly installments of $0.9 million ; the balance was due on June 20, 2022. Blue Torch maintained a first-priority security interest in substantially all the Company’s assets. The BT Term Loan was issued net of the original issue discount of $2.3 million . The Company also incurred $6.7 million of deferred financing costs. On April 22, 2020, the Company amended its BT Loan Agreement with Blue Torch. The amendment provided for an increase in the maximum Total Leverage Ratio, which was a quarterly test, for the remainder of 2020, and also provided for a reduction in the minimum Liquidity requirement from April 2020 through and including November 2020. In connection with the amendment, the Company agreed to pay a one-time fee of approximately $0.7 million , added to the principal balance, and a 1 percentage point increase in the interest rate to LIBOR plus 9% . As of June 30, 2020, interest applicable to any borrowings under the BT Term Loan accrued at a rate equal to LIBOR plus a margin of 9.00% per annum. The BT Term Loan had an interest rate equal to 10.46% at the time the BT Loan Agreement was executed and an interest rate of 10.50% as of June 30, 2020. The BT Loan Agreement, as amended, contained financial covenants requiring the Company, on a consolidated basis, to maintain the following: • Maximum Total Leverage Ratio, defined as funded debt divided by consolidated adjusted EBITDA of the previous four fiscal quarters, as calculated as of June 30, 2020, September 30, 2020 and December 31, 2020 of not more than 5.0 to 1.0. For all subsequent quarters, the Maximum Total Leverage Ratio of not more than 3.0 to 1.0 as of the last day of the quarter. • Minimum Liquidity, defined as unrestricted cash and cash equivalents, of not less than $20.0 million as of the last business day of each fiscal month from April through November 2020. Beginning with the fiscal month ending December 31, 2020, if the total leverage ratio is less than 2.50 to 1.0 as of the last business day of any fiscal month, the Company’s liquidity could not be less than $20.0 million . The BT Loan Agreement also specified that any prepayment of the loan, voluntary or mandatory, as defined in the BT Loan Agreement, subjected MiMedx to a prepayment penalty as of the date of the prepayment with respect to the BT Term Loan of: • During the period from June 10, 2019 through June 10, 2020, an amount equal to 3% of the principal amount of the BT Term Loan prepaid on such date; and • During the period from June 11, 2020 through June 10, 2021, an amount equal to 2% of the principal amount of the BT Term Loan prepaid on such date. Principal prepayments after June 10, 2021 were not subject to a prepayment penalty. The BT Loan Agreement also included events of default customary for facilities of this type, and upon the occurrence of such events of default, subject to customary cure rights, all outstanding loans under the BT Loan Agreement could have been accelerated and/or the lenders’ commitments terminated. The balances of the BT Term Loan were as follows (amounts in thousands): June 30, 2020 December 31, 2019 Current portion Long-term Current portion Long-term Liability component - principal $ 3,750 $ 68,222 $ 3,750 $ 69,375 Original issue discount — (1,540 ) — (1,890 ) Amendment fee — (671 ) — — Deferred financing cost — (4,539 ) — (5,579 ) Liability component - net carrying value $ 3,750 $ 61,472 $ 3,750 $ 61,906 Interest expense related to the BT Term Loan, included in Interest (expense) income, net in the condensed consolidated statements of operations was as follows (amounts in thousands): For the Three Months Ended For the Six Months Ended June 30, 2020 June 30, 2019 June 30, 2020 June 30, 2019 Interest on principal balance $ 1,891 $ 393 $ 3,731 $ 393 Accretion of original issue discount 183 31 350 31 Accretion of amendment fee 51 — 51 — Amortization of deferred financing costs 542 85 1,040 85 Total term loan interest expense $ 2,667 $ 509 $ 5,172 $ 509 The future principal payments for the BT Term Loan as of June 30, 2020 are as follows (in thousands): Year ending December 31, Principal 2020 (excluding the six months ended June 30, 2020) $ 1,875 2021 3,750 2022 66,347 2023 — 2024 — Thereafter — Total Long Term Debt $ 71,972 As of June 30, 2020 , the fair value of the Company’s BT Term Loan was $69.2 million . This valuation was calculated based on a series of Level 2 and Level 3 inputs by calculating a discount rate based on the credit risk spread of debt instruments of a similar risk character in reference to U.S. Treasury instruments with identical securities, with an incremental risk premium for Company-specific risk factors. The remaining cash flows associated with the BT Term Loan were discounted to June 30, 2020 with this calculated discount rate to derive the fair value as of that date. On July 2, 2020, a portion of the proceeds from the Preferred Stock Transaction and the Hayfin Loan Transaction was used to repay the outstanding balance of principal, accrued but unpaid interest, and prepayment premium under the BT Loan Agreement. In connection with the repayment of the BT Term Loan, the Company terminated the BT Loan Agreement. As of June 30, 2020, the Company was in compliance with all covenants under the Hayfin Term Loan. Paycheck Protection Program Loan The Company applied for and on April 24, 2020 received proceeds $10 million in the form of a loan under the Paycheck Protection Program (the “ PPP Loan ”). On May 11, 2020, the Company repaid the PPP Loan in full. There are no continuing obligations under the PPP Loan as of June 30, 2020 .

Net Loss Per Common Share

Net Loss Per Common Share	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Net Loss Per Common Share	Net Loss Per Common Share Basic net loss per common share is computed using the weighted-average number of common shares outstanding during the period. Diluted net loss per common share is computed using the weighted-average number of common and dilutive common equivalent shares from stock options, restricted stock and warrants using the treasury stock method. For all periods presented with a net loss, the shares underlying the common share options, warrants and restricted stock have been excluded from the calculation because their effect would have been anti-dilutive. Therefore, the weighted average shares outstanding used to calculate both basic and diluted loss per share are the same for periods with a net loss. The following table sets forth the computation of basic and diluted net loss per common share (in thousands except share data): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Net loss $ (8,466 ) $ (17,210 ) $ (13,287 ) $ (30,483 ) Denominator for basic earnings per share - weighted average shares 108,119,461 106,942,429 108,081,625 106,885,893 Effect of dilutive securities: Stock options and restricted stock outstanding(a) 1,635,618 1,611,959 2,117,833 1,203,886 Denominator for diluted earnings per share - weighted average shares adjusted for dilutive securities 108,119,461 106,942,429 108,081,625 106,885,893 Loss per common share - basic $ (0.08 ) $ (0.16 ) $ (0.12 ) $ (0.29 ) Loss per common share - diluted $ (0.08 ) $ (0.16 ) $ (0.12 ) $ (0.29 ) (a) Securities outstanding that are included in the computation above, utilizing the treasury stock method are as follows: Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Outstanding Stock Options 562,513 878,134 714,600 792,760 Performance Based Awards 28,626 — 16,559 — Restricted Stock Awards 1,044,479 733,825 1,386,674 411,126 1,635,618 1,611,959 2,117,833 1,203,886

Income taxes

Income taxes	6 Months Ended
	Jun. 30, 2020
Income Tax Disclosure [Abstract]
Income taxes	Income taxes The effective tax rates for the Company were (0.3)% and (0.2)% for the three months ended June 30, 2020 and June 30, 2019 , respectively. The effective tax rates for the Company were 45.9% and (0.3)% for the six months ended June 30, 2020 and June 30, 2019 , respectively. These effective tax rates include the impact of discrete items of $11.4 million in 2020 and $0 in 2019. The discrete items recorded for the six months ended June 30, 2020 are primarily related to modifications to the tax rules for carryback of net operating losses as a result of the CARES Act which are expected to result in a federal tax refund of $11.3 million and an income tax benefit of the same amount. No benefit had been recognized with respect to the net operating losses due to a previously-recorded valuation allowance.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow and Non-Cash Investing and Financing Activities	6 Months Ended
	Jun. 30, 2020
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow and Non-Cash Investing and Financing Activities	Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Six Months Ended June 30, 2020 2019 Cash paid for interest $ 3,731 $ 394 Income taxes paid 13 308 Non-cash activities: Deferred financing costs 1,715 — Amendment fee on BT Term Loan 722 —

Contractual Commitments and Con

Contractual Commitments and Contingencies	6 Months Ended
	Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]
Contractual Commitments and Contingencies	Contractual Commitments and Contingencies Contractual Commitments In addition to the leases noted under Note 6 “ Leases ,” the Company has commitments for meeting space. These leases expire over 3 to 3.5 years following June 30, 2020, and generally contain renewal options. The Company anticipates that most of these leases will be renewed or replaced upon expiration. Rent expense for both the six months ended June 30, 2020 and 2019 was $0.7 million , and $0.4 million for both the three months ended June 30, 2020 and 2019 , respectively, and is allocated among cost of sales, research and development and selling, general and administrative expenses. Separation and Transition Services Agreement of Edward J. Borkowski On November 18, 2019, the Company entered into a Separation and Transition Services Agreement (“ Separation Agreement ”) with Edward J. Borkowski, under which Mr. Borkowski resigned as Executive Vice President and Interim Chief Financial Officer of the Company, as well as from any and all officer, director or other positions that he held with the Company and its affiliates, effective November 15, 2019. Pursuant to the Separation Agreement, Mr. Borkowski agreed to perform the duties of the Interim Chief Financial Officer with respect to the Company’s Annual Report on Form 10-K for the year ended December 31, 2018 (the “ 2018 Form 10-K ”) and assist with the transition of his duties as described in the Separation Agreement from November 15, 2019 through the earlier of the first business day following the Company’s filing of its 2018 Form 10-K with the SEC or December 31, 2019 (the “ Transition Period ”). From the end of the Transition Period until March 31, 2020, Mr. Borkowski agreed to provide services as may be requested by the Company with respect to matters related to the 2018 Form 10-K and the 2019 Form 10-K. As of June 30, 2020, the Company has paid Mr. Borkowski the full $4.0 million owed under the Separation Agreement. Of this amount, $2.3 million was paid during the six months ended June 30, 2020 . Litigation and Regulatory Matters In the ordinary course of business, the Company and its subsidiaries are parties to numerous civil claims and lawsuits and subject to regulatory examinations, investigations, and requests for information. Some of these matters involve claims for substantial amounts. The Company’s experience has shown that the damages alleged by plaintiffs or claimants are often overstated, based on unsubstantiated legal theories, unsupported by facts, and/or bear no relation to the ultimate award that a court might grant. Additionally, the outcome of litigation and regulatory matters and the timing of ultimate resolution are inherently difficult to predict. These factors make it difficult for the Company to provide a meaningful estimate of the range of reasonably possible outcomes of claims in the aggregate or by individual claim. However, on a case-by-case basis, reserves are established for those legal claims in which it is probable that a loss will be incurred and the amount of such loss can be reasonably estimated. The Company's unaudited condensed consolidated financial statements as of June 30, 2020 reflect the Company's current best estimate of probable losses associated with these matters, including costs to comply with various settlement agreements, where applicable. The actual costs of resolving these claims, as well as the cost to resolve claims which either are not probable or not estimable at this time, may be substantially higher or lower than the amounts reserved. For more information regarding the Company’s legal proceedings, refer to the disclosure under Item 3, “ Legal Proceedings ” and Note 16, “ Commitments and Contingencies ” in the 2019 Form 10-K. The following is a description of certain litigation and regulatory matters: Shareholder Derivative Suits On December 6, 2018, the United States District Court for the Northern District of Georgia entered an order consolidating three shareholder derivative actions ( Evans v. Petit, et al. filed September 25, 2018, Georgalas v. Petit, et al. filed September 27, 2018, and Roloson v. Petit, et al. filed October 22, 2018) that had been filed in the Northern District of Georgia. On January 22, 2019, plaintiffs filed a verified consolidated shareholder derivative complaint. The consolidated action sets forth claims of breach of fiduciary duty, corporate waste and unjust enrichment against certain former officers, and certain current and former directors, of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Alexandra O. Haden, Joseph G. Bleser, J. Terry Dewberry, Charles R. Evans, Larry W. Papasan, Luis A. Aguilar, Bruce L. Hack, Charles E. Koob, Neil S. Yeston and Christopher M. Cashman. The allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. The Company filed a motion to stay on February 18, 2019, pending the completion of the investigation by the Company’s Special Litigation Committee. The Special Litigation Committee completed its investigation relating to this action and filed an executive summary of its findings with the Court on July 1, 2019. The parties (together with parties from the Hialeah derivative lawsuit, the Nix and Demaio derivative lawsuit, and the Murphy derivative lawsuit, each described below) held a mediation on February 11, 2020. Following continued discussions, on May 1, 2020, the parties notified the Court that plaintiffs and the Company had reached an agreement in principle to settle this consolidated derivative action, which settlement also encompasses all claims asserted in the Hialeah derivative lawsuit, the Nix and Demaio derivative lawsuit, and the Murphy derivative lawsuit. As of the date of the filing of this Form 10-Q, the parties are drafting, and intend to file, a stipulation of settlement and motion seeking preliminary approval of the settlement. On October 29, 2018, the City of Hialeah Employees Retirement System (“ Hialeah ”) filed a shareholder derivative complaint in the Circuit Court for the Second Judicial Circuit in and for Leon County, Florida (the “ Florida Court ”). The complaint alleges claims for breaches of fiduciary duty and unjust enrichment against certain former officers, and certain current and former directors, of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Alexandra O. Haden, Joseph G. Bleser, J. Terry Dewberry, Charles R. Evans, Bruce L. Hack, Charles E. Koob, Larry W. Papasan, and Neil S. Yeston. The allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. The Company moved to stay the action on February 7, 2019, to allow the prior-filed consolidated derivative action in the Northern District of Georgia to be resolved first and to allow the Company’s Special Litigation Committee time to complete its investigation. The Company also filed a motion to dismiss on April 8, 2019. As discussed above, the plaintiff participated in the mediation that took place in connection with the prior-filed consolidated derivative action in the Northern District of Georgia and is a party to the agreement in principle to settle that consolidated derivative action. The agreement in principle provides that the plaintiff in this action will file a notice of dismissal to dismiss its action with prejudice within seven calendar days after the date that the judgment entered by the Northern District of Georgia becomes final. On May 15, 2019, two individuals purporting to be shareholders of the Company filed a shareholder derivative complaint in the Superior Court for Cobb County, Georgia. ( Nix and Demaio v. Evans, et al. ) The complaint alleges claims for breaches of fiduciary duty, corporate waste and unjust enrichment against certain current and former directors and officers of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Alexandra O. Haden, Chris Cashman, Lou Roselli, Mark Diaz, Charles R. Evans, Luis A. Aguilar, Joseph G. Bleser, J. Terry Dewberry, Bruce L. Hack, Charles E. Koob, Larry W. Papasan and Neil S. Yeston. The allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. The Court ordered this matter stayed pending the resolution of the consolidated derivative suit pending in the Northern District of Georgia. As discussed above, the plaintiff participated in the mediation that took place in connection with the prior-filed consolidated derivative action in the Northern District of Georgia and is a party to the agreement in principle to settle that consolidated derivative action. The agreement in principle provides that the plaintiffs in this action will file a notice of dismissal to dismiss their action with prejudice within seven calendar days after the date that the judgment entered by the Northern District of Georgia becomes final. On August 12, 2019, John Murphy filed a shareholder derivative complaint in the United States District Court for the Southern District of Florida ( Murphy v. Petit, et al. ). The complaint alleged claims for breaches of fiduciary duty and unjust enrichment against certain former officers, and certain current and former directors, of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Alexandra O. Haden, Charles R. Evans, Luis A. Aguilar, Joseph G. Bleser, J. Terry Dewberry, Bruce L. Hack, Charles E. Koob, Larry W. Papasan and Neil S. Yeston. The allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. The Company filed a motion to transfer this action to the Northern District of Georgia. Prior to resolution of that motion, the plaintiff voluntarily dismissed this action without prejudice. As discussed above, the plaintiff participated in the mediation that took place in connection with the prior-filed consolidated derivative action in the Northern District of Georgia and is a party to the agreement in principle to settle that consolidated derivative action. Under the agreement in principle, the plaintiff has agreed that this action shall not be reinstated and, after the judgment entered by the Northern District of Georgia becomes final, this action shall be deemed dismissed with prejudice. On February 10, 2020, Charles Pike filed a shareholder derivative complaint in the United States District Court for the Southern District of Florida ( Pike v. Petit, et al. ). The complaint alleges claims for breaches of fiduciary duty against certain former officers, and certain current and former directors, of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Charles R. Evans, Luis A. Aguilar, Joseph G. Bleser, J. Terry Dewberry, Bruce L. Hack, Charles E. Koob, Larry W. Papasan and Neil S. Yeston. Similar to the prior-filed actions discussed above, the allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. On May 12, 2020, prior to the Company’s time to respond to the complaint, the plaintiff filed a notice of voluntary dismissal of this action without prejudice. On February 18, 2020, Bruce Cassamajor filed a shareholder derivative complaint in the United States District Court for the Northern District of Florida ( Cassamajor v. Petit, et al. ). The complaint alleges claims for breaches of fiduciary duty against certain former officers, and certain current and former directors, of the Company: Parker H. Petit, William C. Taylor, Michael J. Senken, John E. Cranston, Charles R. Evans, Luis A. Aguilar, Joseph G. Bleser, J. Terry Dewberry, Bruce L. Hack, Charles E. Koob, Larry W. Papasan and Neil S. Yeston. Similar to the prior-filed actions discussed above, the allegations generally involve claims that the defendants breached their fiduciary duties by causing or allowing the Company to misrepresent its financial statements as a result of improper revenue recognition. On May 22, 2020, prior to service of the complaint, the plaintiff filed a notice of voluntary dismissal of this action without prejudice. On May 26, 2020, the court ordered this case to be dismissed for failure to serve process. Securities Class Action On January 16, 2019, the United States District Court for the Northern District of Georgia entered an order consolidating two purported securities class actions ( MacPhee v. MiMedx Group, Inc., et al. filed February 23, 2018 and Kline v. MiMedx Group, Inc., et al. filed February 26, 2018). The order also appointed Carpenters Pension Fund of Illinois as lead plaintiff. On May 1, 2019, the lead plaintiff filed a consolidated amended complaint, naming as defendants the Company, Michael J. Senken, Parker H. Petit, William C. Taylor, Christopher M. Cashman and Cherry Bekaert & Holland LLP. The amended complaint (the “ Securities Class Action Complaint ”) alleged violations of Section 10(b) of the Securities Exchange Act of 1934, as amended (the “ Exchange Act ”), Rule 10b-5 promulgated thereunder and Section 20(a) of the Exchange Act. It asserted a class period of March 7, 2013 through June 29, 2018. Following the filing of motions to dismiss by the various defendants, the lead plaintiff was granted leave to file an amended complaint. The lead plaintiff filed its amended complaint against the Company, Michael Senken, Pete Petit, William Taylor, and Cherry Bekaert & Holland (Christopher Cashman was dropped as a defendant) on March 30, 2020; defendants filed motions to dismiss on May 29, 2020. Investigations United States Attorney’s Office for the Southern District of New York (“ USAO-SDNY ”) Investigation The USAO-SDNY conducted an investigation into, among other things, the Company’s recognition of revenue and practices with certain distributors and customers. The USAO-SDNY requested that the Company provide it with copies of all information the Company furnished to the SEC and made additional requests for information. The USAO-SDNY conducted interviews of various individuals, including employees and former employees of the Company. The USAO-SDNY issued indictments in November 2019 against former executives Messrs. Petit and Taylor for securities fraud and conspiracy to commit securities fraud, to make false filings with the SEC, and to influence improperly the conduct of audits relating to alleged misconduct that resulted in inflated revenue figures for fiscal 2015. The Company is cooperating with the USAO-SDNY. Department of Veterans’ Affairs Office of Inspector General (“ VA-OIG ”) and Civil Division of the Department of Justice (“ DOJ-Civil ”) Subpoenas and/or Investigations VA-OIG has issued subpoenas to the Company seeking, among other things, information concerning the Company’s financial relationships with VA clinicians. DOJ-Civil has requested similar information. The Company has cooperated fully and produced responsive information to VA-OIG and DOJ-Civil. Periodically, VA-OIG has requested additional documents and information regarding payments to individual VA clinicians. Most recently, on June 3, 2020, the Company received a subpoena from the VA-OIG requesting information regarding the Company’s financial relationships and interactions with two healthcare providers at the VA Long Beach Healthcare System. The Company has continued to cooperate and respond to these requests. United States Attorney’s Office for the Middle District of North Carolina (“USAO-MDNC”) Investigation On January 9, 2020, the USAO-MDNC informed the Company that it is investigating the Company’s financial relationships with two former clinicians at the Durham VA Medical Center. The Company is cooperating with the investigation. Qui Tam Actions On January 19, 2017, a former employee of the Company filed a qui tam False Claims Act complaint in the United States District Court for the District of South Carolina ( United States of America, ex rel. Jon Vitale v. MiMedx Group, Inc. ) alleging that the Company’s donations to the patient assistance program, Patient Access Network Foundation, violated the Anti-Kickback Statute and resulted in submission of false claims to the government. The government declined to intervene and the complaint was unsealed on August 10, 2018. The Company filed a motion to dismiss on October 1, 2018. The Company’s motion to dismiss was granted in part and denied in part on May 15, 2019. The case is in discovery. On January 20, 2017, two former employees of the Company, filed a qui tam False Claims Act complaint in the United States District Court for the District of Minnesota ( Kruchoski et. al. v. MiMedx Group, Inc. ). An amended complaint was filed on January 27, 2017. The operative complaint alleges that the Company failed to provide truthful, complete and accurate information about the pricing offered to commercial customers in connection with the Company’s Federal Supply Schedule contract. On May 7, 2019, the Department of Justice (“ DOJ ”) declined to intervene, and the case was unsealed. In April 2020, without admitting the allegations, the Company agreed to pay $6.5 million to the DOJ to resolve this matter. This amount was paid during the three and six months ended June 30, 2020. Accordingly, there is no liability outstanding with respect to this matter as of June 30, 2020. Former Employee Litigation On November 19, 2018, the Company’s former Chief Financial Officer filed a complaint in the Superior Court for Cobb County, Georgia ( Michael J. Senken v. MiMedx Group, Inc. ) in which he claims that the Company has breached its obligations under the Company’s charter and bylaws to advance to him, and indemnify him for, his legal fees and costs that he incurred in connection with certain Company internal investigations and litigation. The Company filed its answer denying the plaintiff’s claims on April 19, 2019. To date, no deadlines have been established by the court. On January 21, 2019, a former employee filed a complaint in the Fifth Judicial Circuit, Richland County, South Carolina ( Jon Michael Vitale v. MiMedx Group, Inc. et. al. ) against the Company alleging retaliation, defamation and unjust enrichment and seeking monetary damages. The former employee claims he was retaliated against after raising concerns related to insurance fraud and later defamed by comments concerning the indictments of three South Carolina VA employees. On February 19, 2019, the case was removed to the U.S. District Court for the District of South Carolina. The Company filed a motion to dismiss on April 8, 2019, which was denied by the Court. This case is in discovery. In December 2019, MiMedx received notice of a complaint filed in July 2018 with the Occupational Safety and Health Administration (“OSHA”) section of the Department of Labor (“DOL”) by Thomas Tierney, a former Regional Sales Director, against MiMedx and the referenced individuals, Tierney v. MiMedx Group, Inc., Parker Petit, William Taylor, Christopher Cashman, Thornton Kuntz, Jr. and Alexandra Haden, DOL No. 4-5070-18-243. Mr. Tierney alleged that he was terminated from MiMedx in retaliation for reporting concerns about revenue recognition practices, compliance issues, and the corporate culture, in violation of the anti-retaliation provisions of the Sarbanes-Oxley Act. The parties settled this matter and OSHA dismissed the complaint on May 20, 2020. Defamation Claims On June 4, 2018, Sparrow Fund Management, LP (“ Sparrow ”) filed a complaint against the Company and Mr. Petit, including claims for defamation and civil conspiracy in the United States District Court for the Southern District of New York ( Sparrow Fund Management, L.P. v. MiMedx Group, Inc. et. al. ). The complaint seeks monetary damages and injunctive relief and alleges the defendants commenced a campaign to publicly discredit Sparrow by falsely claiming it was a short seller who engaged in illegal and criminal behavior by spreading false information in an attempt to manipulate the price of our common stock. On March 31, 2019, a judge granted defendants’ motions to dismiss in full, but allowed Sparrow the ability to file an amended complaint. The Magistrate has recommended Sparrow’s motion for leave to amend be granted in part and denied in part and the Judge adopted the Magistrate’s recommendation. Sparrow filed its amended complaint against MiMedx (Mr. Petit has been dropped from the lawsuit) on April 3, 2020 and the Company filed its answer. This case is in discovery. On June 17, 2019, the principals of Viceroy Research (“ Viceroy ”), filed suit in the Circuit Court for the Seventeenth Judicial Circuit in Broward County, Florida ( Fraser John Perring et. al. v. MiMedx Group, Inc. et. al. ) against the Company and Mr. Petit, alleging defamation and malicious prosecution based on the defendants’ alleged campaign to publicly discredit Viceroy and the lawsuit the Company previously filed against the plaintiffs, but which the Company subsequently dismissed without prejudice. On November 1, 2019, the Court granted Mr. Petit’s motion to dismiss on jurisdictional grounds, denied the Company’s motion to dismiss, and granted plaintiffs leave to file an amended complaint to address the deficiencies in its claims against Mr. Petit, which they did on November 21, 2019. The Company filed its answer on December 20, 2019. Intellectual Property Litigation The NuTech Action On March 2, 2015, the Company filed a patent infringement lawsuit against NuTech Medical, Inc. (“ NuTech ”) and DCI Donor Services, Inc. (“ DCI ”) in the United States District Court for the Northern District of Alabama ( MiMedx Group, Inc. v. NuTech Medical, Inc. et. al. ). The Company has alleged that NuTech and DCI infringed and continue to infringe the Company’s patents through the manufacture, use, sale and/or offering of their tissue graft product. The Company has also asserted that NuTech knowingly and willfully made false and misleading representations about its products to customers and prospective customers. The Company is seeking permanent injunctive relief and unspecified damages. The case was stayed pending the restatement of the Company’s financial statements. Since the Company has completed its restatement, the case has resumed and discovery has recommenced. The Osiris Action On February 20, 2019, Osiris Therapeutics, Inc. (“ Osiris ”) refiled its trade secret and breach of contract action against the Company (which had been dismissed in a different forum) in the United States District Court for the Northern District of Georgia ( Osiris Therapeutics, Inc. v. MiMedx Group, Inc. ). Osiris has alleged that the Company acquired Stability, a former distributor of Osiris, in order to illegally obtain trade secrets. On February 24, 2020, the Court issued an order granting in part and denying in party MiMedx’s motion to dismiss. The Court dismissed Osiris’s claims for tortious interference, conspiracy to breach contract, unfair competition, and conspiracy to commit unfair competition. The Court denied MiMedx’s motion to dismiss with respect to the claim for breach of the contract between Osiris and Stability, finding that there is a question as to whether Osiris can maintain such a claim by piercing the corporate veil between MiMedx and its former subsidiary. If Osiris cannot pierce the corporate veil, the claim against MiMedx fails; if Osiris can pierce the corporate veil, the breach of contract claim must be brought in an arbitration proceeding. MiMedx did not move to dismiss Osiris’s claims for misappropriation of trade secrets and conspiracy to misappropriate trade secrets. MiMedx plans to defend against all remaining claims. As of June 30, 2020 , the Company has accrued $5.8 million related to the legal proceedings discussed above. The Company paid $7.0 million in connection with legal settlements during the six months ended June 30, 2020 . Other Matters Under the Florida Business Corporation Act and agreements with its current and former officers and directors, the Company is obligated to indemnify its current and former officers and directors who are made party to a proceeding, including a proceeding brought by or in the right of the corporation, with certain exceptions, and to advance expenses to defend such matters. The Company has already borne substantial costs to satisfy these indemnification and expense advance obligations and expects to continue to do so in the future. In addition to the matters described above, the Company is a party to a variety of other legal matters that arise in the ordinary course of the Company’s business, none of which is deemed to be individually material at this time. Due to the inherent uncertainty of litigation, there can be no assurance that the resolution of any particular claim or proceeding would not have a material adverse effect on the Company’s business, results of operations, financial position or liquidity.

Revenue Data by Customer Type

Revenue Data by Customer Type	6 Months Ended
	Jun. 30, 2020
Segment Reporting [Abstract]
Revenue Data by Customer Type	Revenue Data by Customer Type MiMedx has two primary distribution channels: (1) direct to customers (healthcare professionals and/or facilities) (“ Direct Customers ”), and (2) sales through distributors (“ Distributors ”). For purposes of the required disclosure under ASC 606-10-50-5, the Company groups its customers into these two groups. This grouping by customer types does not constitute a basis for resource allocation but is information intended to provide the reader with ability to better understand how the nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factors applicable to each customer type. These groupings also do not meet the criteria under ASC 280-10-50-1 to qualify as separate operating segments. The Company did not have significant foreign operations or a single external customer from which 10% or more of revenues were derived during the six months ended June 30, 2020 and 2019. Below is a summary of net sales by each customer type (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Direct Customers $ 52,755 $ 65,208 $ 112,651 $ 129,750 Distributors 892 2,229 2,732 4,242 Total $ 53,647 $ 67,437 $ 115,383 $ 133,992

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2020
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events Refer to Note 3, Liquidity and Capital Resources , for discussion surrounding the Preferred Stock Transaction, the Hayfin Term Loan, the Repayment of the BT Term Loan, and the Termination of the BT Term Loan Agreement, all of which occurred subsequent to June 30, 2020. As of June 30, 2020, the Company had incurred $1.7 million of financing costs associated with the Preferred Stock Transaction and the Hayfin Loan Agreement. This amount is included in Other assets on the consolidated balance sheet as of June 30, 2020. Of this amount, less than $0.1 million had been paid as of June 30, 2020.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Segment Reporting	The Company operates in one
Basis of Presentation	Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) from interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring accruals) considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and six months ended June 30, 2020 and 2019 , are not necessarily indicative of the results that may be expected for the fiscal year. The balance sheet as of December 31, 2019 , was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2019 Form 10-K.
Use of Estimates	Use of Estimates The unaudited condensed consolidated financial statements have been prepared in accordance with GAAP. Conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the unaudited condensed consolidated financial statements and the reported unaudited condensed consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment and intangible assets, estimates for contingent liabilities, the measurement of right-of-use assets and lease liabilities, management’s assessment of the Company’s ability to continue as a going concern, estimates of fair value of share-based payments and valuation of deferred tax assets.
Principles of Consolidation	Principles of Consolidation The unaudited condensed consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation.
Cash and Cash Equivalents	Cash and Cash Equivalents Cash and cash equivalents include cash and Federal Deposit Insurance Corporation (“ FDIC ”) insured certificates of deposit held at various banks with an original maturity of three months or less.
Accounts Receivable and Notes Receivable	Accounts Receivable Accounts receivable represent amounts due from customers for which revenue has been recognized. Generally, the Company does not require collateral or any other security to support its receivables. The allowance for doubtful accounts is the Company’s best estimate of the amount of probable credit losses in the Company’s existing receivables. The Company determines the allowance based on factors such as historical collection experience, customers’ current creditworthiness, customer concentrations, age of accounts receivable and general economic conditions that may affect customers’ ability to pay. The Company’s allowance for doubtful accounts was $0.2 million and $0 as of June 30, 2020 and December 31, 2019 , respectively. Notes Receivable Notes receivable represent formal payment agreements with customers which generally arise in situations where amounts shipped and billed have aged significantly as well as the promissory note issued by Stability Biologics, LLC (“ Stability ’’) as part of the divestiture of Stability in 2017. The promissory note from Stability was paid in full in the three months ended September 30, 2019. The Company’s notes receivable are included in other current and long-term assets in the unaudited condensed consolidated balance sheets and were valued taking into consideration cost of the market participant inputs, market conditions, liquidity, operating results and other qualitative factors.
Inventories	Inventories Inventories are valued at the lower of cost or net realizable value, using the first-in, first-out (“ FIFO ”) method. Inventory is tracked through raw material, work-in-process, and finished good stages as the product progresses through various production steps and stocking locations. Labor and overhead costs are absorbed through the various production processes until the work order closes. Historical yields and normal capacities are utilized in the calculation of production overhead rates. Reserves for inventory obsolescence are utilized to account for slow-moving inventory as well as inventory no longer needed due to diminished market demand.
Revenue Recognition	Revenue Recognition The Company sells its products primarily to individual customers and independent distributors (collectively referred to as “ customers ”). During the six months ended June 30, 2019, the Company’s control environment was such that it created uncertainty surrounding all of its customer arrangements, which required consideration related to the proper revenue recognition under the applicable literature. The control environment allowed for the existence of extra-contractual or undocumented terms or arrangements initiated by or agreed to by the Company and former members of Company management at the outset of the transactions (side agreements). Concessions were also agreed to subsequent to the initial sale (e.g. sales above established customer credit limits extended and unusually long payment terms, return or exchange rights, and contingent payment obligations) that called into question the ability to recognize revenue at the time that product was shipped to a customer. As a result, the Company’s application of the applicable revenue recognition guidance varies for the three and six months ended June 30, 2020 as compared to the three and six months ended June 30, 2019 . Additionally, the Company changed its pattern of revenue recognition effective October 1, 2019. The application of the relevant revenue recognition guidance and the pattern of revenue recognition are further discussed below for each period presented. Three and Six Months Ended June 30, 2019 The Company follows Accounting Standards Codification (“ ASC ”) Topic 606, Revenue from Contracts with Customers (“ ASC 606” ) which establishes principles for reporting information about the nature, amount, timing and uncertainty of revenue and cash flows arising from the entity’s contracts to provide goods or services to customers. The core principle requires an entity to recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration that it expects to be entitled to receive in exchange for those goods or services recognized as performance obligations are satisfied. The Company’s inability to fulfill these criteria (the “ Step 1 Criteria ”) was due to uncertainties of contractual adjustments with customers created by a combination of an inappropriate tone at the top and extra-contractual arrangements. Consequently, the Company concluded that it did not meet the Step 1 Criteria upon shipment of the product. Subsequent to the shipment of product, uncertainties surrounding contractual adjustment were not resolved until either: (1) the customer returned the product prior to payment; or (2) the Company received payment from the customer. At that point, the Company determined that an accounting contract existed and the performance obligations of the Company to deliver product and the customer to pay for the product were satisfied. The Company determined the transaction price of its contracts to equal the amount of consideration received from customers less the amount expected to be refunded or credited to customers, which is recognized as a refund liability that is updated at the end of each reporting period for changes in circumstances. The refund liability is included within accrued expenses in the unaudited condensed consolidated balance sheet. Transition and the Six Months Ended June 30, 2020 Beginning October 1, 2019, for all new customer arrangements, the Company determined adequate measures were in place to understand the terms of its contracts with customers. As such, beginning October 1, 2019, the Company concluded that the criteria under ASC 606 would be met prior to shipment of product to the customer or implantation of the products on consignment. For all customer transactions concluded to meet the Step 1 Criteria, the Company then assessed the remaining criteria of ASC 606 to determine the proper timing of revenue recognition. For the remaining customer arrangements at September 30, 2019 (the “ Remaining Contracts ”), the Company concluded that due to the uncertainty that extracontractual arrangement may continue the Step 1 Criteria would not be satisfied until the Company receives payment from the customer. At that point, the Company determined that an accounting contract would exist and the performance obligations of the company to deliver product and the customer to pay for the product would be satisfied. As of June 30, 2020, upon reassessment, the Company concluded that the Step 1 Criteria continued not to be met with respect to the Remaining Contracts due to the same circumstances described above. The amount of sales related to these Remaining Contracts which have not been recognized as of June 30, 2020 was $2.8 million . This amount is not recognized on the unaudited condensed consolidated balance sheet as of June 30, 2020. In addition, the Company continued to defer the cost of sales for the Remaining Contracts for which revenue recognition criteria have not been met. These amounts were recorded within other current assets on the condensed consolidated balance sheet in the amount of $0.4 million and $1.3 million as of June 30, 2020 and December 31, 2019, respectively. A rollforward of this activity from December 31, 2019 to June 30, 2020, along with the deferred cost of sales associated with such unrecognized sales, is presented in the following table (amounts in thousands): Amounts Invoiced and Not Collected Deferred Cost of Sales Amounts as of December 31, 2019 $ 9,006 $ 1,261 Revenue recognized related to amounts invoiced and not collected at September 30, 2019: Cash collected during the six months ended June 30, 2020 related to the Remaining Contracts (6,201 ) (868 ) Amounts as of June 30, 2020 $ 2,805 $ 393 Under ASC 606, the Company recognizes revenue following the five-step model: (i) identify the contracts with a customer (the Step 1 Criteria); (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies a performance obligation. As noted above, during the third quarter of 2019, the Company determined that they had met the Step 1 Criteria. The Company also determined that the performance obligation was met upon delivery of the product to the customer, or at the time the product is implanted for products on consignment, at which point the Company determined it will collect the consideration it is entitled to in exchange for the product transferred to the customer. As a result, the Company recognizes as revenue the amount of the transaction price that is allocated to the respective performance obligation when (or as) the performance obligation is satisfied, generally upon shipment of the product to the customer. The nature of the Company’s contracts gives rise to certain types of variable consideration, including rebates and other discounts. The Company includes estimated amounts of variable consideration in the transaction price to the extent that it is probable there will not be a significant reversal of revenue. Estimates are based on historical or anticipated performance. The Company does have consignment agreements with several customers and distributors which allow the Company to better market its products by moving them closer to the end user. In these cases, the Company determined that it has fulfilled its performance obligation once control of the product has been delivered to the customer, which occurs simultaneously with the product being implanted. The Company acts as the principal in all of its customer arrangements and therefore records revenue on a gross basis. Shipping is considered immaterial in the context of the overall customer arrangement, and damages or loss of goods in transit are rare. Therefore, shipping is not deemed a separately recognized performance obligation. The Company maintains a returns policy that allows its customers to return product that is consigned, damaged or non-conforming, ordered in error, or due to a recall. The estimate of the provision for returns is based upon historical experience with actual returns. The Company’s payment terms for customers are typically 30 to 60 days from receipt of title of the goods. GPO Fees The Company sells to Group Purchasing Organization (“ GPO ”) members who transact directly with the Company at GPO-agreed pricing. GPOs are funded by administrative fees that are paid by the Company. These fees are set as a percentage of the purchase volume, which is typically 3% of sales made to the GPO members. The Company presents the administrative fees paid to GPOs as a reduction of revenues because the benefit received by the Company in exchange for the GPO fees is not sufficiently separable from the GPO member’s purchase of the Company’s products. Cost of Sales Cost of sales includes all costs directly related to bringing the Company’s products to their final selling destination. Amounts include direct and indirect costs to manufacture products including raw materials, personnel costs and direct overhead expenses necessary to convert collected tissues into finished goods, product testing costs, quality assurance costs, facility costs associated with the Company’s manufacturing and warehouse facilities, depreciation, freight charges, costs to operate equipment and other shipping and handling costs for products shipped to customers.
Leases	Leases The Company determines if an arrangement is, or contains, a lease at inception. Right-of-use assets and the related liabilities result from operating leases which were included in Right of use asset, Other current liabilities and Other liabilities, respectively. Operating lease assets represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Operating lease assets and liabilities are recognized at the lease commencement date based on the estimated present value of lease payments over the lease term. The lease term used in the calculation includes options to extend or terminate the lease when the exercise of such options are reasonably certain. The Company uses its estimated incremental borrowing rate in determining the present value of lease payments. Variable components of the lease payments such as fair market value adjustments, utilities, and maintenance costs are expensed as incurred and not included in determining the present value of lease liabilities. As an accounting policy election, the Company excludes short-term leases having initial terms of 12 months or fewer. Lease expense is recognized on a straight-line basis over the lease term. See Note 6, “ Leases ” for further information regarding lease obligations.
Patent Costs	Patent Costs
Treasury Stock	Treasury Stock The Company accounts for the purchase of treasury stock under the cost method. Treasury stock which is reissued for the exercise of option grants and the issuance of restricted stock grants is accounted for on a FIFO basis.
Recently Issued and Adopted Accounting Standards	Recently Issued and Adopted Accounting Standards In June 2016, the FASB issued Accounting Standards Updated (“ ASU ”) 2016-13, “ Financial Instruments - Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments ,” that introduces a new model for recognizing credit losses on financial instruments based on an estimate of current expected credit losses. This includes accounts receivable, trade receivables, loans, held-to-maturity debt securities, net investments in leases and certain off-balance sheet credit exposures. The guidance also modifies the impairment model for available-for-sale debt securities. The ASU is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2019. The Company adopted this ASU on January 1, 2020 using a modified retrospective transition method which requires a cumulative-effect adjustment to the opening balance of retained earnings to be recognized on the date of adoption with no change to financial results reported in prior periods. The cumulative effect adjustment recorded on January 1, 2020 is not material. The adoption of this ASU did not have a significant impact on the Company’s consolidated financial statements and related disclosures. All other ASUs issued and not yet effective for the six months ended June 30, 2020 , and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s financial position or results of operations.

Significant Accounting Polici_3

Significant Accounting Policies Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2020
Accounting Policies [Abstract]
Assessment of Revenue under ASC 606	A rollforward of this activity from December 31, 2019 to June 30, 2020, along with the deferred cost of sales associated with such unrecognized sales, is presented in the following table (amounts in thousands): Amounts Invoiced and Not Collected Deferred Cost of Sales Amounts as of December 31, 2019 $ 9,006 $ 1,261 Revenue recognized related to amounts invoiced and not collected at September 30, 2019: Cash collected during the six months ended June 30, 2020 related to the Remaining Contracts (6,201 ) (868 ) Amounts as of June 30, 2020 $ 2,805 $ 393

Inventory (Tables)

Inventory (Tables)	6 Months Ended
	Jun. 30, 2020
Inventory Disclosure [Abstract]
Inventory	Inventory consisted of the following (in thousands): June 30, 2020 December 31, 2019 Raw materials $ 417 $ 318 Work in process 3,716 4,299 Finished goods 6,934 5,206 Inventory, gross 11,067 9,823 Reserve for obsolescence (502 ) (719 ) Inventory, net $ 10,565 $ 9,104

Property and Equipment (Tables)

Property and Equipment (Tables)	6 Months Ended
	Jun. 30, 2020
Property, Plant and Equipment [Abstract]
Summary of Property and Equipment	Property and equipment consisted of the following (in thousands): June 30, 2020 December 31, 2019 Leasehold improvements $ 5,689 $ 5,321 Laboratory and clean room equipment 15,379 14,894 Furniture and equipment 15,335 15,118 Construction in progress 1,150 972 Property and equipment, gross 37,553 36,305 Less accumulated depreciation (26,733 ) (23,977 ) Property and equipment, net $ 10,820 $ 12,328

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to operating leases is as follows (amounts in thousands, except lease term and discount rate): June 30, 2020 December 31, 2019 Assets Right of use asset $ 2,911 $ 3,397 Liabilities Short term lease liability $ 1,220 $ 1,168 Long term lease liability 2,295 2,919 Weighted-average remaining lease term (years) 2.6 3.1 Weighted-average discount rate 11.5 % 11.5 %
Maturities of Operating Lease Liabilities	Maturities of operating leases liabilities are as follows (amounts in thousands): Year ending December 31, Maturities 2020 (excluding the six months ended June 30, 2020) $ 776 2021 1,528 2022 1,552 2023 196 2024 — Thereafter — Total lease payments 4,052 Less: imputed interest (537 ) Total lease liability $ 3,515

Intangible Assets (Tables)

Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible assets activity summary - indefinite-lived	Intangible assets are summarized as follows (in thousands): June 30, 2020 December 31, 2019 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Licenses $ 1,414 $ (1,267 ) $ 147 $ 1,414 $ (1,200 ) $ 214 Patents and know how 9,226 (5,395 ) 3,831 9,099 (5,070 ) 4,029 Customer and supplier relationships 3,761 (2,552 ) 1,209 3,761 (2,417 ) 1,344 Non-compete agreements 120 (83 ) 37 120 (68 ) 52 Total amortized intangible assets $ 14,521 $ (9,297 ) $ 5,224 $ 14,394 $ (8,755 ) $ 5,639 Unamortized intangible assets Trade names and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in process 1,154 1,154 1,130 1,130 Total intangible assets $ 16,683 $ 7,386 $ 16,532 $ 7,777
Intangible assets activity summary - finite-lived	Intangible assets are summarized as follows (in thousands): June 30, 2020 December 31, 2019 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Licenses $ 1,414 $ (1,267 ) $ 147 $ 1,414 $ (1,200 ) $ 214 Patents and know how 9,226 (5,395 ) 3,831 9,099 (5,070 ) 4,029 Customer and supplier relationships 3,761 (2,552 ) 1,209 3,761 (2,417 ) 1,344 Non-compete agreements 120 (83 ) 37 120 (68 ) 52 Total amortized intangible assets $ 14,521 $ (9,297 ) $ 5,224 $ 14,394 $ (8,755 ) $ 5,639 Unamortized intangible assets Trade names and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in process 1,154 1,154 1,130 1,130 Total intangible assets $ 16,683 $ 7,386 $ 16,532 $ 7,777
Estimated Future Amortization Expense for Intangible Assets	Expected future amortization of intangible assets as of June 30, 2020 , is as follows (in thousands): Year ending December 31, Estimated Amortization Expense 2020 (excluding the six months ended June 30, 2020) $ 544 2021 1,023 2022 921 2023 921 2024 921 Thereafter 894 $ 5,224

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2020
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued expenses consisted of the following (in thousands): June 30, 2020 December 31, 2019 Legal costs $ 15,067 $ 12,202 Settlement costs 5,784 5,931 Pricing adjustment settlement with Veterans Affairs — 6,894 Estimated returns 1,431 2,581 External commissions 1,635 1,722 Accrued clinical trials 647 1,076 Other 1,204 1,755 Total $ 25,768 $ 32,161

Long Term Debt (Tables)

Long Term Debt (Tables)	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Schedule of Debt	The balances of the BT Term Loan were as follows (amounts in thousands): June 30, 2020 December 31, 2019 Current portion Long-term Current portion Long-term Liability component - principal $ 3,750 $ 68,222 $ 3,750 $ 69,375 Original issue discount — (1,540 ) — (1,890 ) Amendment fee — (671 ) — — Deferred financing cost — (4,539 ) — (5,579 ) Liability component - net carrying value $ 3,750 $ 61,472 $ 3,750 $ 61,906
Schedule of Interest Expense	Interest expense related to the BT Term Loan, included in Interest (expense) income, net in the condensed consolidated statements of operations was as follows (amounts in thousands): For the Three Months Ended For the Six Months Ended June 30, 2020 June 30, 2019 June 30, 2020 June 30, 2019 Interest on principal balance $ 1,891 $ 393 $ 3,731 $ 393 Accretion of original issue discount 183 31 350 31 Accretion of amendment fee 51 — 51 — Amortization of deferred financing costs 542 85 1,040 85 Total term loan interest expense $ 2,667 $ 509 $ 5,172 $ 509
Future Principal Payments for the Term Loan	The future principal payments for the BT Term Loan as of June 30, 2020 are as follows (in thousands): Year ending December 31, Principal 2020 (excluding the six months ended June 30, 2020) $ 1,875 2021 3,750 2022 66,347 2023 — 2024 — Thereafter — Total Long Term Debt $ 71,972

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Loss per Share	The following table sets forth the computation of basic and diluted net loss per common share (in thousands except share data): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Net loss $ (8,466 ) $ (17,210 ) $ (13,287 ) $ (30,483 ) Denominator for basic earnings per share - weighted average shares 108,119,461 106,942,429 108,081,625 106,885,893 Effect of dilutive securities: Stock options and restricted stock outstanding(a) 1,635,618 1,611,959 2,117,833 1,203,886 Denominator for diluted earnings per share - weighted average shares adjusted for dilutive securities 108,119,461 106,942,429 108,081,625 106,885,893 Loss per common share - basic $ (0.08 ) $ (0.16 ) $ (0.12 ) $ (0.29 ) Loss per common share - diluted $ (0.08 ) $ (0.16 ) $ (0.12 ) $ (0.29 ) (a) Securities outstanding that are included in the computation above, utilizing the treasury stock method are as follows: Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Outstanding Stock Options 562,513 878,134 714,600 792,760 Performance Based Awards 28,626 — 16,559 — Restricted Stock Awards 1,044,479 733,825 1,386,674 411,126 1,635,618 1,611,959 2,117,833 1,203,886

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow and Non-Cash Investing and Financing Activities (Tables)	6 Months Ended
	Jun. 30, 2020
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Six Months Ended June 30, 2020 2019 Cash paid for interest $ 3,731 $ 394 Income taxes paid 13 308 Non-cash activities: Deferred financing costs 1,715 — Amendment fee on BT Term Loan 722 —

Revenue Data by Customer Type (

Revenue Data by Customer Type (Tables)	6 Months Ended
	Jun. 30, 2020
Segment Reporting [Abstract]
Summary of Net Sales by Customer Type	Below is a summary of net sales by each customer type (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Direct Customers $ 52,755 $ 65,208 $ 112,651 $ 129,750 Distributors 892 2,229 2,732 4,242 Total $ 53,647 $ 67,437 $ 115,383 $ 133,992

Nature of Business (Details)

Nature of Business (Details) $ in Millions	6 Months Ended
	Jun. 30, 2020USD ($)segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of business segments (segment) | segment	1
Federal tax refund resulting from CARES Act	$ 11.3
Income tax benefit, CARES Act	$ 11.3

Significant Accounting Polici_4

Significant Accounting Policies (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Allowance for doubtful accounts	$ 200		$ 0
Amounts invoiced and not collected	2,805		9,006
Deferred cost of sales	$ 393		$ 1,261
Group purchasing organization administrative fees (percent)	3.00%
Patent application costs	$ 151	$ 253
Minimum
Finite-Lived Intangible Assets [Line Items]
Typical payment period for customers	30 days
Maximum
Finite-Lived Intangible Assets [Line Items]
Typical payment period for customers	60 days

Significant Accounting Polici_5

Significant Accounting Policies - Assessment of Revenue under ASC 606 (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2020USD ($)
Accounts Receivable, Net [Roll Forward]
Amounts as of December 31, 2019	$ 9,006
Cash collected during the six months ended June 30, 2020 related to the Remaining Contracts	(6,201)
Amounts as of June 30, 2020	2,805
Deferred Cost of Sales [Roll Forward]
Amounts as of December 31, 2019	1,261
Cash collected during the six months ended June 30, 2020 related to the Remaining Contracts	(868)
Amounts as of June 30, 2020	$ 393

Liquidity and Capital Resourc_2

Liquidity and Capital Resources (Details)	Jul. 02, 2020USD ($)$ / shares	Jun. 30, 2020USD ($)$ / shares	Jun. 30, 2021	Dec. 31, 2020	Nov. 30, 2020USD ($)	Jun. 20, 2022USD ($)	Jun. 29, 2025	Dec. 31, 2019USD ($)$ / shares
Subsequent Event [Line Items]
Cash and cash equivalents		$ 48,189,000						$ 69,069,000
Total current assets		107,592,000						123,245,000
Total current liabilities		63,663,000						$ 67,322,000
Working capital		$ 43,900,000
Preferred stock par value (in dollars per share) | $ / shares		$ 0.001						$ 0.001
Subsequent Event | Series B Convertible Preferred Stock
Subsequent Event [Line Items]
Stock issued during the period	$ 100,000,000
Preferred stock par value (in dollars per share) | $ / shares	$ 0.001
Proceeds from issuance of convertible preferred stock	$ 100,000,000
Hayfin Loan Agreement | Subsequent Event
Subsequent Event [Line Items]
Debt instrument, face amount	75,000,000
Senior secured term loan | Hayfin Loan Agreement Term Loan | Subsequent Event
Subsequent Event [Line Items]
Debt instrument, face amount	$ 50,000,000
Senior secured term loan | Hayfin Loan Agreement | Subsequent Event
Subsequent Event [Line Items]
Upfront commitment fee (percent)	2.00%
Debt covenant, cap on cash netting	$ 10,000,000
Debt covenant, minimum liquidity	10,000,000
Term loan | Hayfin Loan Agreement Delayed Draw Term Loan | Subsequent Event
Subsequent Event [Line Items]
Debt instrument, face amount	$ 25,000,000
Commitment fee on undrawn amounts (percent)	1.00%
Total net leverage ratio	3.5
Term loan | BT Term Loan | Subsequent Event
Subsequent Event [Line Items]
Repayment of principal	$ 72,000,000
Accrued interest and fees paid	100,000
Prepayment premium paid	$ 1,400,000
London Interbank Offered Rate (LIBOR) | Senior secured term loan | Hayfin Loan Agreement | Subsequent Event
Subsequent Event [Line Items]
Floor interest rate (percent)	1.50%
Debt instrument, basis spread on variable rate	6.75%
London Interbank Offered Rate (LIBOR) | Term loan | BT Term Loan
Subsequent Event [Line Items]
Debt instrument, basis spread on variable rate		9.00%
Minimum | London Interbank Offered Rate (LIBOR) | Senior secured term loan | Hayfin Loan Agreement | Subsequent Event
Subsequent Event [Line Items]
Debt instrument, basis spread on variable rate, based on total net leverage levels (percent)	6.50%
Maximum | London Interbank Offered Rate (LIBOR) | Senior secured term loan | Hayfin Loan Agreement | Subsequent Event
Subsequent Event [Line Items]
Debt instrument, basis spread on variable rate, based on total net leverage levels (percent)	6.00%
Forecast | Senior secured term loan | Hayfin Loan Agreement
Subsequent Event [Line Items]
Total net leverage ratio			4.5	5			4
Forecast | Term loan | BT Term Loan
Subsequent Event [Line Items]
Debt covenant, minimum liquidity					$ 20,000,000	$ 20,000,000
Discounted Dividend Rate prior to Quarterly Dividend Payment ending on June 30,2021 | Subsequent Event | Series B Convertible Preferred Stock
Subsequent Event [Line Items]
Preferred stock, cumulative dividend per annum (percent)	4.00%
Perpetual Dividend Rate after Quarterly Dividend Payment ending on June 30, 2021 | Subsequent Event | Series B Convertible Preferred Stock
Subsequent Event [Line Items]
Preferred stock, cumulative dividend per annum (percent)	6.00%

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Raw materials	$ 417	$ 318
Work in process	3,716	4,299
Finished goods	6,934	5,206
Inventory, gross	11,067	9,823
Reserve for obsolescence	(502)	(719)
Inventory, net	$ 10,565	$ 9,104

Property and Equipment - Summar

Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 37,553	$ 36,305
Less accumulated depreciation	(26,733)	(23,977)
Property and equipment, net	10,820	12,328
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	5,689	5,321
Laboratory and clean room equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,379	14,894
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,335	15,118
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,150	$ 972

Property and Equipment - Narrat

Property and Equipment - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Property, Plant and Equipment [Abstract]
Depreciation	$ 1,400	$ 1,600	$ 2,928	$ 3,340

Leases (Details)

Leases (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Leases [Abstract]
Operating lease cost	$ 300	$ 400	$ 700	$ 800
Interest on lease obligations	100	100	200	300
Operating lease liability	400	400	800	900
Amortization of right of use asset	$ 200	$ 200	$ 486	$ 492

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Leases [Abstract]
Right of use asset	$ 2,911	$ 3,397
Short term lease liability	1,220	1,168
Long term lease liability	$ 2,295	$ 2,919
Weighted-average remaining lease term (years)	2 years 7 months 6 days	3 years 1 month 6 days
Weighted-average discount rate	11.50%	11.50%

Leases - Maturities of Operatin

Leases - Maturities of Operating Lease Liabilities (Details) $ in Thousands	Jun. 30, 2020USD ($)
Leases [Abstract]
2020 (excluding the six months ended June 30, 2020)	$ 776
2021	1,528
2022	1,552
2023	196
2024	0
Thereafter	0
Total lease payments	4,052
Less: imputed interest	(537)
Operating lease liability	$ 3,515

Intangible Assets - Summary of

Intangible Assets - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Gross carrying value	$ 14,521	$ 14,394
Accumulated amortization	(9,297)	(8,755)
Net carrying amount	5,224	5,639
Intangible assets, gross carrying value	16,683	16,532
Net	7,386	7,777
Trade names and trademarks
Finite-Lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,008	1,008
Patents in process
Finite-Lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,154	1,130
Licenses
Finite-Lived Intangible Assets [Line Items]
Gross carrying value	1,414	1,414
Accumulated amortization	(1,267)	(1,200)
Net carrying amount	147	214
Patents and know-how
Finite-Lived Intangible Assets [Line Items]
Gross carrying value	9,226	9,099
Accumulated amortization	(5,395)	(5,070)
Net carrying amount	3,831	4,029
Customer and supplier relationships
Finite-Lived Intangible Assets [Line Items]
Gross carrying value	3,761	3,761
Accumulated amortization	(2,552)	(2,417)
Net carrying amount	1,209	1,344
Non compete agreements
Finite-Lived Intangible Assets [Line Items]
Gross carrying value	120	120
Accumulated amortization	(83)	(68)
Net carrying amount	$ 37	$ 52

Intangible Assets - Narrative (

Intangible Assets - Narrative (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of intangible assets	$ 271,000	$ 267,000	$ 542,000	$ 500,000
Impairment of intangible assets for write-down of patents		0		800,000
Impairment of intangible assets related to customer relationships	$ 0	$ 0	$ 0	$ 500,000

Intangible Assets - Estimated F

Intangible Assets - Estimated Future Amortization Expense for Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Estimated future amortization expense [Abstract]
2020 (excluding the six months ended June 30, 2020)	$ 544
2020	1,023
2021	921
2022	921
2023	921
Thereafter	894
Net book value	$ 5,224	$ 5,639

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Payables and Accruals [Abstract]
Legal costs	$ 15,067	$ 12,202
Settlement costs	5,784	5,931
Pricing adjustment settlement with Veterans Affairs	0	6,894
Estimated returns	1,431	2,581
External commissions	1,635	1,722
Accrued clinical trials	647	1,076
Other	1,204	1,755
Total	$ 25,768	$ 32,161

Long Term Debt - Term Loan (Det

Long Term Debt - Term Loan (Details)	May 11, 2020USD ($)	Apr. 24, 2020USD ($)	Apr. 22, 2020USD ($)	Jun. 10, 2019USD ($)	Jun. 30, 2020USD ($)	Nov. 30, 2020USD ($)	Jun. 10, 2021	Jun. 10, 2020	Jun. 20, 2022USD ($)	Mar. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Proceeds from Payroll Protection Program loan		$ 10,000,000
Repayment of Payroll Protection Program loan	$ 10,000,000
Term loan | BT Term Loan
Debt Instrument [Line Items]
Debt instrument, periodic payment				$ 900,000
Debt instrument, unamortized discount				2,300,000
Debt issuance costs, gross				$ 6,700,000
Stated interest rate (percent)				10.46%	10.50%
Debt covenant, total leverage ratio					5
Debt instrument, prepayment penalty as percent of prepaid principal								3.00%
Fair value of term loan					$ 69,200,000
Term loan | BT Term Loan | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate					9.00%
Term loan | Amended Term Loan Agreement [Member]
Debt Instrument [Line Items]
Debt issuance costs, gross			$ 700,000
Term loan | Amended Term Loan Agreement [Member] | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Increase in interest rate (percent)			1.00%
Debt instrument, basis spread on variable rate			9.00%
Forecast | Term loan | BT Term Loan
Debt Instrument [Line Items]
Debt covenant, total leverage ratio										3	2.50
Debt covenant, minimum liquidity						$ 20,000,000			$ 20,000,000
Debt instrument, prepayment penalty as percent of prepaid principal							2.00%

Long Term Debt - Term Loan Bala

Long Term Debt - Term Loan Balances (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current portion
Liability component - principal	$ 3,750	$ 3,750
Original issue discount	0	0
Amendment fee	0	0
Deferred financing cost	0	0
Liability component - net carrying value	3,750	3,750
Long-term
Liability component - principal	68,222	69,375
Original issue discount	(1,540)	(1,890)
Amendment fee	(671)	0
Deferred financing cost	(4,539)	(5,579)
Liability component - net carrying value	$ 61,472	$ 61,906

Long Term Debt - Term Loan Inte

Long Term Debt - Term Loan Interest Expense (Details) - Term loan - BT Term Loan - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Debt Instrument [Line Items]
Interest on principal balance	$ 1,891	$ 393	$ 3,731	$ 393
Accretion of original issue discount	183	31	350	31
Interest expense - accretion of amendment fee	51	0	51	0
Amortization of deferred financing costs	542	85	1,040	85
Total term loan interest expense	$ 2,667	$ 509	$ 5,172	$ 509

Long Term Debt - Term Loan Matu

Long Term Debt - Term Loan Maturity (Details) $ in Thousands	Jun. 30, 2020USD ($)
Debt Disclosure [Abstract]
2020 (excluding the six months ended June 30, 2020)	$ 1,875
2021	3,750
2022	66,347
2023	0
2024	0
Thereafter	0
Total Long Term Debt	$ 71,972

Net Loss Per Common Share (Deta

Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Computation of basic and diluted net loss per share [Abstract]
Net loss	$ (8,466)	$ (17,210)	$ (13,287)	$ (30,483)
Denominator for basic earnings per share - weighted average shares (in shares)	108,119,461	106,942,429	108,081,625	106,885,893
Effect of dilutive securities: Stock options and restricted stock outstanding (in shares)	1,635,618	1,611,959	2,117,833	1,203,886
Denominator for diluted earnings per share - weighted average shares adjusted for dilutive securities (in shares)	108,119,461	106,942,429	108,081,625	106,885,893
Loss per common share - basic (in dollars per share)	$ (0.08)	$ (0.16)	$ (0.12)	$ (0.29)
Loss per common share - diluted (in dollars per share)	$ (0.08)	$ (0.16)	$ (0.12)	$ (0.29)
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	1,635,618	1,611,959	2,117,833	1,203,886
Outstanding Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	562,513	878,134	714,600	792,760
Performance Based Awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	28,626	0	16,559	0
Restricted Stock Awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	1,044,479	733,825	1,386,674	411,126

Income taxes (Details)

Income taxes (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Income Tax Disclosure [Abstract]
Effective tax rate	(0.30%)	(0.20%)	45.90%	(0.30%)
Effective income tax rate impact of discrete items			$ 11,400,000	$ 0
Income taxes receivable	$ 11,300,000		11,300,000
Tax benefit recognized with respect to net operating loss			$ 0

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow and Non-Cash Investing and Financing Activities (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest	$ 3,731	$ 394
Income taxes paid	13	308
Non-cash activities:
Deferred financing costs	1,715	0
Amendment fee on BT Term Loan	$ 722	$ 0

Contractual Commitments and C_2

Contractual Commitments and Contingencies - Narrative (Details) $ in Thousands	May 20, 2020USD ($)	May 15, 2019shareholder	Jan. 16, 2019lawsuit	Jan. 20, 2017USD ($)former_employee	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 06, 2018lawsuit
Loss Contingencies [Line Items]
Rent expense					$ 400	$ 400	$ 700	$ 700
Accrued settlement costs					$ 5,784		5,784		$ 5,784	$ 5,931
Payments for legal settlements							$ 7,000
Shareholder Derivative Suits
Loss Contingencies [Line Items]
Number of shareholder derivative actions | lawsuit											3
Nix and Damiano v. Evans, et al.
Loss Contingencies [Line Items]
Number of shareholders | shareholder		2
Securities Class Action
Loss Contingencies [Line Items]
Number of class actions | lawsuit			2
Kruchoski et. al. v. Mimedx Group, Inc.
Loss Contingencies [Line Items]
Litigation settlement				$ 6,500
Number of former employees | former_employee				2
OSHA Complaint
Loss Contingencies [Line Items]
Litigation settlement	$ 600
Minimum
Loss Contingencies [Line Items]
Lease expiration period					3 years		3 years		3 years
Maximum
Loss Contingencies [Line Items]
Lease expiration period					3 years 6 months		3 years 6 months		3 years 6 months
Former Chief Financial Officer
Loss Contingencies [Line Items]
Severance costs paid							$ 2,300		$ 4,000

Revenue Data by Customer Type_2

Revenue Data by Customer Type (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020USD ($)distribution_channel	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)distribution_channel	Jun. 30, 2019USD ($)
Revenue, Major Customer [Line Items]
Number of primary distribution channels | distribution_channel	2		2
Net sales	$ 53,647	$ 67,437	$ 115,383	$ 133,992
Direct Customers
Revenue, Major Customer [Line Items]
Net sales	52,755	65,208	112,651	129,750
Distributors
Revenue, Major Customer [Line Items]
Net sales	$ 892	$ 2,229	$ 2,732	$ 4,242

Subsequent Events (Details)

Subsequent Events (Details) $ in Millions	Jun. 30, 2020USD ($)
Subsequent Event [Line Items]
Payments of financing costs	$ 0.1
Other Assets
Subsequent Event [Line Items]
Debt issuance costs, gross	$ 1.7