MiMedx (MDXG) 10-Q 2 May 23 2023 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2023	Apr. 27, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
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
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	MDXG
Security Exchange Name	NASDAQ
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		115,601,238
Entity Central Index Key	0001376339
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 61,221	$ 65,950
Accounts receivable, net	44,694	43,084
Inventory	14,657	13,183
Prepaid expenses	8,824	8,646
Other current assets	2,306	3,335
Total current assets	131,702	134,198
Property and equipment, net	7,562	7,856
Right of use asset	3,066	3,400
Goodwill	19,976	19,976
Intangible assets, net	5,706	5,852
Other assets	147	148
Total assets	168,159	171,430
Current liabilities:
Accounts payable	7,823	8,847
Accrued compensation	18,212	21,852
Accrued expenses	13,041	11,024
Other current liabilities	1,794	1,834
Total current liabilities	40,870	43,557
Long term debt, net	48,714	48,594
Other liabilities	4,027	4,773
Total liabilities	93,611	96,924
Commitments and contingencies (Note 13)
Convertible preferred stock Series B; $0.001 par value; 100,000 shares authorized, issued and outstanding at March 31, 2023 and December 31, 2022	92,494	92,494
Stockholders' deficit
Preferred stock Series A; $0.001 par value; 5,000,000 shares authorized, 0 issued and outstanding at March 31, 2023 and December 31, 2022	0	0
Common stock; $0.001 par value; 187,500,000 shares authorized; 115,380,542 issued and 115,380,208 outstanding at March 31, 2023 and 113,705,447 issued and outstanding at December 31, 2022	115	114
Additional paid-in capital	178,829	173,804
Treasury stock at cost; 334 shares at March 31, 2023 and 0 shares at December 31, 2022	(1)	0
Accumulated deficit	(196,889)	(191,906)
Total stockholders' deficit	(17,946)	(17,988)
Total liabilities, convertible preferred stock, and stockholders’ deficit	$ 168,159	$ 171,430

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
LIABILITIES, CONVERTIBLE PREFERRED STOCK, AND STOCKHOLDERS’ DEFICIT
Series B convertible preferred stock par value (in dollars per share)	$ 0.001	$ 0.001
Series B convertible preferred stock, shares authorized (in shares)	100,000	100,000
Series B convertible preferred stock, shares issued (in shares)	100,000	100,000
Series B convertible preferred stock, shares outstanding (in shares)	100,000	100,000
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)	187,500,000	187,500,000
Common stock, shares issued (in shares)	115,380,542	113,705,447
Common stock, shares outstanding (in shares)	115,380,208	113,705,447
Treasury stock, shares (in shares)	334	0

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Statement [Abstract]
Net sales	$ 71,676	$ 58,894
Cost of sales	12,419	9,936
Gross profit	59,257	48,958
Operating expenses:
Selling, general and administrative	52,279	49,570
Research and development	6,496	5,964
Investigation, restatement and related	3,673	2,552
Amortization of intangible assets	190	172
Operating loss	(3,381)	(9,300)
Other expense, net
Interest expense, net	(1,553)	(1,126)
Other income, net	2	0
Loss before income tax provision	(4,932)	(10,426)
Income tax provision expense	(51)	(63)
Net loss	(4,983)	(10,489)
Net loss available to common stockholders - basic	(6,667)	(12,075)
Net loss available to common stockholders - diluted	$ (6,667)	$ (12,075)
Net loss per common share - basic (in dollars per share)	$ (0.06)	$ (0.11)
Net loss per common share - diluted (in dollars per share)	$ (0.06)	$ (0.11)
Weighted average common shares outstanding - basic (in shares)	114,398,813	111,615,839
Weighted average common shares outstanding - diluted (in shares)	114,398,813	111,615,839

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' (DEFICIT) EQUITY - USD ($) $ in Thousands	Total	Common Stock Issued	Additional Paid-in Capital	Treasury Stock	Accumulated Deficit
Balance beginning of period (in shares) at Dec. 31, 2021		112,703,926
Balance, beginning of period at Dec. 31, 2021	$ 82	$ 113	$ 165,695	$ (4,017)	$ (161,709)
Treasury stock, beginning balance (in shares) at Dec. 31, 2021				778,710
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	3,998		3,998
Exercise of stock options (in shares)				124,334
Exercise of stock options	166		(972)	$ 1,138
Employee stock purchase plan	0
Issuance of restricted stock (in shares)		821,252		732,053
Issuance of restricted stock	0	$ 1	(3,237)	$ 3,236
Restricted stock canceled/forfeited (in shares)				667
Restricted stock shares canceled/forfeited	0		6	$ (6)
Shares repurchased for tax withholding (in shares)				249,778
Shares repurchased for tax withholding	(1,191)			$ (1,191)
Net loss	(10,489)				(10,489)
Balance end of period (in shares) at Mar. 31, 2022		113,525,178
Balance, end of period at Mar. 31, 2022	$ (7,434)	$ 114	165,490	$ (840)	(172,198)
Treasury stock, ending balance (in shares) at Mar. 31, 2022				172,768
Balance beginning of period (in shares) at Dec. 31, 2022	113,705,447	113,705,447
Balance, beginning of period at Dec. 31, 2022	$ (17,988)	$ 114	173,804	$ 0	(191,906)
Treasury stock, beginning balance (in shares) at Dec. 31, 2022	0			0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	$ 4,345		4,345
Exercise of stock options (in shares)	0
ESPP stock issued (in shares)		235,419
Employee stock purchase plan	$ 680		680
Issuance of restricted stock (in shares)		1,439,676		57,770
Issuance of restricted stock	0	$ 1	(179)	$ 178
Restricted stock canceled/forfeited (in shares)				58,104
Restricted stock shares canceled/forfeited	0		179	$ (179)
Net loss	$ (4,983)				(4,983)
Balance end of period (in shares) at Mar. 31, 2023	115,380,542	115,380,542
Balance, end of period at Mar. 31, 2023	$ (17,946)	$ 115	$ 178,829	$ (1)	$ (196,889)
Treasury stock, ending balance (in shares) at Mar. 31, 2023	334			334

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net loss	$ (4,983,000)	$ (10,489,000)
Adjustments to reconcile net loss to net cash flows used in operating activities:
Share-based compensation	4,345,000	3,998,000
Depreciation	714,000	860,000
Non-cash lease expenses	334,000	295,000
Amortization of intangible assets	190,000	172,000
Amortization of deferred financing costs	121,000	112,000
Accretion of asset retirement obligation	22,000	22,000
Gain on fixed asset disposal	0	(15,000)
Bad debt expense	(60,000)	0
Increase (decrease) in cash resulting from changes in:
Accounts receivable	(1,551,000)	2,679,000
Inventory	(1,474,000)	(1,781,000)
Prepaid expenses	(178,000)	11,000
Other assets	1,030,000	(235,000)
Accounts payable	(1,023,000)	456,000
Accrued compensation	(3,347,000)	(6,494,000)
Accrued expenses	2,210,000	550,000
Other liabilities	(398,000)	(364,000)
Net cash flows used in operating activities	(4,048,000)	(10,223,000)
Cash flows from investing activities:
Purchases of equipment	(633,000)	(118,000)
Patent application costs	(44,000)	(54,000)
Proceeds from sale of equipment	0	24,000
Net cash flows used in investing activities	(677,000)	(148,000)
Cash flows from financing activities:
Principal payments on finance lease	(4,000)	(11,000)
Stock repurchased for tax withholdings on vesting of restricted stock	0	(1,191,000)
Proceeds from exercise of stock options	0	166,000
Net cash flows used in financing activities	(4,000)	(1,036,000)
Net change in cash	(4,729,000)	(11,407,000)
Cash and cash equivalents, beginning of period	65,950,000	87,083,000
Cash and cash equivalents, end of period	$ 61,221,000	$ 75,676,000

Nature of Business

Nature of Business	3 Months Ended
	Mar. 31, 2023
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 a pioneer and leader in placental biologics focused on addressing the needs of patients with acute and chronic non-healing wounds. The Company is also advancing a promising late-stage biologics pipeline targeted at decreasing pain and improving function of patients with knee osteoarthritis (“ KOA ”). To accomplish these goals, the Company operates as two defined, internal business units: Wound & Surgical and Regenerative Medicine. All of the Company’s products sold in the United States are regulated by the United States Food & Drug Administration (“ FDA ”). The Company’s business is focused primarily on the United States of America but the Company is pursuing opportunities for international expansion, with specific focus on the sale of its placental tissue products in Japan.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Please see Note 2, Significant Accounting Policies , to the Company’s Consolidated Financial Statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022 (the “ 2022 Form 10-K ”), filed with the Securities and Exchange Commission (“ SEC ”) on February 28, 2023 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 ”) for 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 considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three months ended March 31, 2023 and 2022 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2022 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 2022 Form 10-K. Reclassifications Increase in cash resulting from changes in income taxes of $0.1 million for the three months ended March 31, 2022, which was separately presented in the unaudited condensed consolidated statement of cash flows in previously-issued financial statements, is included as part of increases and decreases in cash resulting from changes in other assets in the unaudited condensed consolidated statement of cash flows included as part of these financial statements. Principles of Consolidation The 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. Use of Estimates 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 consolidated financial statements and the reported 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, estimates of impairment for goodwill and intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, management’s assessment of the Company’s ability to continue as a going concern, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets. Share-Based Compensation The Company grants share-based awards to employees and members of the Company’s Board of Directors (the “ Board ”). Awards to employees and the Board are generally made annually. Grants are issued outside of the annual cadence for certain new hires, promotions, and other events. The amount of expense to be recognized is determined by the fair value of the award using inputs available as of the grant date. The fair value of non-option share awards that are not subject to a market condition is the value of the common stock on the grant date. For non-option share awards that are subject to a market condition, the fair value of the common stock on the grant date is adjusted to reflect the value of the market condition, generally using a path-dependent pricing model, such as a Monte Carlo simulation. The fair value of stock option grants is estimated using an option pricing model, as appropriate based on the terms of the grant. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, which generally follows the inputs to a Black-Scholes option pricing model. Absent the availability of an option market with similar terms to the awarded options, the Company uses the historical volatility of daily price changes in its share price for a period equal to the contractual or expected term of the option, as applicable, subject to adjustment for price activity associated with certain events which are not expected to recur during the relevant term to infer an expectation of volatility. The expected term is derived based on the Company’s expectations for option exercise by the recipients. The Company uses U.S. Treasury yields with a maturity similar to the expected or contractual term, as applicable, as the basis for its risk-free interest rate assumption. The Company has never declared a dividend on its common stock and, therefore, assumes a dividend yield of 0%. For awards with service-based vesting conditions only, the Company recognizes share-based compensation expense on a straight-line basis through the vesting date of the last tranche of the award. For awards which vest based on more than a service condition, the Company recognizes share-based compensation expense using a graded-vesting method, treating each tranche as if it were a separately-granted award and recognizing expense through the vesting date of each individual tranche. In each scenario, the Company recognizes share-based compensation expense to the extent associated service and performance conditions are considered probable to occur. Determinations of probability are made during each reporting period and use available evidence considered relevant for the particular performance condition. The Company recognizes the cumulative effect of changes in the probability of occurrence in the period of re-evaluation. The probability and ultimate resolution of market conditions is not considered in expense recognition. Consequently, the Company could recognize expense for awards that do not ultimately vest. Basic and Diluted Net Loss Per Common Share Basic net loss per common share is calculated as net loss available to common stockholders divided by the weighted average common shares outstanding for the applicable period. Net loss available to common stockholders is calculated by adjusting net loss for periodic accumulated dividends on the Company’s Series B Convertible Preferred Stock (“ Series B Preferred Stock ”). This amount is divided by the weighted average common shares outstanding during the period. Weighted average common shares outstanding is calculated as shares of the Company outstanding adjusted for the portion of the period for which they are outstanding. Unvested non-option share awards are excluded from the calculation of weighted average common shares outstanding until they have vested. Unvested stock options are excluded from the calculation of weighted average common shares outstanding until they are exercised. Shares issuable pursuant to the Company’s Employee Stock Purchase Plan (“ ESPP ”) are included for the minimum number of shares issuable beginning at the point in time that all contingencies for share issuance are resolved. Diluted net loss per common share adjusts basic net loss per common share for convertible securities, options, equity incentive awards, and other share-based payment awards which have yet to vest and vest only on the satisfaction of a service condition. Equity incentive awards and options that are subject to a performance or market condition are included only if the performance or market condition would be satisfied if the end of the applicable period were the end of the performance period. In any case, these adjustments are reflected in the calculation of diluted net loss per common share to the extent that they reduce basic net loss per common share. The Company uses the if-converted method to calculate the dilutive effect of the Series B Preferred Stock and other convertible securities to the extent they are outstanding. The if-converted method assumes that convertible securities are converted at the later of the issuance date and the beginning of the period. If the hypothetical conversion of convertible securities, and the consequential avoidance of any accumulated preferred dividends, would decrease basic net loss per common share, these effects are incorporated in the calculation of diluted net loss per common share, adjusted for the portion of the period the securities were outstanding. The Company uses the treasury stock method to calculate the dilutive effect of options, non-option share awards, and certain other share-based payments. The treasury stock method assumes that the proceeds from exercise are used to repurchase common shares at the weighted average market price during the period, increasing the denominator for the net effect of shares issued upon exercise less hypothetical shares repurchased. Share-based payment awards which are subject to a performance or market condition are included if or to the extent that the applicable performance or market condition has been resolved as if the end of the applicable reporting period were the end of the applicable performance period. Shares issuable pursuant to the ESPP are included in the calculation of diluted net loss per common share to the extent that such shares would be issued based on the share price at the conclusion of the period, to the extent such shares are not already included in the calculation of weighted average common shares outstanding. Recently Issued Accounting Standards Not Yet Adopted All ASUs issued and not yet effective for the three months ended March 31, 2023, 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 and results of operations.

Accounts Receivable, Net

Accounts Receivable, Net	3 Months Ended
	Mar. 31, 2023
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable, net, consisted of the following (in thousands): March 31, 2023 December 31, 2022 Accounts receivable, gross $ 48,295 $ 46,867 Less: allowance for doubtful accounts (3,601) (3,783) Accounts receivable, net $ 44,694 $ 43,084 Activity related to the Company’s allowance for doubtful accounts for the three months ended March 31, 2023 was as follows (in thousands): Allowance for Doubtful Accounts Balance at December 31, 2022 $ 3,783 Bad debt expense (60) Write-offs (122) Balance at March 31, 2023 $ 3,601 Bad debt expense and write-offs were not material for the three months ended March 31, 2022.

Inventory

Inventory	3 Months Ended
	Mar. 31, 2023
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 896 $ 810 Work in process 6,087 6,855 Finished goods 7,674 5,518 Inventory $ 14,657 $ 13,183

Property and Equipment, Net

Property and Equipment, Net	3 Months Ended
	Mar. 31, 2023
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and Equipment, Net Property and equipment, net, consisted of the following (in thousands): March 31, 2023 December 31, 2022 Laboratory and clean room equipment $ 16,955 $ 16,422 Furniture and equipment 15,016 15,016 Leasehold improvements 9,190 9,190 Construction in progress 1,889 1,983 Asset retirement cost 963 983 Finance lease right-of-use asset 189 189 Property and equipment, gross 44,202 43,783 Less: accumulated depreciation and amortization (36,640) (35,927) Property and equipment, net $ 7,562 $ 7,856 Depreciation expense for the three months ended March 31, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended March 31, 2023 2022 Depreciation expense $ 714 $ 860 Depreciation expense is allocated amongst cost of sales, research and development expense, and selling, general, and administrative expense on the unaudited condensed consolidated statements of operations.

Intangible Assets, Net

Intangible Assets, Net	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	Intangible Assets, Net Intangible assets, net, are summarized as follows (in thousands): March 31, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,963 $ (7,282) $ 2,681 $ 9,923 $ (7,106) $ 2,817 Licenses 1,000 (17) 983 1,000 (4) $ 996 Total amortized intangible assets $ 10,963 $ (7,299) $ 3,664 $ 10,923 $ (7,110) $ 3,813 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 1,034 1,034 1,031 1,031 Total intangible assets $ 13,005 $ 5,706 $ 12,962 $ 5,852 Amortization expense three months ended March 31, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended March 31, 2023 2022 Amortization expense $ 190 $ 172 Expected future amortization of intangible assets as of March 31, 2023, is as follows (in thousands): Year ending December 31, Estimated 2023 (excluding the three months ended March 31, 2023) $ 569 2024 759 2025 364 2026 209 2027 209 Thereafter 1,554 Total amortized intangible assets $ 3,664

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2023
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): March 31, 2023 December 31, 2022 Legal and settlement costs $ 6,302 $ 4,447 Commissions to sales agents 3,060 2,941 Accrued rebates 874 707 Accrued group purchasing organization fees 643 638 Estimated sales returns 610 659 Accrued travel 287 566 Accrued clinical trials 90 90 Other 1,175 976 Accrued expenses $ 13,041 $ 11,024

Long Term Debt, Net

Long Term Debt, Net	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Long Term Debt, Net	Long Term Debt, Net Hayfin Loan Agreement On June 30, 2020, the Company entered into a Loan Agreement with, among others, Hayfin Services, LLP (“ Hayfin ”), an affiliate of Hayfin Capital Management LLP (the “ Hayfin Loan Agreement ”), which Hayfin funded on July 2, 2020, providing the Company with a senior secured term loan in an aggregate amount of $50.0 million (the “ Term Loan ”). On February 28, 2022, the Company executed an Amendment to the Hayfin Loan Agreement (as amended, the “Amended Hayfin Loan Agreement” ). The Term Loan matures on June 30, 2025 (the “ Maturity Date ”). Interest on any borrowings under the Amended Hayfin Loan Agreement is equal to the London Interbank Offered Rate (“ LIBOR ”), subject to a floor of 1.5%, plus a margin of 6.75% per annum (the “ Margin ”). If LIBOR is unavailable, the Term Loan will carry interest equal to the Margin plus the greatest of the Prime Rate, the Federal Funds Rate plus 0.5%, and 2.5%. The Term Loan carried an interest rate of 11.9% as of March 31, 2023. As of March 31, 2023, the Company is in compliance with all applicable financial covenants under the Amended Hayfin Loan Agreement. A breach of a financial covenant in the Amended Hayfin Loan Agreement, if uncured or unable to be cured, would likely result in an event of default that could trigger the lender’s remedies, including acceleration of the entire principal balance of the loan as well as any applicable prepayment premiums. The balances of the Term Loan as of March 31, 2023 and December 31, 2022 were as follows (in thousands): March 31, 2023 December 31, 2022 Outstanding principal $ 50,000 $ 50,000 Deferred financing costs (1,114) (1,219) Original issue discount (172) (187) Long term debt, net $ 48,714 $ 48,594 Interest expense related to the Term Loan, included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2023 2022 Stated interest $ 1,436 $ 1,031 Amortization of deferred financing costs 105 97 Accretion of original issue discount 16 15 Interest expense $ 1,557 $ 1,143 A summary of principal payments due on the Term Loan, by year, from March 31, 2023 through maturity are as follows (in thousands): Year ending December 31, Principal 2023 (excluding the three months ended March 31, 2023) $ — 2024 — 2025 50,000 2026 — 2027 — Thereafter — Outstanding principal $ 50,000

Net Loss Per Common Share

Net Loss Per Common Share	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Net Loss Per Common Share	Net Loss Per Common ShareNet loss per common share is calculated using two methods: basic and diluted. Basic Net Loss Per Common Share The following table provides a reconciliation of net loss to net loss available to common stockholders and calculation of basic net loss per common share for each of the three months ended March 31, 2023 and 2022 (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Net loss $ (4,983) $ (10,489) Accumulated dividends on Series B Preferred Stock 1,684 1,586 Net loss available to common stockholders $ (6,667) $ (12,075) Weighted average common shares outstanding 114,398,813 111,615,839 Basic net loss per common share $ (0.06) $ (0.11) The following table sets forth the computation of diluted net loss per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Net loss available to common stockholders $ (6,667) $ (12,075) Adjustments: Accumulated dividends on Series B Convertible Preferred Stock 1,684 1,586 Less: antidilutive adjustments (1,684) (1,586) Total adjustments — — Numerator $ (6,667) $ (12,075) Weighted average shares outstanding 114,398,813 111,615,839 Adjustments Potential common shares 30,151,138 29,459,846 Less: antidilutive potential common shares (a) (30,151,138) (29,459,846) Total adjustments — — Weighted average shares outstanding adjusted for potential common shares 114,398,813 111,615,839 Diluted net loss per common share $ (0.06) $ (0.11) (a) Weighted average common shares outstanding for the calculation of diluted net loss per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented. Three Months Ended March 31, 2023 2022 Series B Convertible Preferred Stock 29,559,946 27,850,916 Restricted stock unit awards 567,167 822,642 Restricted stock awards 13,133 597,805 Employee stock purchase plan 5,740 — Performance stock unit awards 5,152 — Outstanding stock options — 188,483 Potential common shares 30,151,138 29,459,846

Equity

Equity	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Equity	Equity Series B Convertible Preferred Stock The Company has not declared or paid any dividends on the Series B Preferred Stock since issuance. Dividends accumulated but not paid as of March 31, 2023 were $15.5 million. As this amount has not been declared, the Company has not recorded this amount on its unaudited condensed consolidated balance sheet as of March 31, 2023. Based on accumulated dividends as of March 31, 2023, the Series B Preferred Stock was convertible into an aggregate of 29,997,271 shares of the Company’s common stock as of that date. Equity Incentive Awards The Company has issued restricted stock awards (“ RSAs ”), restricted stock unit awards (“ RSUs ”), and performance stock unit awards (“ PSUs ”, collectively the “Equity Incentive Awards” ) to its employees. The following is summary information for Equity Incentive Awards for the three months ended March 31, 2023. As of March 31, 2023, there was $34.8 million of unrecognized share-based compensation expense related to share-based payment arrangements. This expense is expected to be recognized over a weighted-average period of 2.58 years, which approximates the remaining vesting period of these grants. The below table summarizes activity of unvested Equity Incentive Awards by award type from January 1, 2023 through March 31, 2023. RSA RSU PSU Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Unvested at January 1, 2023 122,755 $ 6.13 4,774,971 $ 6.28 241,072 $ 4.62 Granted — — 2,792,086 4.42 3,689,427 3.72 Vested — — (1,497,446) 6.96 — — Forfeited (58,104) 5.77 (421,701) 6.34 (59,524) 4.62 Unvested at March 31, 2023 64,651 $ 6.47 5,647,910 $ 5.18 3,870,975 $ 3.76 Stock Options A summary of stock option activity for the three months ended March 31, 2023 is presented below: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2023 933,894 $ 6.46 Granted 3,600,000 3.70 Exercised — — Unvested options forfeited — — Vested options expired (289,231) 5.44 Outstanding at March 31, 2023 4,244,663 4.19 6.51 — Exercisable at March 31, 2023 644,663 $ 6.91 0.92 $ — CEO Performance Grant On January 27, 2023, the Board of Directors appointed Joseph H. Capper to serve as Chief Executive Officer. The Company entered into a Letter Agreement with Mr. Capper that included, among other things, a grant of 3,300,000 PSUs (the “ CEO Performance PSUs ”) and a non-qualified stock option (the “ CEO Performance Option ”, collectively with the CEO Performance PSUs, the “ CEO Performance Grant ”) for 3,600,000 shares of the Company’s common stock. In addition to continued employment with the Company, the occurrence and extent of vesting of each component of the CEO Performance Grant is dependent upon the Company’s operating and share price performance: the CEO Performance PSUs vest on the basis of achieved revenue growth, while the CEO Performance Option vests on the basis of share price appreciation. CEO Performance PSUs The CEO Performance PSUs vest in a single tranche on the earlier of the filing date of the Company’s 2026 Annual Report on Form 10-K and March 15, 2027. The occurrence and extent of vesting depends on the Company’s compound annual growth rate (“ CAGR ”) achieved with respect to its revenue growth between the year ended December 31, 2022 and the year ending December 31, 2026. The PSUs may vest with respect to 50% to 200% of the granted number of PSUs, depending on the extent of CAGR achievement. Failure to achieve the CAGR associated with 50% of achievement would result in no vesting. Management determined the probable level of vesting using internally-developed forecasts for the relevant period representing the Company’s best estimate for revenue, with a factor applied to calculate the highest level of CAGR evaluated to be probable of occurring based on that estimate. The Company recognized $0.3 million of expense related to the CEO Performance PSUs during the three months ended March 31, 2023. CEO Performance Option The CEO Performance Option grants Mr. Capper the right to purchase up to 3,600,000 shares of common stock for $3.70 per share. The CEO Performance Option vests based on the satisfaction of service and market conditions. Mr. Capper may vest in 25% of the CEO Performance Option on each of the first four anniversary dates of the date of grant provided that he remains employed by the Company and provided that specified share price goals are achieved at any point between the date of grant and January 31, 2027. There are three separate share price goals associated with the CEO Performance Option. If specified share price goals are met at one level, one-third of the option may vest, at a second level, a further one-third may vest, and at a third level, the full amount of the option may vest. Satisfaction of the share price goals is based on the average of the closing price of the Company’s common stock during any 20 consecutive trading days through January 31, 2027 exceeding the stipulated share price goal. The CEO Performance Option expires on February 1, 2030. The Company estimated the fair value of the awards using a Monte Carlo simulation using the following assumptions: Assumption Stock price on grant date $ 3.70 Exercise price $ 3.70 Risk-free interest rate 3.58 % Expected volatility (annualized) 75.00 % Dividend yield — % Weighted average grant date fair value $ 1.93 The risk-free interest rate was derived based on the U.S. Treasury Yield curve in effect at the date of grant for maturities of similar periods to the contractual term. The expected volatility was estimated principally based on the Company’s historical daily stock price movements for a term similar in length to the contractual term. The dividend yield was based on the Company’s history of dividends on its common stock. The fair value was determined using an expected term which reflects the anticipated holding and post-vesting behavior pattern, calculated for each individual simulation. The total grant date fair value of the CEO Performance Option was $7.0 million. The fair value associated with each tranche of the award will be recognized, straight-line, over the associated requisite service period for that tranche, subject to acceleration if the market condition is met prior to the end of the derived service period. Failure to meet the market condition for an award does not result in reversal of previously-recognized expense, so long as the service is provided for the duration of the required service period. The Company recognized $0.5 million of expense related to the CEO Performance Option during the three months ended March 31, 2023.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe effective tax rates for the Company were (1.0)% and (0.6)% for the three months ended March 31, 2023 and 2022, respectively. There were no material discrete items affecting the effective tax rate in any period. Net operating losses incurred were offset by a valuation allowance.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	3 Months Ended
	Mar. 31, 2023
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): Three Months Ended March 31, 2023 2022 Cash paid for interest $ 1,452 $ 1,034 Cash paid for income taxes — — Non-cash activities: Purchases of equipment in accounts payable 223 287 Issuance of shares pursuant to employee stock purchase plan 680 — Right of use assets arising from operating lease liabilities — (37)

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Separation Agreement with Timothy R. Wright On September 15, 2022, the Company entered into a Separation Agreement and General Release with Timothy R. Wright, the former Chief Executive Officer of the Company (the “ Separation Agreement ”). Pursuant to the terms of the Separation Agreement and Mr. Wright’s general release of all claims against the Company, the Company will pay Mr. Wright a total of $3.1 million in cash in a series of installments through September 2024. Of the $3.1 million, $0.9 million was paid during the three months ended March 31, 2023. $1.6 million, reflecting payments owed to Mr. Wright within one year, is reflected in accrued compensation together with the remaining $0.6 million reflected in other liabilities in the unaudited condensed consolidated balance sheet as of March 31, 2023. Nordic Agreement In June 2022, the Company entered into a collaboration agreement (the “ Nordic Agreement ”) with Nordic Bioscience Clinical Development A/S (“ NBCD ”) to provide full operational support for the Company’s KOA clinical trial program. Under the terms of the Nordic Agreement, the Company is obligated to pay $10.2 million upon the achievement of specified milestones over the course of the clinical trial. As of March 31, 2023, the Company has paid $3.6 million under the Nordic Agreement, relating to milestones which have been achieved from inception through that date. During the three months ended March 31, 2023, the Company recognized $0.6 million of expense. This amount is included as part of research and development expense in the unaudited condensed consolidated statements of operations for those periods. $2.2 million is reflected in prepaid expenses on the consolidated balance sheet as of March 31, 2023. Turn Agreement On December 7, 2022, the Company acquired intellectual property rights pursuant to a Platform Intellectual Property License (the “ Turn Agreement ”) with Global Health Solutions, Inc. (d.b.a. Turn Therapeutics or “ Turn ”). The Turn Agreement provided MIMEDX with an exclusive, worldwide, sub-licensable license to use Turn’s proprietary antimicrobial technology platform (PermaFusion®) to develop antimicrobial product line extensions and new products. In addition, the Turn Agreement granted the Company the commercial rights to Turn’s placental collagen matrix product, FleX™ AM (“ Flex ”), contingent upon Turn’s receipt of FDA 510(k) clearance and other conditions. The Turn Agreement provided for a potential milestone payment by the Company of $9.6 million upon Turn’s receipt of 510(k) clearance for FleX. As of March 31, 2023, FleX has not received 510(k) clearance. Litigation and Regulatory Matters In the ordinary course of business, the Company and its subsidiaries may be a party to pending and threatened legal, regulatory, and governmental actions and proceedings (including those described below). In view of the inherent difficulty of predicting the outcome of such matters, particularly where the plaintiffs or claimants seek very large or indeterminate damages or where the matters present novel legal theories or involve a large number of parties, the Company generally cannot predict what the eventual outcome of the pending matters will be, what the timing of the ultimate resolution of these matters will be, or what the eventual recovery, loss, fines or penalties related to each pending matter may be. The Company's unaudited condensed consolidated balance sheet as of March 31, 2023 reflects the Company's current best estimate of probable losses associated with these matters, including costs to comply with various settlement agreements, where applicable. For more information regarding the Company’s legal proceedings, refer to Note 16, “ Commitments and Contingencies ” in the 2022 Form 10-K. The Company has not accrued for any potential losses related to legal matters as of March 31, 2023. The Company paid $0.2 million toward the resolution of legal matters involving the Company during the three months ended March 31, 2023. The following is a description of certain litigation and regulatory matters to which the Company is a party: 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 (“ CPFI ”) as lead plaintiff. On May 1, 2019, CPFI filed a consolidated amended complaint, naming as defendants the Company, Michael J. Senken, Parker H. “Pete” 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, CPFI was granted leave to file an amended complaint. CPFI filed its amended complaint against the Company, Michael J. Senken, Parker H. Petit, William C. Taylor, and Cherry Bekaert & Holland (Christopher Cashman was dropped as a defendant) on March 30, 2020. The defendants filed motions to dismiss on May 29, 2020. On March 25, 2021, the Court granted defendants’ respective motions to dismiss, finding that CPFI lacked standing to bring the underlying claims and also could not establish loss causation because it sold all of its shares in MIMEDX prior to any corrective disclosures, and dismissed the case. On April 22, 2021, CPFI filed a motion for reconsideration of the dismissal and for leave to amend to add a new plaintiff to attempt to cure the standing and loss causation issues. On January 28, 2022, the Court denied CPFI’s motion to reconsider and motion to substitute class representative. On February 25, 2022, CPFI filed a Notice of Appeal in the 11th Circuit Court of Appeals. Oral arguments were held on January 24, 2023. Welker v. MiMedx, et. al. On November 4, 2022, Troy Welker and Min Turner, former optionholders of the Company, brought a lawsuit in Fulton County State Court against the Company, former directors Terry Dewberry and Charles Evans, and former officers Parker H. “Pete” Petit, William C. Taylor, and Michael Senken alleging violations of the Georgia Racketeer Influenced and Corrupt Organizations (“ RICO ”) Act against all defendants, and conspiracy to violate the Georgia RICO Act and breach of fiduciary duty against the individual defendants. The Company is defending against the allegations and removed the case to the United States District Court for the Northern District of Georgia. Plaintiffs have filed a motion to remand back to state court, which is currently pending. Former Employee Litigation and Related Matters On January 12, 2021, the Company filed suit in the Circuit Court of the Eleventh Judicial District in and for Miami-Dade County, Florida (MiMedx Group, Inc. v. Petit, et. al.) against its former CEO, Parker H. “Pete” Petit, and its former COO, William C. Taylor, seeking a determination of its rights and obligations under indemnification agreements with Petit and Taylor following a federal jury’s guilty verdict against Petit for securities fraud and Taylor for conspiracy to commit securities fraud. The Company is seeking a declaratory judgment that it is not obligated to indemnify or advance expenses to Petit and Taylor in connection with certain cases to which Petit and Taylor are parties and also seeking to recoup amounts previously paid on behalf of Petit and Taylor in connection with such cases. On April 22, 2021, Petit and Taylor filed an answer and asserted counterclaims against the Company alleging breach of their indemnification agreements, breach of the covenant of good faith and fair dealing with respect to their indemnification agreements, and seeking a declaration that the Company remains obligated to indemnify and advance fees in connection with certain cases. Petit and Taylor simultaneously also filed a motion seeking to compel the Company to advance and reinstate its payments of Petit and Taylor’s legal expenses. The Company opposed Petit and Taylor’s motion and a hearing was set for June 23, 2021. At the joint request of the parties, the hearing was cancelled to allow the parties to attend a mediation to attempt a resolution of this matter; such mediation was held on August 11, 2021. Following the mediation, the Company and Mr. Taylor reached an agreement to settle the matter between them. Negotiations with Mr. Petit are ongoing. 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 may continue to do so in the future. Costs incurred pursuant to these agreements are included in investigation, restatement and related expense in the unaudited condensed consolidated statements of operations. 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 are 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

Revenue	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Revenue	RevenueNet Sales by Product MIMEDX has two primary classes of products: (1) Advanced Wound Care, or Section 361, products, consisting of its tissue and cord sheet allograft products as well as certain particulate products regulated under Section 361, and (2) Section 351 products, consisting of the Company’s micronized and certain other particulate products. Advanced Wound Care is further disaggregated between the Company’s Tissue/Other and Cord products. Below is a summary of net sales by class of product (in thousands): Three Months Ended March 31, 2023 2022 Advanced Wound Care Tissue/Other $ 65,771 $ 52,852 Cord 5,439 5,597 Total Advanced Wound Care 71,210 58,449 Section 351 (1) 466 445 Total $ 71,676 $ 58,894 (1) Revenue recognized from collections relating to revenue transactions for which performance obligations were fulfilled prior to October 1, 2019, the date at which the Company changed its pattern of revenue recognition, for the three months ended March 31, 2022 of $0.1 million, which were separately presented in previously-issued financial statements, are presented as part of Section 351 in the table above. Net Sales by Site of Service MIMEDX has three sites of service for its products (1) Hospital settings and wound care clinics, which are stable reimbursement settings in which products are used for surgical applications, (2) Private offices, which generally represents doctors and practitioners with independent operations, and (3) Other, which includes federal facilities, international sales, and other sites of service. Below is a summary of net sales by site of service (in thousands): Three Months Ended March 31, 2023 2022 Hospital $ 42,171 $ 35,981 Private Office 21,487 16,157 Other 8,018 6,756 Total $ 71,676 $ 58,894 The Company did not have significant foreign operations or a single external customer from which 10% or more of revenues were derived during the three months ended March 31, 2023 or 2022.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Segment Information	Segment Information The Company has two reportable segments: Wound & Surgical and Regenerative Medicine. See Note 13, Segment Information, included in the 2022 Form 10-K for descriptions of each reportable segment. The accounting policies of the segments are the same as the Company’s accounting policies. See Note 2, Significant Accounting Policies , included in the 2022 Form 10-K. The Company evaluates the performance of its segments and allocates resources based on segment contribution, defined as net sales less (i) cost of sales, (ii) selling, general and administrative expense, (iii) research and development expense, and (iv) amortization of intangible assets. Prior period results were recast on the basis of new operating segments. The only components which comprise loss before income tax provision that are not included in operating loss are interest expense, net and other expense, net. The Company does not allocate any assets to the reportable segments. No asset information is reported or disclosed to the chief operating decision maker in the financial information for each segment. Net sales and segment contribution by each reportable segment for the three months ended March 31, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 70,629 — $ 1,047 $ 71,676 Cost of sales 11,332 — 1,087 12,419 Selling, general and administrative expense 37,666 — 14,613 52,279 Research and development expense 1,522 4,974 — 6,496 Amortization of intangible assets — — 190 190 Segment contribution $ 20,109 $ (4,974) Investigation, restatement and related expense 3,673 Operating loss $ (3,381) Supplemental information Depreciation expense $ 389 $ 64 $ 261 $ 714 Share-based compensation $ 1,383 $ 452 $ 2,510 $ 4,345 Net sales and segment contribution by each reportable segment for the three months ended March 31, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 58,330 $ — $ 564 $ 58,894 Cost of sales 9,129 — 807 9,936 Selling, general and administrative expense 34,044 — 15,526 49,570 Research and development expense 1,951 4,013 — 5,964 Amortization of intangible assets — — 172 172 Segment contribution $ 13,206 $ (4,013) Investigation, restatement and related expense 2,552 Operating loss $ (9,300) Supplemental information Depreciation expense $ 455 $ 44 $ 361 $ 860 Share-based compensation $ 1,765 $ 263 $ 1,970 $ 3,998

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2023
Accounting Policies [Abstract]
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 ”) for 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 considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three months ended March 31, 2023 and 2022 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2022 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 2022 Form 10-K.
Reclassifications	Reclassifications Increase in cash resulting from changes in income taxes of $0.1 million for the three months ended March 31, 2022, which was separately presented in the unaudited condensed consolidated statement of cash flows in previously-issued financial statements, is included as part of increases and decreases in cash resulting from changes in other assets in the unaudited condensed consolidated statement of cash flows included as part of these financial statements.
Principles of Consolidation	Principles of Consolidation The 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.
Use of Estimates	Use of Estimates 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 consolidated financial statements and the reported 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, estimates of impairment for goodwill and intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, management’s assessment of the Company’s ability to continue as a going concern, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets.
Share-Based Compensation	Share-Based Compensation The Company grants share-based awards to employees and members of the Company’s Board of Directors (the “ Board ”). Awards to employees and the Board are generally made annually. Grants are issued outside of the annual cadence for certain new hires, promotions, and other events. The amount of expense to be recognized is determined by the fair value of the award using inputs available as of the grant date. The fair value of non-option share awards that are not subject to a market condition is the value of the common stock on the grant date. For non-option share awards that are subject to a market condition, the fair value of the common stock on the grant date is adjusted to reflect the value of the market condition, generally using a path-dependent pricing model, such as a Monte Carlo simulation. The fair value of stock option grants is estimated using an option pricing model, as appropriate based on the terms of the grant. Use of a valuation model requires management to make certain assumptions with respect to selected model inputs, which generally follows the inputs to a Black-Scholes option pricing model. Absent the availability of an option market with similar terms to the awarded options, the Company uses the historical volatility of daily price changes in its share price for a period equal to the contractual or expected term of the option, as applicable, subject to adjustment for price activity associated with certain events which are not expected to recur during the relevant term to infer an expectation of volatility. The expected term is derived based on the Company’s expectations for option exercise by the recipients. The Company uses U.S. Treasury yields with a maturity similar to the expected or contractual term, as applicable, as the basis for its risk-free interest rate assumption. The Company has never declared a dividend on its common stock and, therefore, assumes a dividend yield of 0%. For awards with service-based vesting conditions only, the Company recognizes share-based compensation expense on a straight-line basis through the vesting date of the last tranche of the award. For awards which vest based on more than a service condition, the Company recognizes share-based compensation expense using a graded-vesting method, treating each tranche as if it were a separately-granted award and recognizing expense through the vesting date of each individual tranche. In each scenario, the Company recognizes share-based compensation expense to the extent associated service and performance conditions are considered probable to occur. Determinations of probability are made during each reporting period and use available evidence considered relevant for the particular performance condition. The Company recognizes the cumulative effect of changes in the probability of occurrence in the period of re-evaluation. The probability and ultimate resolution of market conditions is not considered in expense recognition. Consequently, the Company could recognize expense for awards that do not ultimately vest.
Basic and Diluted Net Loss Per Common Share	Basic and Diluted Net Loss Per Common Share Basic net loss per common share is calculated as net loss available to common stockholders divided by the weighted average common shares outstanding for the applicable period. Net loss available to common stockholders is calculated by adjusting net loss for periodic accumulated dividends on the Company’s Series B Convertible Preferred Stock (“ Series B Preferred Stock ”). This amount is divided by the weighted average common shares outstanding during the period. Weighted average common shares outstanding is calculated as shares of the Company outstanding adjusted for the portion of the period for which they are outstanding. Unvested non-option share awards are excluded from the calculation of weighted average common shares outstanding until they have vested. Unvested stock options are excluded from the calculation of weighted average common shares outstanding until they are exercised. Shares issuable pursuant to the Company’s Employee Stock Purchase Plan (“ ESPP ”) are included for the minimum number of shares issuable beginning at the point in time that all contingencies for share issuance are resolved. Diluted net loss per common share adjusts basic net loss per common share for convertible securities, options, equity incentive awards, and other share-based payment awards which have yet to vest and vest only on the satisfaction of a service condition. Equity incentive awards and options that are subject to a performance or market condition are included only if the performance or market condition would be satisfied if the end of the applicable period were the end of the performance period. In any case, these adjustments are reflected in the calculation of diluted net loss per common share to the extent that they reduce basic net loss per common share. The Company uses the if-converted method to calculate the dilutive effect of the Series B Preferred Stock and other convertible securities to the extent they are outstanding. The if-converted method assumes that convertible securities are converted at the later of the issuance date and the beginning of the period. If the hypothetical conversion of convertible securities, and the consequential avoidance of any accumulated preferred dividends, would decrease basic net loss per common share, these effects are incorporated in the calculation of diluted net loss per common share, adjusted for the portion of the period the securities were outstanding. The Company uses the treasury stock method to calculate the dilutive effect of options, non-option share awards, and certain other share-based payments. The treasury stock method assumes that the proceeds from exercise are used to repurchase common shares at the weighted average market price during the period, increasing the denominator for the net effect of shares issued upon exercise less hypothetical shares repurchased. Share-based payment awards which are subject to a performance or market condition are included if or to the extent that the applicable performance or market condition has been resolved as if the end of the applicable reporting period were the end of the applicable performance period. Shares issuable pursuant to the ESPP are included in the calculation of diluted net loss per common share to the extent that such shares would be issued based on the share price at the conclusion of the period, to the extent such shares are not already included in the calculation of weighted average common shares outstanding.
Recently Issued Accounting Standards Not Yet Adopted	Recently Issued Accounting Standards Not Yet Adopted All ASUs issued and not yet effective for the three months ended March 31, 2023, 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 and results of operations.
Segment Reporting	The accounting policies of the segments are the same as the Company’s accounting policies. See Note 2, Significant Accounting Policies , included in the 2022 Form 10-K. The Company evaluates the performance of its segments and allocates resources based on segment contribution, defined as net sales less (i) cost of sales, (ii) selling, general and administrative expense, (iii) research and development expense, and (iv) amortization of intangible assets. Prior period results were recast on the basis of new operating segments. The only components which comprise loss before income tax provision that are not included in operating loss are interest expense, net and other expense, net. The Company does not allocate any assets to the reportable segments. No asset information is reported or disclosed to the chief operating decision maker in the financial information for each segment.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	3 Months Ended
	Mar. 31, 2023
Receivables [Abstract]
Schedule of Accounts, Notes, Loans and Financing Receivable	Accounts receivable, net, consisted of the following (in thousands): March 31, 2023 December 31, 2022 Accounts receivable, gross $ 48,295 $ 46,867 Less: allowance for doubtful accounts (3,601) (3,783) Accounts receivable, net $ 44,694 $ 43,084
Schedule of Activity Related to the Allowance for Doubtful Accounts	Activity related to the Company’s allowance for doubtful accounts for the three months ended March 31, 2023 was as follows (in thousands): Allowance for Doubtful Accounts Balance at December 31, 2022 $ 3,783 Bad debt expense (60) Write-offs (122) Balance at March 31, 2023 $ 3,601

Inventory (Tables)

Inventory (Tables)	3 Months Ended
	Mar. 31, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consisted of the following (in thousands): March 31, 2023 December 31, 2022 Raw materials $ 896 $ 810 Work in process 6,087 6,855 Finished goods 7,674 5,518 Inventory $ 14,657 $ 13,183

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	3 Months Ended
	Mar. 31, 2023
Property, Plant and Equipment [Abstract]
Summary of Property and Equipment	Property and equipment, net, consisted of the following (in thousands): March 31, 2023 December 31, 2022 Laboratory and clean room equipment $ 16,955 $ 16,422 Furniture and equipment 15,016 15,016 Leasehold improvements 9,190 9,190 Construction in progress 1,889 1,983 Asset retirement cost 963 983 Finance lease right-of-use asset 189 189 Property and equipment, gross 44,202 43,783 Less: accumulated depreciation and amortization (36,640) (35,927) Property and equipment, net $ 7,562 $ 7,856
Schedule of Depreciation Expense	Depreciation expense for the three months ended March 31, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended March 31, 2023 2022 Depreciation expense $ 714 $ 860

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	3 Months Ended
	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets Activity Summary - Indefinite-lived	Intangible assets, net, are summarized as follows (in thousands): March 31, 2023 December 31, 2022 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,963 $ (7,282) $ 2,681 $ 9,923 $ (7,106) $ 2,817 Licenses 1,000 (17) 983 1,000 (4) $ 996 Total amortized intangible assets $ 10,963 $ (7,299) $ 3,664 $ 10,923 $ (7,110) $ 3,813 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 1,034 1,034 1,031 1,031 Total intangible assets $ 13,005 $ 5,706 $ 12,962 $ 5,852
Schedule of Intangible Assets Activity Summary - Finite-lived	Amortization expense three months ended March 31, 2023 and 2022 is summarized in the table below (in thousands): Three Months Ended March 31, 2023 2022 Amortization expense $ 190 $ 172
Schedule of Estimated Future Amortization Expense for Intangible Assets	Expected future amortization of intangible assets as of March 31, 2023, is as follows (in thousands): Year ending December 31, Estimated 2023 (excluding the three months ended March 31, 2023) $ 569 2024 759 2025 364 2026 209 2027 209 Thereafter 1,554 Total amortized intangible assets $ 3,664

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2023
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued expenses consisted of the following (in thousands): March 31, 2023 December 31, 2022 Legal and settlement costs $ 6,302 $ 4,447 Commissions to sales agents 3,060 2,941 Accrued rebates 874 707 Accrued group purchasing organization fees 643 638 Estimated sales returns 610 659 Accrued travel 287 566 Accrued clinical trials 90 90 Other 1,175 976 Accrued expenses $ 13,041 $ 11,024

Long Term Debt, Net (Tables)

Long Term Debt, Net (Tables)	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Schedule of Debt	The balances of the Term Loan as of March 31, 2023 and December 31, 2022 were as follows (in thousands): March 31, 2023 December 31, 2022 Outstanding principal $ 50,000 $ 50,000 Deferred financing costs (1,114) (1,219) Original issue discount (172) (187) Long term debt, net $ 48,714 $ 48,594
Schedule of Interest Expense	Interest expense related to the Term Loan, included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2023 2022 Stated interest $ 1,436 $ 1,031 Amortization of deferred financing costs 105 97 Accretion of original issue discount 16 15 Interest expense $ 1,557 $ 1,143
Schedule of Future Principal Payments for the Term Loan	A summary of principal payments due on the Term Loan, by year, from March 31, 2023 through maturity are as follows (in thousands): Year ending December 31, Principal 2023 (excluding the three months ended March 31, 2023) $ — 2024 — 2025 50,000 2026 — 2027 — Thereafter — Outstanding principal $ 50,000

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Basic Net Loss Per Common Share	The following table provides a reconciliation of net loss to net loss available to common stockholders and calculation of basic net loss per common share for each of the three months ended March 31, 2023 and 2022 (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Net loss $ (4,983) $ (10,489) Accumulated dividends on Series B Preferred Stock 1,684 1,586 Net loss available to common stockholders $ (6,667) $ (12,075) Weighted average common shares outstanding 114,398,813 111,615,839 Basic net loss per common share $ (0.06) $ (0.11)
Diluted Net Loss Per Common Share	The following table sets forth the computation of diluted net loss per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2023 2022 Net loss available to common stockholders $ (6,667) $ (12,075) Adjustments: Accumulated dividends on Series B Convertible Preferred Stock 1,684 1,586 Less: antidilutive adjustments (1,684) (1,586) Total adjustments — — Numerator $ (6,667) $ (12,075) Weighted average shares outstanding 114,398,813 111,615,839 Adjustments Potential common shares 30,151,138 29,459,846 Less: antidilutive potential common shares (a) (30,151,138) (29,459,846) Total adjustments — — Weighted average shares outstanding adjusted for potential common shares 114,398,813 111,615,839 Diluted net loss per common share $ (0.06) $ (0.11) (a) Weighted average common shares outstanding for the calculation of diluted net loss per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented.
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	Three Months Ended March 31, 2023 2022 Series B Convertible Preferred Stock 29,559,946 27,850,916 Restricted stock unit awards 567,167 822,642 Restricted stock awards 13,133 597,805 Employee stock purchase plan 5,740 — Performance stock unit awards 5,152 — Outstanding stock options — 188,483 Potential common shares 30,151,138 29,459,846

Equity (Tables)

Equity (Tables)	3 Months Ended
	Mar. 31, 2023
Equity [Abstract]
Summary of Restricted Stock Awards by Award Type	The below table summarizes activity of unvested Equity Incentive Awards by award type from January 1, 2023 through March 31, 2023. RSA RSU PSU Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Number of Weighted-Average Grant Date Unvested at January 1, 2023 122,755 $ 6.13 4,774,971 $ 6.28 241,072 $ 4.62 Granted — — 2,792,086 4.42 3,689,427 3.72 Vested — — (1,497,446) 6.96 — — Forfeited (58,104) 5.77 (421,701) 6.34 (59,524) 4.62 Unvested at March 31, 2023 64,651 $ 6.47 5,647,910 $ 5.18 3,870,975 $ 3.76
Summary of Stock Options Activity	A summary of stock option activity for the three months ended March 31, 2023 is presented below: Number of Weighted- Weighted- Aggregate Outstanding at January 1, 2023 933,894 $ 6.46 Granted 3,600,000 3.70 Exercised — — Unvested options forfeited — — Vested options expired (289,231) 5.44 Outstanding at March 31, 2023 4,244,663 4.19 6.51 — Exercisable at March 31, 2023 644,663 $ 6.91 0.92 $ —
Schedule of Valuation Assumptions	The Company estimated the fair value of the awards using a Monte Carlo simulation using the following assumptions: Assumption Stock price on grant date $ 3.70 Exercise price $ 3.70 Risk-free interest rate 3.58 % Expected volatility (annualized) 75.00 % Dividend yield — % Weighted average grant date fair value $ 1.93

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Tables)	3 Months Ended
	Mar. 31, 2023
Supplemental Cash Flow Elements [Abstract]
Schedule of 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): Three Months Ended March 31, 2023 2022 Cash paid for interest $ 1,452 $ 1,034 Cash paid for income taxes — — Non-cash activities: Purchases of equipment in accounts payable 223 287 Issuance of shares pursuant to employee stock purchase plan 680 — Right of use assets arising from operating lease liabilities — (37)

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	Below is a summary of net sales by class of product (in thousands): Three Months Ended March 31, 2023 2022 Advanced Wound Care Tissue/Other $ 65,771 $ 52,852 Cord 5,439 5,597 Total Advanced Wound Care 71,210 58,449 Section 351 (1) 466 445 Total $ 71,676 $ 58,894 (1) Revenue recognized from collections relating to revenue transactions for which performance obligations were fulfilled prior to October 1, 2019, the date at which the Company changed its pattern of revenue recognition, for the three months ended March 31, 2022 of $0.1 million, which were separately presented in previously-issued financial statements, are presented as part of Section 351 in the table above. Below is a summary of net sales by site of service (in thousands): Three Months Ended March 31, 2023 2022 Hospital $ 42,171 $ 35,981 Private Office 21,487 16,157 Other 8,018 6,756 Total $ 71,676 $ 58,894

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2023
Segment Reporting [Abstract]
Schedule of Net Sales and Segment Contribution for Each Reportable Segment	Net sales and segment contribution by each reportable segment for the three months ended March 31, 2023 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 70,629 — $ 1,047 $ 71,676 Cost of sales 11,332 — 1,087 12,419 Selling, general and administrative expense 37,666 — 14,613 52,279 Research and development expense 1,522 4,974 — 6,496 Amortization of intangible assets — — 190 190 Segment contribution $ 20,109 $ (4,974) Investigation, restatement and related expense 3,673 Operating loss $ (3,381) Supplemental information Depreciation expense $ 389 $ 64 $ 261 $ 714 Share-based compensation $ 1,383 $ 452 $ 2,510 $ 4,345 Net sales and segment contribution by each reportable segment for the three months ended March 31, 2022 were as follows (in thousands): Wound & Surgical Regenerative Medicine Corporate & Other Consolidated Net sales $ 58,330 $ — $ 564 $ 58,894 Cost of sales 9,129 — 807 9,936 Selling, general and administrative expense 34,044 — 15,526 49,570 Research and development expense 1,951 4,013 — 5,964 Amortization of intangible assets — — 172 172 Segment contribution $ 13,206 $ (4,013) Investigation, restatement and related expense 2,552 Operating loss $ (9,300) Supplemental information Depreciation expense $ 455 $ 44 $ 361 $ 860 Share-based compensation $ 1,765 $ 263 $ 1,970 $ 3,998

Nature of Business (Details)

Nature of Business (Details)	3 Months Ended
	Mar. 31, 2023 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of reportable segments	2

Significant Accounting Polici_3

Significant Accounting Policies (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Dividends Payable [Line Items]
Increase in cash resulting from changes in income tax		$ 0.1
Stock Options
Dividends Payable [Line Items]
Expected dividend yield	0%

Accounts Receivable, Net - Acco

Accounts Receivable, Net - Accounts Receivable (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Accounts receivable, gross	$ 48,295	$ 46,867
Less: allowance for doubtful accounts	(3,601)	(3,783)
Accounts receivable, net	$ 44,694	$ 43,084

Accounts Receivable, Net - Sche

Accounts Receivable, Net - Schedule of Activity Related to the Allowance for Doubtful Accounts (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Allowance for Doubtful Accounts
Beginning balance	$ 3,783,000
Bad debt expense	(60,000)	$ 0
Write-offs	(122,000)
Ending balance	$ 3,601,000

Accounts Receivable, Net - Narr

Accounts Receivable, Net - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Receivables [Abstract]
Bad debt expense	$ (60,000)	$ 0

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 896	$ 810
Work in process	6,087	6,855
Finished goods	7,674	5,518
Inventory	$ 14,657	$ 13,183

Property and Equipment, Net - S

Property and Equipment, Net - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Finance lease right-of-use asset	$ 189	$ 189
Property and equipment, gross	44,202	43,783
Less: accumulated depreciation and amortization	(36,640)	(35,927)
Property and equipment, net	7,562	7,856
Laboratory and clean room equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	16,955	16,422
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,016	15,016
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9,190	9,190
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,889	1,983
Asset retirement cost
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 963	$ 983

Property and Equipment, Net - D

Property and Equipment, Net - Depreciation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 714	$ 860

Intangible Assets, Net - Activi

Intangible Assets, Net - Activity Summary (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 10,963	$ 10,923
Accumulated Amortization	(7,299)	(7,110)
Net Carrying Amount	3,664	3,813
Indefinite-lived Intangible Assets [Line Items]
Intangible assets, gross carrying amount	13,005	12,962
Intangible assets, net carrying amount	5,706	5,852
Tradenames and trademarks
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,008	1,008
Patents in Process
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,034	1,031
Patents and know-how
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	9,963	9,923
Accumulated Amortization	(7,282)	(7,106)
Net Carrying Amount	2,681	2,817
Licenses
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,000	1,000
Accumulated Amortization	(17)	(4)
Net Carrying Amount	$ 983	$ 996

Intangible Assets, Net - Amorti

Intangible Assets, Net - Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 190	$ 172

Intangible Assets, Net - Estima

Intangible Assets, Net - Estimated Future Amortization Expense for Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Estimated future amortization expense [Abstract]
2023 (excluding the three months ended March 31, 2023)	$ 569
2024	759
2025	364
2026	209
2027	209
Thereafter	1,554
Net Carrying Amount	$ 3,664	$ 3,813

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Legal and settlement costs	$ 6,302	$ 4,447
Commissions to sales agents	3,060	2,941
Accrued rebates	874	707
Accrued group purchasing organization fees	643	638
Estimated sales returns	610	659
Accrued travel	287	566
Accrued clinical trials	90	90
Other	1,175	976
Accrued expenses	$ 13,041	$ 11,024

Long Term Debt, Net - Term Loan

Long Term Debt, Net - Term Loan (Details) - Term loan - Hayfin Loan Agreement Term Loan - USD ($)	Feb. 28, 2022	Mar. 31, 2023	Jul. 02, 2020
Debt Instrument [Line Items]
Principal issued			$ 50,000,000
Effective interest rate		11.90%
Fair value of the Term Loan		$ 48,100,000
London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Debt instrument, interest rate, floor	1.50%
Debt instrument, basis spread on variable rate	6.75%
Minimum | Federal Funds Rate
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	0.50%
Maximum
Debt Instrument [Line Items]
Interest rate	2.50%

Long Term Debt, Net - Term Lo_2

Long Term Debt, Net - Term Loan Balances (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Outstanding principal	$ 50,000
Term loan | Hayfin Loan Agreement Term Loan
Debt Instrument [Line Items]
Outstanding principal	50,000	$ 50,000
Deferred financing costs	(1,114)	(1,219)
Original issue discount	(172)	(187)
Long term debt, net	$ 48,714	$ 48,594

Long Term Debt, Net - Term Lo_3

Long Term Debt, Net - Term Loan Interest Expense (Details) - Term loan - Hayfin Loan Agreement Term Loan - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Debt Instrument [Line Items]
Stated interest	$ 1,436	$ 1,031
Amortization of deferred financing costs	105	97
Accretion of original issue discount	16	15
Interest expense	$ 1,557	$ 1,143

Long Term Debt, Net - Term Lo_4

Long Term Debt, Net - Term Loan Maturity (Details) $ in Thousands	Mar. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2023 (excluding the three months ended March 31, 2023)	$ 0
2024	0
2025	50,000
2026	0
2027	0
Thereafter	0
Outstanding principal	$ 50,000

Net Loss Per Common Share - Bas

Net Loss Per Common Share - Basic Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Net loss	$ (4,983)	$ (10,489)
Accumulated dividends on Series B Preferred Stock	1,684	1,586
Net loss available to common stockholders	$ (6,667)	$ (12,075)
Weighted average common shares outstanding	114,398,813	111,615,839
Basic net loss per common share (in dollars per share)	$ (0.06)	$ (0.11)

Net Loss Per Common Share - Dil

Net Loss Per Common Share - Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Earnings Per Share [Abstract]
Net loss available to common stockholders	$ (6,667)	$ (12,075)
Accumulated dividends on Series B Convertible Preferred Stock	1,684	1,586
Less: antidilutive adjustments	(1,684)	(1,586)
Numerator	$ (6,667)	$ (12,075)
Weighted average common shares outstanding	114,398,813	111,615,839
Potential common shares	30,151,138	29,459,846
Less: antidilutive potential common shares	(30,151,138)	(29,459,846)
Weighted average shares outstanding adjusted for potential common shares	114,398,813	111,615,839
Diluted net loss per common share (in dollars per share)	$ (0.06)	$ (0.11)

Net Loss Per Common Share - Ant

Net Loss Per Common Share - Antidilutive Securities (Details) - shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	30,151,138	29,459,846
Series B Convertible Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	29,559,946	27,850,916
Restricted stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	567,167	822,642
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	13,133	597,805
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	5,740	0
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	5,152	0
Stock Options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares	0	188,483

Equity - Narrative (Details)

Equity - Narrative (Details) $ / shares in Units, $ in Millions		3 Months Ended
	Jan. 27, 2023 USD ($) trading_day $ / shares shares	Mar. 31, 2023 USD ($) $ / shares shares
Dividends Payable [Line Items]
Options granted in period (in shares) | shares		3,600,000
Granted (in dollars per share) | $ / shares		$ 3.70
Executive Officer
Dividends Payable [Line Items]
Options granted in period (in shares) | shares	3,600,000
Granted (in dollars per share) | $ / shares	$ 3.70
Trading days (in days) | trading_day	20
Grant date fair value | $	$ 7
Executive Officer | Share-Based Payment Arrangement, Tranche One
Dividends Payable [Line Items]
Vesting percentage	25%
Award vesting percentage if performance metrics are achieved	0.333%
Executive Officer | Share-Based Payment Arrangement, Tranche Two
Dividends Payable [Line Items]
Vesting percentage	25%
Award vesting percentage if performance metrics are achieved	0.333%
Executive Officer | Share-Based Payment Arrangement, Tranche Three
Dividends Payable [Line Items]
Vesting percentage	25%
Award vesting percentage if performance metrics are achieved	0.333%
Executive Officer | Share-Based Payment Arrangement, Tranche Four
Dividends Payable [Line Items]
Vesting percentage	25%
Restricted Stock, Restricted Stock Units, And Performance Stock Units
Dividends Payable [Line Items]
Total unrecognized stock-based compensation related to time-based, nonvested restricted stock | $		$ 34.8
Expenses expected to be recognized over a weighted-average period (in years)		2 years 6 months 29 days
Performance stock unit awards
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares		3,689,427
Performance stock unit awards | Executive Officer
Dividends Payable [Line Items]
Awards granted in period (in shares) | shares	3,300,000
Performance achievement percentage threshold in order to vest	50%
Share based compensation expense | $		$ 0.3
Performance stock unit awards | Executive Officer | Minimum
Dividends Payable [Line Items]
Percentage of granted shares to vest	50%
Performance stock unit awards | Executive Officer | Maximum
Dividends Payable [Line Items]
Percentage of granted shares to vest	200%
Stock Options | Executive Officer
Dividends Payable [Line Items]
Share based compensation expense | $		0.5
Series B Convertible Preferred Stock
Dividends Payable [Line Items]
Dividends accumulated but not paid | $		$ 15.5
Convertible shares issuable (in shares) | shares		29,997,271

Equity - Restricted Stock Award

Equity - Restricted Stock Awards (Details)	3 Months Ended
	Mar. 31, 2023 $ / shares shares
RSA
Number of Shares
Unvested, Beginning Balance (in shares) | shares	122,755
Granted (in shares) | shares	0
Vested (in shares) | shares	0
Forfeited (in shares) | shares	(58,104)
Unvested, Ending Balance (in shares) | shares	64,651
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 6.13
Granted (in dollars per share) | $ / shares	0
Vested (in dollars per share) | $ / shares	0
Forfeited (in dollars per share) | $ / shares	5.77
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 6.47
RSU
Number of Shares
Unvested, Beginning Balance (in shares) | shares	4,774,971
Granted (in shares) | shares	2,792,086
Vested (in shares) | shares	(1,497,446)
Forfeited (in shares) | shares	(421,701)
Unvested, Ending Balance (in shares) | shares	5,647,910
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 6.28
Granted (in dollars per share) | $ / shares	4.42
Vested (in dollars per share) | $ / shares	6.96
Forfeited (in dollars per share) | $ / shares	6.34
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 5.18
PSU
Number of Shares
Unvested, Beginning Balance (in shares) | shares	241,072
Granted (in shares) | shares	3,689,427
Vested (in shares) | shares	0
Forfeited (in shares) | shares	(59,524)
Unvested, Ending Balance (in shares) | shares	3,870,975
Weighted-Average Grant Date Fair Value
Unvested, Beginning Balance (in dollars per share) | $ / shares	$ 4.62
Granted (in dollars per share) | $ / shares	3.72
Vested (in dollars per share) | $ / shares	0
Forfeited (in dollars per share) | $ / shares	4.62
Unvested, Ending Balance (in dollars per share) | $ / shares	$ 3.76

Equity - Options (Details)

Equity - Options (Details) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($) $ / shares shares
Number of Shares
Outstanding, beginning of period (in shares) | shares	933,894
Granted (in shares) | shares	3,600,000
Exercised (in shares) | shares	0
Unvested options forfeited (in shares) | shares	0
Vested options expired (in shares) | shares	(289,231)
Outstanding, end of period (in shares) | shares	4,244,663
Exercisable options, vested and expected to vest (in shares) | shares	644,663
Weighted- Average Exercise Price
Outstanding, beginning of period (in dollars per share) | $ / shares	$ 6.46
Granted (in dollars per share) | $ / shares	3.70
Exercised (in dollars per share) | $ / shares	0
Unvested options forfeited (in dollars per share) | $ / shares	0
Vested options expired (in dollars per share) | $ / shares	5.44
Outstanding, end of period (in dollars per share) | $ / shares	4.19
Exercisable (in dollars per share) | $ / shares	$ 6.91
Weighted- Average Remaining Contractual Term (in years)
Outstanding	6 years 6 months 3 days
Exercisable	11 months 1 day
Aggregate Intrinsic Value
Outstanding | $	$ 0
Exercisable | $	$ 0

Equity - Fair Value Assumptions

Equity - Fair Value Assumptions (Details) - Stock option	3 Months Ended
	Mar. 31, 2023 $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	0%
Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock price on grant date (in dollars per share)	$ 3.70
Exercise price (in dollars per share)	$ 3.70
Risk-free interest rate	3.58%
Expected volatility (annualized)	75%
Dividend yield	0%
Weighted average grant date fair value (in dollars per share)	$ 1.93

Income Taxes (Details)

Income Taxes (Details)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Effective tax rate	(1.00%)	(0.60%)

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest	$ 1,452	$ 1,034
Cash paid for income taxes	0	0
Non-cash activities:
Purchases of equipment in accounts payable	223	287
Issuance of shares pursuant to employee stock purchase plan	680	0
Right of use assets arising from operating lease liabilities	$ 0	$ (37)

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions			1 Months Ended	3 Months Ended
	Dec. 07, 2022 USD ($)	Jan. 16, 2019 class_action	Jun. 30, 2022 USD ($)	Mar. 31, 2023 USD ($)	Sep. 15, 2022 USD ($)
Loss Contingencies [Line Items]
Payments for legal settlements				$ 0.2
Number of securities class actions | class_action		2
Turn Therapeutics
Loss Contingencies [Line Items]
Long-term purchase commitment amount	$ 9.6
Research and Development Arrangement | Nordic Bioscience Clinical Development A/S
Loss Contingencies [Line Items]
Long-term purchase commitment amount			$ 10.2
Payments made on long-term purchase commitment				3.6
Expenses on long-term purchase commitment				0.6
Remaining prepaid expenses on long-term purchase commitment				2.2
Chief Executive Officer | Separation Agreement
Loss Contingencies [Line Items]
Other commitment				3.1	$ 3.1
Other commitments paid				0.9
Other Commitment, Current				1.6
Other Commitment, Noncurrent				$ 0.6

Revenue - Summary of Revenue by

Revenue - Summary of Revenue by Product Type (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($) product	Mar. 31, 2022 USD ($)
Revenue from Contract with Customer [Abstract]
Number of products | product	2
Revenue, Major Customer [Line Items]
Net sales	$ 71,676	$ 58,894
Advanced Wound Care
Revenue, Major Customer [Line Items]
Net sales	71,210	58,449
Tissue/Other
Revenue, Major Customer [Line Items]
Net sales	65,771	52,852
Cord
Revenue, Major Customer [Line Items]
Net sales	5,439	5,597
Section 351
Revenue, Major Customer [Line Items]
Net sales	$ 466	445
Other
Revenue, Major Customer [Line Items]
Net sales		$ 100

Revenue - Summary of Revenue _2

Revenue - Summary of Revenue by Site Of Service (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2023 USD ($) service_site	Mar. 31, 2022 USD ($)
Revenue from Contract with Customer [Abstract]
Number of sites of service | service_site	3
Revenue, Major Customer [Line Items]
Net sales	$ 71,676	$ 58,894
Hospital
Revenue, Major Customer [Line Items]
Net sales	42,171	35,981
Private Office
Revenue, Major Customer [Line Items]
Net sales	21,487	16,157
Other
Revenue, Major Customer [Line Items]
Net sales	$ 8,018	$ 6,756

Segment Information - Narrative

Segment Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2023 segment
Segment Reporting [Abstract]
Number of reportable segments	2

Segment Information - Net Sales

Segment Information - Net Sales and Operating Income (Loss) by each Reportable Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Net sales	$ 71,676	$ 58,894
Cost of sales	12,419	9,936
Selling, general and administrative expense	52,279	49,570
Research and development expense	6,496	5,964
Amortization of intangible assets	190	172
Investigation, restatement and related expense	3,673	2,552
Operating loss	(3,381)	(9,300)
Supplemental Information [Abstract]
Depreciation expense	714	860
Share-based compensation	4,345	3,998
Corporate & Other
Segment Reporting Information [Line Items]
Net sales	1,047	564
Cost of sales	1,087	807
Selling, general and administrative expense	14,613	15,526
Research and development expense	0	0
Amortization of intangible assets	190	172
Supplemental Information [Abstract]
Depreciation expense	261	361
Share-based compensation	2,510	1,970
Wound & Surgical | Operating Segments
Segment Reporting Information [Line Items]
Net sales	70,629	58,330
Cost of sales	11,332	9,129
Selling, general and administrative expense	37,666	34,044
Research and development expense	1,522	1,951
Amortization of intangible assets	0	0
Segment contribution	20,109	13,206
Supplemental Information [Abstract]
Depreciation expense	389	455
Share-based compensation	1,383	1,765
Regenerative Medicine | Operating Segments
Segment Reporting Information [Line Items]
Net sales	0	0
Cost of sales	0	0
Selling, general and administrative expense	0	0
Research and development expense	4,974	4,013
Amortization of intangible assets	0	0
Segment contribution	(4,974)	(4,013)
Supplemental Information [Abstract]
Depreciation expense	64	44
Share-based compensation	$ 452	$ 263