Fuse Medical (FZMD) 10-K 31 Mar 22 2021 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2021	Mar. 21, 2022	Jun. 30, 2020
Cover [Abstract]
Entity Registrant Name	Fuse Medical, Inc.
Entity Central Index Key	0000319016
Document Type	10-K
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 2021
Document Fiscal Year Focus	2021
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Is Entity a Well-known Seasoned Issuer	No
Is Entity a Voluntary Filer	No
Is Entity's Reporting Status Current	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Public Float			$ 1,086,529
Entity Common Stock, Shares Outstanding		72,895,793
Document Fiscal Period Focus	FY
Entity Small Business	true
Entity Shell Company	false
Entity Emerging Growth Company	false
Entity Tax Identification Number	59-1224913
Entity File Number	000-10093
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	1565 N. Central Expressway
Entity Address, Address Line Two	Suite 220
Entity Address, City or Town	Richardson
Entity Address, State or Province	TX
Entity Address, Postal Zip Code	75080
City Area Code	469
Local Phone Number	862-3030
ICFR Auditor Attestation Flag	false
Auditor Firm ID	32
Auditor Name	Armanino LLP
Auditor Location	Dallas, TX, US
Title of 12(b) Security	Common Stock
Trading Symbol	FZMD

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($)	Dec. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 553,190	$ 1,187,458
Accounts receivable, net of allowance of $498,261 and $787,766, respectively	3,528,992	4,427,896
Inventories, net of allowance of $2,491,183 and $3,077,728, respectively	8,736,474	6,981,413
Prepaid expenses and other current assets	5,921	24,203
Total current assets	12,824,577	12,620,970
Property and equipment, net	7,251	17,791
Long term accounts receivable, net of allowance of $3,355,391 and $2,615,834, respectively	2,182,437	1,669,510
Intangible assets, net	1,317,341	1,138,080
Goodwill	1,972,886	1,972,886
Total assets	18,304,492	17,419,237
Current liabilities:
Accounts payable	4,461,641	3,236,592
Accrued expenses	2,898,068	2,584,734
Convertible notes payable - related parties	150,000	150,000
Payroll Protection Program loan		361,400
Economic Injury Disaster Loan - short term portion		2,241
Senior secured revolving credit facility	2,432,770	913,352
Total current liabilities	9,942,479	7,248,319
Notes payable - related parties	200,000	200,000
Economic Injury Disaster Loan - long term portion		147,759
Earn-out liability	11,593,832	11,936,000
Total liabilities	21,736,311	19,532,078
Commitments and contingencies
Stockholders’ equity (accumulated deficit):
Preferred stock, $0.01 par value; 20,000,000 shares authorized; no shares issued and outstanding
Common stock, $0.01 par value; 100,000,000 shares authorized; 72,895,793 and 73,124,458 shares issued and outstanding as of December 31, 2021 and 2020	728,958	731,245
Additional paid-in capital	1,455,422	1,184,222
Accumulated deficit	(5,616,199)	(4,028,308)
Total stockholders’ equity (accumulated deficit)	(3,431,819)	(2,112,841)
Total liabilities and stockholders’ equity (accumulated deficit)	$ 18,304,492	$ 17,419,237

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($)	Dec. 31, 2021	Dec. 31, 2020
Statement Of Financial Position [Abstract]
Net of allowance, accounts receivable	$ 498,261	$ 787,766
Net of allowance, inventories	2,491,183	3,077,728
Net of allowance, long term receivable	$ 3,355,391	$ 2,615,834
Preferred Stock Par Value	$ 0.01	$ 0.01
Preferred Stock Shares Authorized	20,000,000	20,000,000
Preferred Stock Shares Issued	0	0
Preferred Stock Shares Outstanding	0	0
Common Stock Par Value	$ 0.01	$ 0.01
Common Stock Shares Authorized	100,000,000	100,000,000
Common Stock Shares Issued	72,895,793	73,124,458
Common Stock Shares Outstanding	72,895,793	73,124,458

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Net revenues	$ 20,414,268	$ 21,398,936
Cost of revenues	8,478,561	8,694,713
Gross profit	11,935,707	12,704,223
Operating expenses
Selling, general, administrative and other	7,013,297	6,541,659
Commissions	7,050,278	7,086,335
Depreciation and amortization	67,638	104,143
Total operating expenses	14,131,213	13,732,137
Operating loss	(2,195,506)	(1,027,914)
Other income (expense):
Change in fair value of contingent purchase consideration	342,168	(290,635)
Gain on Payroll Protection Program Loan extinguishment	361,400
Interest expense	(78,230)	(94,953)
Total other income (expense)	625,338	(385,588)
Operating loss before income tax	(1,570,168)	(1,413,502)
Income tax expense	17,723	18,993
Net loss	$ (1,587,891)	$ (1,432,495)
Loss per common share - basic	$ (0.02)	$ (0.02)
Loss per common share - diluted	$ (0.02)	$ (0.02)
Weighted average number of common shares outstanding - basic	70,321,566	70,221,566
Weighted average number of common shares outstanding - diluted	70,321,566	70,221,566

CONSOLIDATED STATEMENT OF CHANG

CONSOLIDATED STATEMENT OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($)	Total	Common Stock [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member]
Beginning Balance, Amount at Dec. 31, 2019	$ (1,222,133)	$ 731,245	$ 642,435	$ (2,595,813)
Beginning Balance, Shares at Dec. 31, 2019		73,124,458
Stock options granted	553,184		553,184
Franchise tax accrual	(11,397)		(11,397)
Net loss	(1,432,495)			(1,432,495)
Ending Balance, Amount at Dec. 31, 2020	(2,112,841)	$ 731,245	1,184,222	(4,028,308)
Ending Balance, Shares at Dec. 31, 2020		73,124,458
Stock options granted	257,913		257,913
Stock options exercised	$ 11,000	$ 1,000	10,000
Stock options exercised, shares	100,000	100,000
Board compensation		$ 1,470	(1,470)
Board compensation, shares		147,058
Restricted stock forfeiture		$ (4,757)	4,757
Restricted stock forfeiture, Shares		(475,723)
Net loss	$ (1,587,891)			(1,587,891)
Ending Balance, Amount at Dec. 31, 2021	$ (3,431,819)	$ 728,958	$ 1,455,422	$ (5,616,199)
Ending Balance, Shares at Dec. 31, 2021		72,895,793

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net loss	$ (1,587,891)	$ (1,432,495)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	67,638	104,143
Change in fair value of contingent purchase consideration	(342,168)	290,635
Stock based compensation	257,913	553,184
Provision for discounts on long term accounts receivable	739,559	1,887,836
Provision for bad debts and discounts	(289,505)	172,488
Provision for slow moving and obsolete inventory	(586,545)	(728,002)
Gain on Payroll Protection Program Loan extinguishment	(361,400)
Changes in operating assets and liabilities:
Accounts receivable	1,188,408	649,269
Inventories	(1,168,516)	1,602,476
Prepaid expenses and other current assets	18,282	15,647
Long term accounts receivable	(1,252,486)	(2,632,698)
Accounts payable	1,225,049	483,738
Accrued expenses	313,334	(729,567)
Net cash provided by/(used in) operating activities	(1,778,328)	236,654
Cash flows from investing activities:
Purchases of property and equipment		(20,757)
Net cash used in investing activities		(20,757)
Cash flows from financing activities:
Net payments/proceeds on Amegy senior secured revolving credit facility	(913,352)	(839,149)
Net payment/proceeds on senior secured revolving credit facility	2,432,770
Payments for senior secured revolving credit facility	(236,358)
Stock options exercised	11,000
Proceeds from related party notes payable		200,000
Net cash provided by/(used in) financing activities	1,144,060	(127,749)
Net increase in cash and cash equivalents	(634,268)	88,148
Cash and cash equivalents - beginning of year	1,187,458	1,099,310
Cash and cash equivalents - end of year	553,190	1,187,458
Supplemental disclosure of cash flow information:
Cash paid for income taxes	19,581	20,000
Cash paid for interest	42,830	62,866
Payrolll Protection Program [Member]
Cash flows from financing activities:
Payroll protection program proceeds		361,400
Economic Injury Disaster Loan Assistance Program [Member]
Cash flows from financing activities:
Economic injury disaster loan payments	(500,000)
Economic injury disaster loan proceeds	$ 350,000	$ 150,000

Nature of Operations

Nature of Operations	12 Months Ended
	Dec. 31, 2021
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Nature of Operations	Note 1. Nature of Operations Overview The Company was initially incorporated in 1968 as American Metals Service, Inc., a Florida corporation. In July 1999, American Metals Service, Inc. changed its name to GolfRounds.com, Inc. and was redomiciled to Delaware through a merger. On December 19, 2016, the Change-in-Control Date, the Company entered into a Stock Purchase Agreement by and between the Company, NC 143 which is controlled by Mr. Brooks, the Company’s Chairman of the Board and President; and RMI, which is owned and controlled by Mr. Reeg, the Company’s Chief Executive Officer and Secretary. The closing of the Stock Purchase Agreement resulted in a change-in-control of the Company whereby Mr. Brooks and Mr. Reeg beneficially acquired approximately 61.4% of the Company’s issued and outstanding shares of Common Stock, immediately after the Change-in-Control Date. On December 31, 2017, the Company completed the acquisition of CPM pursuant to the CPM Acquisition Agreement. Subsequent to the Change-in-Control Date, CPM and Company operations are consolidated. On August 1, 2018, the Company completed the acquisition of Maxim Surgical, pursuant to the Maxim Purchase Agreement. As of the Maxim Closing Date, Maxim and Company operations are consolidated. Nature of Business The Company is a manufacturer, distributor, and wholesaler of medical device implants, offering a broad portfolio of orthopedic implants and biologics including: (i) internal and external fixation products; (ii) upper and lower extremity plating and total joint reconstruction implants; (iii) soft tissue fixation and augmentation for sports medicine procedures; (iv) full spinal implants for trauma, degenerative disc disease and deformity indications; and (v) a wide array of osteo-biologics, regenerative tissues and amniotic tissue, which include human allografts, substitute bone materials, and tendons and regenerative tissues. All of the Company’s medical devices are approved by the FDA for sale in the United States, and all of the Company’s Biologics suppliers are licensed tissue banks accredited by the American Association of Tissue Banks. The Company’s broad portfolio of Orthopedic Implants and Biologics provide high-quality products to assist surgeons with positive patient outcomes and cost-effective solutions for its customers, which include hospitals, medical facilities, and sub-distributors. The Company operates under exclusive and non-exclusive agreements with certain vendors and supply partners in the geographic territories the Company serves. The Company continuously reviews and expands its product lines to ensure that they offer a comprehensive, high-quality and cost-effective selection of Orthopedic Implants and Biologics so that the Company can be more relevant to its customer needs while continuing to grow its existing customer base. Additionally, the Company continues to grow its manufacturing operations, both by internal product development as well as the acquisition of existing FDA cleared devices .

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Significant Accounting Policies	Note 2. Significant Accounting Policies Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries, CPM and Maxim. Intercompany transactions have been eliminated in consolidation. Use of Estimates The preparation of the consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (GAAP), requires the Company’s management to make estimates and assumptions that affect the Company’s reported amounts in the consolidated financial statements. Actual results could differ from those estimates. Significant estimates on the accompanying consolidated financial statements include the allowances for doubtful accounts, valuation of inventories, the Company’s effective income tax rate and the fair value calculations of stock-based compensation, goodwill, finite lived intangibles and the earn-out liability. Segment Reporting In accordance with Accounting Standards Update (“ASU”) No. 280, “Segment Reporting,” the Company uses the management approach for determining its reportable segments. The management approach is based upon the way that management reviews performance and allocates resources. The Company’s Chief Executive Officer serves as the Company’s chief operating decision maker, and his management team reviews operating results on a consolidated basis for purposes of allocating resources and evaluating the financial performance of the Company. The Company has integrated the operations of both CPM and Maxim. Accordingly, the Company has determined that it has one operating segment and, therefore, one reporting segment. Reclassification Long term accounts receivable, net of allowance was previously reported as a component of current assets as accounts receivable, net of allowance, in the Company’s accompanying consolidated balance sheets. Long term accounts receivable reflects Cases where the patient has obtained a letter of protection, (“LOP”). A LOP is a contract that provides that the medical providers will be paid from any proceeds received from settlement of litigation of the underlying cause of action with respect to the event that necessitated medical goods and services. Once the medical provider receives payment, then the medical provider pays the Company’s invoice which payment is generally greater than 365 days from date of service. The LOP provides medical providers with greater certainty of full payment. This reclassification had no effect on the previously reported total assets or net loss. Loss Per Common Share Loss per common share, basic is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of Common Stock, outstanding during the period, without consideration of Common Stock equivalents. Shares of restricted stock are included in the basic weighted-average number of Common Stock outstanding from the time they vest. Diluted loss per common share is computed by dividing net income/(loss) by the weighted-average number of Common Stock equivalents outstanding for the period determined using the treasury stock method. For the years ended December 31, 2021 and 2020, the Company excluded the effects of outstanding stock options, convertible notes and, to the extent in the money, restricted stock as their effects were antidilutive due to the Company’s operating loss during these periods. (See Note 10, “Stockholders’ Equity” for the terms and conditions of restricted stock). Fair Value Measurements Fair value is the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants. The Company classifies assets and liabilities recorded at fair value under the fair value hierarchy based upon the observability of inputs used in valuation techniques. Observable inputs (highest level) reflect market data obtained from independent sources, while unobservable inputs (lowest level) reflect internally developed market assumptions. The fair value measurements are classified under the following hierarchy: Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets and liabilities in active markets; Level 2—Observable inputs, other than quoted market prices, that are either directly or indirectly observable in the marketplace for identical or similar assets and liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market activity that are significant to the fair value of assets or liabilities. In connection with the CPM Acquisition, the Company initially recorded a $19,244,543 liability related to the Earn-Out portion of the purchase consideration. The Company has classified the Earn-Out liability as a Level 3 liability and the fair value of the Earn-Out liability will be evaluated each reporting period and changes in its fair value will be included in the Company’s earnings. The Earn-Out payments are based on the financial performance of the Company between the period of January 1, 2018, and December 31, 2034. The base amount of the Earn-Out is $16,000,000 with an additional bonus payment of $10,000,000. The payments of the base and bonus Earn-Out amounts are subject to the Company meeting certain earnings thresholds as detailed in the CPM Acquisition Agreement. The Earn-Out payments during the Earn-Out period specified above, ranges from $0 to $26,000,000. The fair value of the Earn-Out liability was calculated using the Monte Carlo simulation, which was then applied to estimated Earn-Out payments with a discount rate of three percent (3%). To determine the fair value of the Earn-Out liability, the Company’s management evaluates assumptions that require significant judgement. Significant assumptions used for estimating the Earn-Out liability included: (i) Earnings before interest, taxes, depreciation, and amortization (“EBITDA”) margins increasing from one percent (1%) to ten percent (10%) over the next four years; and (ii) revenue growth of between approximately six percent (6%) to eleven percent (11%) over the next five years, and between approximately two percent (2%) and four percent (4%) thereafter. The Earn-Out liability, which represented contingent consideration associated with the CPM Acquisition, is recorded as a liability. This liability is subject to re-measurement to fair value at each reporting date until the contingency is resolved and the changes in fair value are recognized in the consolidated statements of operations at each reporting period. For the year ended December 31, 2021 and 2020, the Company has determined the earnings threshold as detailed in the CPM Acquisition Agreement was not met and therefore no payments for either the base or bonus Earn-Out tranches would be achieved, based on the Company’s 2021 and 2020 financial performance. The Earn-Out was remeasured to fair value under the probability weighted income approach. As a result, the fair value of the Earn-Out liability was decreased by $342,168 from $11,936,000 to $ 11,593,832 The estimated fair value of certain financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued expenses are carried at historical cost basis, which approximates their fair values because of the short-term nature of these instruments. The recorded values of notes payable approximate their respective fair values based upon their effective interest rates. Financial Instruments The estimated fair value of certain financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued expenses are carried at historical cost basis, which approximates their fair values because of the short-term nature of these instruments. The recorded values of notes payable approximate their respective fair values based upon their effective interest rates. Cash and Cash Equivalents The Company considers highly liquid investments with maturities of three months or less at the time of purchase to be cash equivalents. There were no cash equivalents as of December 31, 2021, and December 31, 2020. The Company’s cash is concentrated in one large financial institution. The amount of cash held at that financial institution may at times exceed federally insured limits of $250,000 per financial institution. The Company has not experienced any financial institution losses from inception through December 31, 2021. As of December 31, 2021 and 2020, there were deposits of $594,536 and $761,671, respectively, which were greater than federally insured limits. Accounts Receivable, net Accounts receivable are non-interest bearing and are stated at gross invoice amounts less an allowance for doubtful accounts receivable and an allowance for contractual discount pricing. Credit is extended to customers based on an evaluation of their financial condition, industry reputation, and other judgmental factors considered by the Company’s management. The Company generally does not require collateral or other security interest to support accounts receivable. Based on trends and specific factors, the customer’s credit terms may be modified, including required payment upon delivery. The Company performs regular on-going credit evaluations of its customers as deemed relevant. As events, trends, and circumstance warrant, the Company’s management estimates the amounts that are more likely than not to be uncollectible. These amounts are recognized as bad debt expense and are reflected within selling, general, administrative and other expenses on the Company’s accompanying consolidated statement of operations. When accounts are deemed uncollectible, they are often referred to the Company’s outside legal firm for litigation. Accounts deemed uncollectible are written-off in the period when the Company has exhausted its efforts to collect overdue and unpaid receivables or otherwise has evaluated other circumstances that indicate that the Company should abandon such efforts. Accounts deemed uncollectible are removed from the Company’s accounts receivable portfolio, with a corresponding offset to the allowance for doubtful accounts receivable. The Company may record additional allowances for doubtful accounts based on known trends and expectations to ensure the Company’s accounts receivable portfolio is recorded at net realizable value. Specific allowances are re-evaluated and adjusted as additional facts and information become available. Previously written-off accounts receivable subsequently collected are recognized as a reduction of bad debt expense when funds are received. The Company’s management estimates its allowance for contractual discount pricing, by evaluating specific accounts where information indicates the customer is offered contractual pricing and discount allowances. In these arrangements, the Company’s management uses assumptions and judgement, based on the best available facts and circumstances to record a specific allowance for the amounts due from those customers. The allowance is offset by a corresponding reduction to revenue. These specific allowances are re-evaluated, analyzed, and adjusted as additional information becomes available to determine the total amount of the allowance. The Company may record additional allowances based on trends and expectations to ensure the Company’s accounts receivable portfolio is recorded at net realizable value. Inventories Inventories are stated at the lower of cost or net realizable value (first-in, first-out) less an allowance for slow-moving inventory, expired inventory, and inventory obsolescence. Inventories consist entirely of finished goods and include internal and external fixation products; upper and lower extremity plating and total joint reconstruction; soft tissue fixation and augmentation for sports medicine procedures; spinal implants for trauma, degenerative disc disease, and deformity indications (collectively, Orthopedic Implants) and osteo-biologics and regenerative tissue which include human allografts, substitute bone materials and tendons, as well as regenerative tissues (collectively, Biologics). The Company reviews the market value of inventories whenever events and circumstances indicate that the carrying value of inventories may not be recoverable from the estimated future sales price less cost of disposal and normal gross profit. In cases where the market values are less than the carrying value, a write-down is recognized equal to an amount by which the carrying value exceeds the net realizable value of inventories. During 2020, the Company revised its estimate for slow moving and obsolete inventory. As a result, the Company’s management decreased the inventory reserve for slow moving and obsolescence by $728,002 to a balance of $3,077,728. In 2021 based on sales activity for the year and inventory on hand at the end of the year, the Company decreased the reserve by $586,545 to a balance of $2,491,183, which is reflected in inventory and cost of revenues on the Company’s consolidated balance sheets and statements of operations, respectively. Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets per the following table. Expenditures for additions and improvements are capitalized, while repairs and maintenance are expensed as incurred. The Company reviews long-lived assets for impairment annually or whenever changes in circumstances indicate that the carrying amount of an asset might not be recoverable. Category Amortization Period Computer equipment 3 years Furniture and fixtures 3 years Office equipment 3 years Software 3 years Upon the retirement or disposition of property and equipment, the related cost and accumulated depreciation is removed. A gain is recorded when consideration received is more than the disposed asset’s cost, net of depreciation, and a loss is recorded when consideration received is less than the disposed asset’s cost, net of depreciation. Long-Lived Assets The Company reviews other long-lived assets for indicators of impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. The evaluation is performed at the lowest level of identifiable cash flows, which is at the individual asset level or the asset group level. The undiscounted cash flows expected to be generated by the related assets are estimated over their useful life based on updated projections. If the evaluation indicates that the carrying amount of the assets may not be recoverable, any potential impairment is measured based upon the fair value of the related assets or asset group as determined by an appropriate market appraisal or other valuation technique. Assets classified as held for sale, if any, are recorded at the lower of carrying amount or fair value less costs to sell. Goodwill and Other Intangible Assets Goodwill is determined based on an acquisition purchase price in excess of the fair value of identified net assets acquired. Intangible assets with lives restricted by contractual, legal or other means are amortized over their useful lives. Goodwill is not amortized but is tested in the fourth quarter each year for impairment, or more frequently if an event occurs or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. The Company performs its annual, or interim, goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. If the carrying value of a reporting unit exceeds its fair value, an impairment charge is recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value. For the years ended December 31, 2021 and 2020 no impairment charge was recognized. Accounting Standards Codification (“ASC”) 350-30-35-18, intangibles assets not subject to amortization, indicates that an intangible asset that is not subject to amortization shall be tested for impairment annually and more frequently if events or changes in circumstances indicate that it is more likely than not that the asset is impaired. The Company’s 510(k) intangible asset has an indefinite life. The Company does not believe that triggering event has occurred as of December 31, 2021. The Company’s intangible assets subject to amortization consist primarily of acquired non-compete agreements and customer relationships. Amortization expense is calculated using the straight-line method over the asset’s expected useful life. Revenue Recognition The Company’s revenues are generated from the sales of Orthopedic Implants and Biologics to support orthopedic surgeries. The Company obtains purchase orders from its customers for the sale of its products which sets forth the general terms and conditions including line item pricing and payment terms (generally due upon receipt). The Company recognizes revenue when its customers obtain control over the assets (generally when the title passes upon shipment or when a product is utilized in a surgery), and it is probable that the Company will collect substantially all the amounts due. Individual promised goods are the Company’s only performance obligation. Due to the nature of its products, the Company’s product returns have been historically immaterial. The Company includes shipping and handling fees in net revenues. Shipping and handling costs associated with outbound freight after control over a product has transferred to a customer are accounted for as a fulfillment cost and are included in cost of goods sold on the Company’s accompanying consolidated statements of operations. Revenue Differentiation The Company measures sales volume based on medical procedures in which the Company’s products are sold and used (Cases). The Company considers Cases resulting from direct sales to medical facilities to be Retail Cases and Cases resulting from sales to third-parties, such as non-medical facilities, distributors, or sub-distributors, to be Wholesale Cases. Some of the Company’s sales for Wholesale Cases are on a consignment basis with a third-party. When consigned, the revenue is not recorded until the device is implanted in a patient during surgery. In the Company’s industry, Retail Cases are typically sold at higher price points than Wholesale Cases, resulting in greater revenue and gross profit per Case. Year Ended December 31, 2021 December 31, 2020 Category Retail $ 18,749,685 $ 19,092,800 Wholesale 1,664,583 2,306,136 Total $ 20,414,268 $ 21,398,936 Cost of Revenues Cost of revenues consists of (i) cost of goods sold, (ii) freight and shipping costs for items sold to customers, (iii) cost of storage, (iv) investment in medical instruments, which are expensed when acquired, (v) inventory shrink, and (vi) an estimate for slow-moving inventory, expired inventory, and inventory obsolescence. Income Taxes As a result of the CPM Acquisition, the Company became the sole managing member of CPM and as a result, began consolidating the financial results of CPM. CPM is treated as a disregarded entity for U.S. federal and most applicable state and local income tax purposes. As a disregarded entity, CPM is not subject to U.S. federal and most applicable state and local income tax purposes. Any taxable income or loss generated by CPM is included in the taxable income or loss of the Company. As a result of the Maxim Acquisition, the Company and Maxim will elect to file a consolidated tax return for the period after acquisition. The Company uses the asset and liability method to compute the differences between the tax basis of assets and liabilities and the related financial amounts. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that more likely than not will be realized. The Company has deferred tax assets and liabilities that reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Deferred tax assets are subject to periodic recoverability assessments. Realization of the deferred tax assets, net of deferred tax liabilities, is principally dependent upon achievement of projected future taxable income. The Company records a liability for uncertain tax positions when it is probable that a loss has been incurred and the amount can be reasonably estimated. As of December 31, 2021 and 2020, the Company had no liabilities for uncertain tax positions. The Company's policy is to recognize interest and penalties related to income tax matters as a component of income tax expense. The Company continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law, and new authoritative rulings. Stock-Based Compensation Stock-based compensation expense is measured at the grant date fair value of the award and is expensed over the requisite service period. For employee stock-based awards, the Company calculates the fair value of the award on the date of grant using the Black-Scholes option pricing model. Determining the fair value of stock-based awards at the grant date under this model requires judgment, including estimating volatility, employee stock option exercise behaviors and forfeiture rates. The assumptions used in calculating the fair value of stock-based awards represent the Company's best estimates, but these estimates involve inherent uncertainties and the application of management judgment. For non-employee stock-based awards, the Company calculates the fair value of the award on the date of grant in the same manner as employee awards, however, the awards are revalued at the end of each reporting period and the pro-rata compensation expense is adjusted accordingly until such time the non-employee award is fully vested, at which time the total compensation recognized to date shall equal the fair value of the stock-based award as calculated on the measurement date, which is the date at which the award recipient’s performance is complete. The estimation of stock-based awards that will ultimately vest requires judgment, and to the extent actual results or updated estimates differ from original estimates, such amounts are recorded as a cumulative adjustment in the period estimates are revised. Recent Accounting Pronouncements The Company considers the applicability and impact of all Accounting Standard Updates (“ASU”) issued, both effective and not yet effective. In February 2016, the Financial Accounting Standards Board (the “FASB”) issued ASU No. 2016-02, “ Leases Other recent accounting pronouncements issued by the FASB, including its Emerging Issues Task Force, the American Institute of Certified Public Accountants, and the SEC did not or are not believed by the Company’s management to have a material impact on the Company's present or future consolidated financial statements.

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2021
Property Plant And Equipment [Abstract]
Property and Equipment	Note 3. Property and Equipment Property and equipment consisted of the following as of December 31, 2021 and 2020: December 31, 2021 December 31, 2020 Computer equipment and software $ 20,249 $ 49,918 Office equipment - - Property and equipment costs 20,249 49,918 Less: accumulated depreciation (12,998 ) (32,127 ) Property and equipment, net $ 7,251 $ 17,791 Depreciation expense for the year ended December 31, 2021 and 2020 was $10,540 and $35,605 respectively. Additionally, $29,669 of fully depreciated assets were retired during 2021.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Note 4. Goodwill and Intangible Assets The following table summarizes the Company’s goodwill and other intangible assets: December 31, 2021 December 31, 2020 Amortization period (years) Intangible assets: 510k product technology $ 704,380 $ 704,380 Indefinite Customer relationships 555,819 555,819 11 CNH Credit Agreement 236,358 - 3 Total intangible assets 1,496,557 1,260,199 Less: accumulated amortization (179,216 ) (122,119 ) Intangible assets, net 1,317,341 1,138,080 Goodwill $ 1,972,886 $ 1,972,886 Indefinite Amortization expense for the years ended December 31, 2021 and 2020 was $57,097 and $68,538 respectively. The Company’s intangible assets subject to amortization consist primarily of acquired non-compete agreements, customer relationships, and costs associated with the preparation of the Credit Agreement. The following is a schedule by year of the Company’s future amortization expense related to the finite-live intangible assets as of December 31, 2021: Year Ended December 31, 2022 $ 129,318 2023 129,318 2024 122,752 2025 50,532 2026 50,530 Beyond 130,511 $ 612,961 The Company performed its annual goodwill impairment test by comparing the fair value of the reporting units with its carrying amount. The fair value of the reporting units was determined utilizing both a discounted cash flow and merger and acquisitions methodology in the conclusion of value. The carrying value exceeded its fair value and no goodwill impairment charge was recognized for 2021 or 2020.

Senior Secured Revolving Credit

Senior Secured Revolving Credit Facility	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Senior Secured Revolving Credit Facility	Note 5. Senior Secured Revolving Credit Facility On December 29, 2017, the Company became party to the RLOC with Amegy Bank. The RLOC established an asset-based senior secured revolving credit facility in the amount of $5,000,000. The RLOC contains customary representation, warranties, covenants, events of default, and is collateralized by substantially all of the Company’s assets. The Company’s Chairman of the Board and President initially personally guaranteed fifty percent (50%) of the outstanding RLOC amount. On September 21, 2018, the Company executed the First Amendment to the RLOC with Amegy Bank. The First Amendment (i) waived the Company’s events of default under the RLOC through the fiscal quarter ended September 30, 2018, and (ii) added a covenant that the Company achieve quarterly net income of $700,000 or more for the fiscal quarter ending on September 30, 2018. On November 19, 2018, the Company executed the Second Amendment to the RLOC with Amegy Bank. The Second Amendment (i) waived the Company’s events of default under the RLOC, (ii) On May 9, 2019, the Company executed the Third Amendment to the RLOC with Amegy Bank. Pursuant to the Third Amendment, Amegy Bank (i) waived the Company’s events of default under the RLOC, (ii) reduced the aggregate limit of the RLOC to $3,500,000, (iii) reduced the limit of credit card exposure to $500,000, (iv) reduced borrowing base component of Inventory to 30%, (v) amended the financial covenants to state that the Company will not permit EBITDA to be less than $100,000 for the fiscal quarter ending June 30, 2019 and $500,000 for the fiscal quarter ending September 30, 2019 and (vi) rescinded the Loan Sweep Feature, requiring the Company to give notice of each requested loan by delivery of Advance Request to Amegy Bank. On December 18, 2019, the Company executed the Fourth Amendment to the RLOC with Amegy Bank. Pursuant to the Fourth Amendment, Amegy Bank (i) waived the Company’s events of default under the RLOC, (ii) reduced the aggregate limit of the RLOC to $2,750,000, (iii) reduced and limited the annual salary of the Company’s Chairman of the Board and President, Mr. Brooks, to not exceed $550,000, (iv) amended the financial covenants to state that the Company will not permit EBITDA to be less than $600,000 for the fiscal quarter ending December 31, 2019 and $125,000 for the fiscal quarter ending March 31, 2020, (v) extended the termination date of the RLOC to May 4, 2020 and (vi) provides for our Chairman of the Board and President to personally guarantee one hundred percent (100%) of the outstanding RLOC amount. On May 21, 2020, the Company executed the Fifth Amendment to the RLOC with Amegy Bank. Pursuant to the Fifth Amendment, Amegy Bank (i) waived the Company’s events of default under the RLOC, (ii) amended the financial covenants to state that the Company will not permit EBITDA to be less than $25,000 for the six months ended September 30, 2020, and (iii) extended the termination date of the RLOC until November 4, 2020. In conjunction with executing the Fifth Amendment to the RLOC, the Company obtained an additional $200,000 in capital in the form of subordinated debt from affiliates of Messrs. Brooks and Reeg. Specifically, on May 6, 2020, the Company borrowed $180,000 NC 143, and $20,000 from RMI, in exchange for two promissory notes which are unsecured and bear interest at 0.25% per annum until May 6, 2022, the maturity date, and 10.0% per annum after the maturity date, if not paid in full. Principal and interest are due and payable on the maturity date, provided, however, any payment of principal and interest on the loans is subordinated to payment of all indebtedness under the RLOC. On November 12, 2020, the Company executed the Sixth Amendment to the RLOC with Amegy Bank, which extended the termination date of our RLOC to May 4, 2021. The Company was in compliance with all RLOC covenants as of December 31, 2020 On May 4, 2021, the Company executed a Seventh Amendment to the RLOC with Amegy Bank (the “Seventh Amendment”), waiving the events of default for the three months ended March 31, 2021, and extending the termination date of the RLOC until November 4, 2021. On August 5, 2021, the Company received a waiver from Amegy Bank, waiving the events of default for the minimum quarterly EBITDA requirements for the twelve months ended June 30, 2021. The Company was not in compliance with the minimum quarterly EBITDA requirement for the twelve months ended September 30, 2021. On November 4, 2021, the Company executed the Eighth Amendment, to the RLOC with Amegy bank. Pursuant to the Eighth Amendment, Amegy Bank (i) waived the events of default for the Company not meeting the minimum quarterly EBITDA for the twelve months ended September 30, 2021, (ii) reduced the aggregate limit of the loans offered pursuant to the Loan Agreement to $2,550,000, and (iii) extended the termination date of the loan to February 4, 2022. The outstanding balance of the RLOC was zero and $913,352 as of December 31, 2021 and 2020, respectively. Interest expense incurred on the RLOC was $39,883 and $61,036 for the year ended December 31, 2021 and 2020, respectively, and is reflected in interest expense on the Company’s accompanying consolidated statements of operations. Accrued interest on the RLOC as of December 31, 2021 and 2020, was zero and $2,947, respectively, and is reflected in accrued expenses on the Company’s accompanying consolidated balance sheets. As of December 31, 2021, the effective interest rate was calculated to be 4.18%. On December 14, 2021, the Company entered into a Credit and Security Agreement (the “Credit Agreement”) with CNH Finance Fund I, L.P., a Delaware limited partnership (the “Lender”). The Credit Agreement provides for a secured revolving credit facility maturing on January 1, 2025 (the “Facility”) with an initial maximum principal in the amount of $5,000,000. Borrowings under the Facility are subject to a borrowing base as set forth in the Credit Agreement. The Company used borrowings under the Facility to repay in full (i) the Amended and Restated Business Loan Agreement, dated December 31, 2017, among ZB, N.A. (d/b/a Amegy Bank) and the Borrowers as amended, and (ii) the U.S. Small Business Administration Loan Authorization and Agreement, dated May 12, 2020, between the Company and the U.S. Small Business Association, as amended. Borrowings under the Credit Agreement may be used for payment of fees, costs and expenses incurred in connection with the Credit Agreement and working capital for the Borrowers and their subsidiaries. Borrowings under the Credit Agreement bear interest at a floating rate, which will be at the Prime Rate plus 1.75%. Under the Credit Agreement, certain fees are payable by the Borrowers as set forth in the Credit Agreement. The obligations of the Borrowers with respect to the Credit Agreement are secured by a pledge of substantially all of the personal property assets of the Borrowers, including accounts receivables, deposit accounts, intellectual property, investment property, inventory, equipment and equity interests in their respective subsidiaries. The Credit Agreement contains customary affirmative and negative covenants, including limitations on the Company’s and its subsidiaries’ ability to incur additional debt, grant or permit additional liens, make investments and acquisitions, merge or consolidate with others, dispose of assets, pay dividends and distributions, pay subordinated indebtedness and enter into affiliate transactions. In addition, the Credit Agreement contains financial covenants requiring the Company on a consolidated basis to maintain, as of the last day of each calendar month (i) a current ratio of not less than 1.0 to 1.0, (ii) a fixed charge coverage ratio of not less than 1.0 to 1.0, (iii) a loan turnover rate of not greater than 60, and (iv) minimum liquidity of not less than $175,000, provided that if the Borrowers comply with the fixed charge coverage ratio for twelve consecutive months, the minimum liquidity covenant shall cease to be effective. The Credit Agreement also includes events of default customary for facilities of this type and upon the occurrence of any such event of default, all outstanding loans under the Facility may be accelerated and/or the lenders’ commitments terminated. The Credit Agreement contains customary representations and warranties of the Borrowers. These representations and warranties have been made solely for the benefit of the lender and such representations and warranties should not be relied on by any other person, including investors. In addition, such representations and warranties (i) have been qualified by disclosures made to the lenders in connection with the agreement, (ii) are subject to the materiality standards contained in the agreement which may differ from what may be viewed as material by investors and (iii) were made only as of the date of the agreement or such other date as is specified in the Credit Agreement. The foregoing description does not constitute a complete summary of the terms of the Credit Agreement and is qualified in its entirety by reference to the full text of the Credit Agreement, which is filed as Exhibit 10.45 to this Form 10-K and incorporated herein by reference. Pursuant to the Credit Agreement, the Company had an outstanding balance of $2,432,770 as of December 31, 2021. In preparation of the Credit Agreement, the company incurred $236,358 of costs that have been allocated to intangible assets and will be amortized over the life of the Credit Agreement. Interest expense incurred on the RLOC was $6,013 for the year ended December 31, 2021 and is reflected in interest expense on the Company’s accompanying consolidated statements of operations. Accrued interest on the RLOC as of December 31, 2021 was $6,013, and is reflected in accrued expenses on the Company’s accompanying consolidated balance sheets.

Notes Payable - Related Parties

Notes Payable - Related Parties	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Notes Payable - Related Parties	Note 6. Notes Payable – Related Parties During July 2016 through October 2016, the Company obtained three working capital loans from NC 143 and RMI in the aggregate amount of $150,000 in exchange for Notes bearing ten percent (10%) interest per annum until December 31, 2016 (“Maturity Date”) and eighteen percent (18%) interest per annum for periods subsequent to the Maturity Date. The Notes remain outstanding, and principal and interest are due and payable upon demand of the payee and at the holder’s sole discretion. The Notes’ holders have the right to convert all or any portion of the then unpaid principal and interest balance into shares of the Company’s Common Stock at a conversion price of $0.08 per share. On May 6, 2020, the Company borrowed $180,000 from NC 143 and $20,000 from RMI, in exchange for two promissory notes which are unsecured and bear interest at 0.25% per annum until May 6, 2022, the maturity date, and 10.0% per annum after the maturity date, if not paid in full. Principal and interest are due and payable on the maturity date, provided, however, any payment of principal and interest on the loans is subordinated to payment of all indebtedness under the Credit Agreement. On March 25, 2022, the two promissory notes were amended to extend the maturity date from May 6, 2022, to May 6, 2023. During the years ended December 31, 2021 and 2020, interest expense of $27,501 and $27,407, respectively, is reflected in interest expense on the Company’s accompanying consolidated statements of operations. As of December 31, 2021, and 2020, accrued interest was $141,004 and $113,503, respectively, which is reflected in accrued expenses on the Company’s accompanying consolidated balance sheets.

Paycheck Protection Program Loa

Paycheck Protection Program Loan	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Paycheck Protection Program Loan	Note 7. Payroll Protection Program Loan On April 11, 2020, the Company received approval from the SBA to fund the Company’s request for a Payroll Protection Program Loan, (“PPP Loan”), created as part of the recently enacted CARES Act administered by the SBA. In connection with the PPP Loan, the Company has entered into a promissory note in the principal amount of $361,400. In accordance with the requirements of the CARES Act, the Company intends to use the proceeds from the PPP Loan primarily for payroll costs. The PPP Loan is scheduled to mature on April 11, 2022, has a 1.00% interest rate, and is subject to the terms and conditions applicable to all loans made pursuant to the PPP. The PPP Loan is reflected in short term liabilities in the Company’s accompanying consolidated balance sheets. The Company applied for and received forgiveness for the total amount of the PPP Loan during the second quarter of 2021. For the year ended December 31, 2021 and 2020, the Company had a gain of $2,720 and 2,720

Economic Injury Disaster Loan

Economic Injury Disaster Loan	12 Months Ended
	Dec. 31, 2021
Debt Disclosure [Abstract]
Economic Injury Disaster Loan	Note 8. Economic Injury Disaster Loan On May 12, 2020, the Company executed the standard loan documents required for securing a loan from the SBA under its EIDL assistance program in light of the impact of the COVID-19 pandemic on the Company’s business. Pursuant to the SBA Loan Agreement, the principal amount of the EIDL Loan was $150,000, with proceeds to be used for working capital purposes. Interest accrues at the rate of 3.75% per annum. Installment payments, including principal and interest, are due monthly beginning May 12, 2021 (twelve months from the date of the SBA Loan Agreement) in the amount of $731. The balance of principal and interest is payable thirty years from the date of the SBA Loan Agreement. The EIDL Loan is reflected in long term liabilities in the Company’s accompanying consolidated balance sheets. In connection therewith, the Company received a $ 10,000 advance, which does not have to be repaid and is reflected as an offset in Selling, General, Administrative and Other Expenses in the Company’s accompanying consolidated statements of operations. EIDL Loan interest expense incurred was approximately $7,554 and $3,791 for the years ended December 31, 2021 and 2020, respectively, and is reflected in interest expense on the Company’s accompanying consolidated statements of operations. Accrued interest on the EIDL Loan as of December 31, 2021 and 2020 was zero and $3,791, respectively, and is reflected in accrued expenses on the Company’s accompanying consolidated balance sheets. On September 24, 2021, the Company executed the standard loan documents with the SBA for an amended and restated loan and authorization and agreement (“A&R SBA Loan Agreement”) required for securing an increase in the Company’s Original Note from the SBA EIDL Loan. Pursuant to the A&R SBA Loan Agreement, the principal amount for the EIDL Loan was increased by $350,000 to $500,000, with proceeds to be used for working capital purposes. Interest accrues at the rate of 3.75% per annum. Installment payments, including principal and interest, are due monthly beginning May 12, 2022 (twenty-four months from the date of the Original Note) in the amount of $2,515. The balance of principal and interest is payable thirty years from the date of the A&R SBA Loan Agreement. The Company used borrowings under the Credit Agreement to repay in full (i) the Amended and Restated Business Loan Agreement, dated December 31, 2017, among ZB, N.A. (d/b/a Amegy Bank) and the Borrowers as amended, and (ii) the U.S. Small Business Administration Loan Authorization and Agreement, dated May 12, 2020, between the Company and the U.S. Small Business Association, as amended. Borrowings under the Credit Agreement may be used for payment of fees, costs and expenses incurred in connection with the Credit Agreement and working capital for the Borrowers and their subsidiaries

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 9. Commitments and Contingencies Operating Leases The Company leases office space under a noncancelable operating lease agreement, from a real estate investments company that is owned and controlled by the Company’s Chairman of the Board and President. This lease terminated December 31, 2017 with month-to-month renewals. The lease requires monthly payments of $14,000. Annual rent expense was approximately $168,000 and $168,000 for the years ended December 31, 2021 and 2020, and is included in selling, general, administrative and other expenses on the Company’s accompanying consolidated statement of operations. The Company leases office equipment under two noncancelable operating lease agreements of which one expired March 2021, and continued on a month to month basis, and one of which expires March 2024. In aggregate, these office equipment leases require monthly payments of approximately $875. Rent expense for the equipment leases totaled approximately $10,500 and $10,000 for the years ended December 31, 2021 and 2020, respectively, and is included in selling, general, administrative and other expenses on the Company’s accompanying consolidated statement of operations. The following is a schedule by years of future minimum rental payments required under operating leases that have initial or remaining noncancelable lease terms in excess of one year as of December 31, 2021: Year Ended December 31, 2022 $ 7,425 2023 7,425 2024 720 2025 - 2026 - $ 15,570

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2021
Stockholders Equity Deficit [Abstract]
Stockholders' Equity	Note 10. Stockholders’ Equity The 2018 Equity Plan is the Company’s stock-based compensation plan which the Company’s Board adopted on April 5, 2017, and subsequently amended and restated on December 13, 2018. The 2018 Equity Plan provides for the granting of equity awards, including qualified incentive and non-qualified stock options, stock appreciation awards, and restricted stock awards to employees, directors, consultants, and advisors. Awards granted pursuant to the 2018 Equity Plan are subject to a vesting schedule set forth in individual agreements. The Company’s management estimates the fair value of stock-based compensation utilizing the Black-Scholes option pricing model. Black-Scholes option pricing is calculated using several variables, including the expected option term, expected volatility of the Company’s stock price over the expected option term, expected risk-free interest rate over the expected option term, expected dividend yield rate over the expected option term, and an estimate of expected forfeiture rates. The Company’s management believes this valuation methodology is appropriate for estimating the fair value of stock options granted to employees and directors which are subject to ASC 718 “ Compensation -Stock Compensation ” requirements. The Company’s management estimates of fair value may not be reflective of actual future values or amounts ultimately realized by recipients of these grants. The Company recognizes stock compensation expense on a straight-line basis over the requisite service period for each award. The Company’s management utilizes the simplified method to estimate the expected life for stock options granted to employees, as the Company does not have sufficient historical data regarding stock option exercises. The risk-free interest rate is based on the U.S. Treasury yields with terms equivalent to the expected life of the related option at the time of the grant. Dividend yield is based on historical trends. While the Company’s management believes these estimates are reasonable, the compensation expense recorded would increase if the expected life was increased, a higher expected volatility was used, or if the expected dividend yield increased. The Company made an accounting policy election to account for forfeitures when they occur, versus estimating the number of awards that are expected to vest, in accordance with ASU 2016-09. Non-Qualified Stock Option Awards For the years ended December 31, 2021 and 2020, the Board granted zero and zero, respectively, of non-qualified stock option awards (“NQSO”) to the Company’s Scientific Advisory Board members, certain key employees and marketing representatives. For the year ended December 31, 2021 and December 31, 2020, the Company amortized $257,913 and $553,184 relating to the vesting of NQSOs, which is included in selling, general, administrative, and other expenses on the Company’s accompanying consolidated statement of operations. The Company will recognize $22,852 as an expense in future periods as the NQSOs vest. The Company recognizes stock compensation expense on a straight-line basis over the requisite service period for each award, which are subject to a vesting schedule as set forth in individual agreements. A summary of the Company’s stock option activity during the year ended December 31, 2021 is presented below: No. of Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Balance outstanding at December 31, 2020 2,595,000 $ 0.65 5.92 $ 56,000 Granted - - - $ - Exercised 100,000 0.11 Forfeited 150,000 — Expired 600,000 — Balance outstanding at December 31, 2021 1,745,000 $ 0.86 6.73 $ 12,000 Exercisable at December 31, 2021 1,495,000 $ 0.90 6.65 $ 8,000 Restricted Common Stock The non-vested restricted stock awards (“RSAs”), as of December 31, 2021, were granted to the Company’s Board members as compensation. These awards vest only upon: (i) the occurrence of one of the Accelerating Events: (a) a Change in Control (as defined in RSA Agreement); or (b) listing of the Company’s Common Stock on either NYSE or NASDAQ Stock Market; and (ii) the director’s delivery to the Company of a Notice of Acceleration of Vesting (as defined in RSA Agreement), within the Acceleration Notice Period (as defined in RSA Agreement). As of December 31, 2021, it was not probable that the performance conditions on the outstanding options would be met, therefore, no expense has been recorded for the years ended December 31, 2021 and 2020. The following table summarizes the RSAs activity for the year ended December 31, 2021: Number of Shares Fair Value Weighted Average Grant Date Fair Value Non-vested, December 31, 2020 2,902,892 $ 1,382,800 $ 0.48 Granted 147,058 100,000 0.68 Vested - - - Forfeited (475,723 ) (150,700 ) 0.32 Non-vested, December 31, 2021 2,574,227 1,332,100 $ 0.52

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Note 11. Income Taxes The Company began consolidating the financial results of CPM effective January 1, 2016, when the Company became the sole managing member of CPM. CPM is treated as a disregarded entity for U.S. federal and most applicable state and local income taxes. As a disregarded entity, CPM is not subject to U.S. federal and certain state and local income taxes. Beginning January 1, 2019, taxable income or loss generated by CPM is included in its taxable income or loss of the Company. The Company is subject to U.S. federal income taxes, in addition to state and local income taxes. The components of income tax expense (benefit) are as follows: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Current: Federal $ - $ - State 17,723 18,993 17,723 18,993 Deferred: Federal - - State - - - - Total Income tax expense $ 17,723 $ 18,993 Significant components of the Company’s deferred income tax assets and liabilities are as follows: December 31, 2021 December 31, 2020 Deferred tax assets: Net operating loss carryforward $ 1,262,269 $ 786,751 Accounts receivable 104,635 165,431 Compensation 555,936 480,774 Inventory 523,131 588,966 Other 1,244 5,083 Total deferred tax assets 2,447,215 2,027,005 Deferred tax liabilities: Intangibles (198,801 ) (206,723 ) Property and equipment (1,522 ) (3,736 ) Total deferred tax liabilities (200,323 ) (210,459 ) Deferred tax assets, net 2,246,892 1,816,546 Valuation allowance: Beginning of year (1,816,546 ) (1,529,584 ) Increase during year (430,346 ) (286,962 ) Ending balance (2,246,892 ) (1,816,546 ) Net deferred tax asset $ - $ - A valuation allowance is established if it is more likely than not that all or a portion of the deferred tax asset will not be realized. The Company recorded a valuation allowance totaling $430,346 for the twelve months ended December 31, 2021 due to the uncertainty of realization. Management believes that based upon the history of losses that the Company has incurred to date and its projection of future taxable operating income for the foreseeable future, it is more likely than not that the Company will not be able to realize the tax benefit associated with deferred tax assets. The valuation allowance established during the year ended December 31, 2021 was $2,246,892 At December 31, 2021, the Company estimates it has approximately $6,010,806 of net operating loss carryforwards of which $3,863,299 will expire during 2021 through 2037. Under Section 382 of the Internal Revenue Code of 1986, as amended ("IRC Section 382"), a corporation that undergoes an "ownership change", as defined therein, is subject to limitation on its use of pre-change tax attributes carryforward to offset future taxable income. The Company completed a 382 study and determined that there were changes in ownership in prior years which limited the net operating loss from 2013 and earlier, and 2014 through 2016. The 382 limitation mathematically precludes the use of approximately $2,963,968 of net operating loss carryforwards, therefore, the deferred net operating loss carryover asset excludes the portion of net operating loss that are mathematically excluded from future use by the Company. The Company’s management believes its tax positions will more likely than not be upheld upon examination. As such, the Company has not recorded a liability for unrecognized tax positions. As of December 31, 2021, all the tax years remained open to examination for three years from the tax year in which net operating losses are utilized. The Company was not subject to examination by any income taxing authority as of December 31, 2021. A reconciliation of income tax computed at the U.S. statutory rate to the effective income tax rate is as follows: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Statutory U.S. federal income tax rate 21.0 % 21.0 % Gain on Payroll Protection Program Loan 4.5 % 0.0 % Other reconciling items 0.0 % 4.2 % Permanent differences 0.0 % 0.0 % State income taxes, net of federal tax benefit -0.8 % -1.3 % Deferred tax asset valuation allowance -25.8 % -25.6 % Effective income tax rate -1.1 % -1.7 % Our effective income tax rates for the years ended December 31, 2021 and 2020 were -1.1% and -1.7%, respectively. The decrease between years is driven by the valuation allowance allocated to the deferred tax asset for the current period.

Concentrations

Concentrations	12 Months Ended
	Dec. 31, 2021
Nature Of Operations And Going Concern [Abstract]
Concentrations	Note 12. Concentrations Concentration of Revenues, Accounts Receivable and Suppliers For the years ended December 31, 2021 and 2020, the following significant customers had an individual percentage of total revenue of approximately ten percent (10%) or greater: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Top customer 8.73 % 12.63 % Totals 8.73 % 12.63 % For the years ended December 31, 2021 and 2020, the following significant customers had a concentration of total accounts receivables of approximately ten percent (10%) or greater: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Customer 1 13.46 % 8.80 % Customer 2 11.20 % 7.70 % Totals 24.66 % 16.50 % For the years ended December 31, 2021 and 2020, the following significant suppliers represented ten percent (10%) or greater of goods purchased: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Supplier 1 20.40 % 25.60 % Supplier 2 11.00 % 8.30 % Totals 31.40 % 33.90 %

Related Party Transactions

Related Party Transactions	12 Months Ended
	Dec. 31, 2021
Related Party Transactions [Abstract]
Related Party Transactions	Note 13. Related Party Transactions Operations Historically, the Company conducts various related-party transactions with entities that are owned by or affiliated with Mr. Brooks and Mr. Reeg. These transactions are based on commission or wholesale contractual agreements that the Company’s management believes are on terms and conditions substantially similar to other third-party contractual agreements. As described more fully below, these transactions include: selling and purchasing of inventory on wholesale basis, commissions earned and paid, and shared-service fee arrangements. Lease with 1565 North Central Expressway, LP For its principal executive office, the Company leases an aggregate of approximately 11,500 square-foot space at 1565 North Central Expressway, Suite 220, Richardson, Texas 75080 from NCE, LP, a real estate investment company that is owned and controlled by Mr. Brooks. The Company’s lease arrangement includes (1) the lease acquired pursuant to the CPM Acquisition effective January 1, 2013 and (2) a lease effective July 14, 2017 entered-into to support the Company’s relocation of its Fort Worth, Texas corporate offices to CPM’s executive offices. Both leases terminated December 31, 2017, with month-to-month renewals thereafter. For the year ended December 31, 2021 and 2020, the Company paid approximately $168,000 and $168,000 in rent expense, which is reflected in selling, general, administrative, and other expenses in the Company’s accompanying consolidated statements of operations. F-21 AmBio Contract The Company engaged AmBio Staffing, LLC (“AmBio”), a Texas licensed professional employment organization, to provide payroll processing, employee benefit administration, and related human capital services effective January 1, 2017. Mr. Brooks owns and controls AmBio. As of December 31, 2021, AmBio operations support approximately 42 FTEs. Of those 42 FTEs, 36 FTEs directly support the Company, 5 FTEs support the operations of other companies and the Company shares 1 FTE with other companies. As of December 31, 2021, and December 31, 2020, the Company owed amounts to AmBio of approximately $170,784 and $154,051, respectively, which is reflected in the accounts payable on the Company’s accompanying consolidated balance sheets. For the year ended December 31, 2021, and 2020, the Company paid approximately $195,093 and $172,221, respectively, to AmBio in administrative fees, which is reflected in selling, general, administrative, and other expenses in the Company’s accompanying consolidated statements of operations. Operations Historically, the Company conducts various related-party transactions with entities that are owned by or affiliated with Mr. Brooks and Mr. Reeg. These transactions are based on wholesale contractual agreements that the Company’s management believes are on terms and conditions substantially similar to other third-party contractual agreements. As described more fully below, these transactions include: selling and purchasing of inventory on wholesale basis, commissions earned and paid, and shared-service fee arrangements. MedUSA Group, LLC MedUSA is a sub-distributor owned and controlled by Mr. Brooks and Mr. Reeg. During the years ended December 31, 2021 and 2020, the Company: • sold Orthopedic Implants and Biologics products to MedUSA in the amounts of approximately $1,400 and $29,822, respectively, which is reflected in net revenues in the Company’s accompanying consolidated statements of operations; and • incurred approximately $3,696,583 and $3,527,783, respectively, in commission costs, which are reflected in commissions in the Company’s accompanying consolidated statements of operations. As of December 31, 2021, and December 31, 2020, the Company had outstanding balances due from MedUSA of approximately $63,498 and $398,151, respectively. These amounts are reflected in accounts receivable, net in the Company’s accompanying consolidated balance sheets. As of December 31, 2021, and December 31, 2020, the Company had approximately $923,960 and $960,932, respectively, of unpaid commission costs due to MedUSA, which is reflected in accrued liabilities in the Company’s accompanying consolidated balance sheets. Payment terms per the stocking and distribution agreement with MedUSA are 30 days from receipt of invoice. Texas Overlord, LLC Overlord is an investment holding-company owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company: • incurred approximately $240,000 and $190,000, respectively, in commission costs to Overlord, which is reflected in commissions in the Company’s accompanying consolidated statements of operations. As of December 31, 2021, and December 31, 2020, the Company had approximately $40,000 and $20,000, respectively, of unpaid commission costs due to Overlord, which is reflected in accrued liabilities in the Company’s accompanying consolidated balance sheets. N.B.M.J., Inc. NBMJ is a durable medical equipment, wound care, and surgical supplies distributor owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company sold Biologics products to NBMJ in the amounts of approximately $74,501 and $24,708, respectively, which is reflected in net revenues in the Company’s accompanying consolidated statements of operations; As of December 31, 2021, and December 31, 2020, the Company had $2,080 outstanding balances due from NBMJ. Payment terms per the stocking and distribution agreement with NBMJ are 30 days from receipt of invoice. F-22 Bass Bone and Spine Specialists Bass operates as a sub-distributor of surgical implants and is owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company: • sold Orthopedic Implants and Biologics products to Bass in the amounts of approximately $35,065 and $81,350, respectively, which is reflected in net revenues in the Company’s accompanying consolidated statements of operations; • incurred approximately zero and $16,885, respectively, in commission costs to Bass, which is reflected in commissions in the Company’s accompanying consolidated statements of operations. As of December 31, 2021, and December 31, 2020, the Company has outstanding balances due from Bass of approximately $8,413 and $20,117, respectively. These amounts are reflected in accounts receivable, net in the Company’s accompanying consolidated balance sheets. Payment terms per the stocking and distribution agreement with Bass are 30 days from receipt of invoice. Sintu, LLC Sintu operates as a sub-distributor of surgical implants and is owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company: incurred approximately $583,218 and $575,918, respectively, in commission costs to Sintu, which is reflected in commissions in the Company’s accompanying consolidated statements of operations. As of December 31, 2021, and December 31, 2020, the Company had approximately $557,228 and $163,567, respectively, of unpaid commission costs due to Sintu, which is reflected in accrued liabilities in the Company’s accompanying consolidated balance sheets. Tiger Orthopedics, LLC Tiger operates as a sub-distributor of surgical implants and is owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company sold Orthopedic Implants and Biologics products to Tiger in the amounts of approximately $502 and $39,922, respectively, which is reflected in net revenues in the Company’s accompanying consolidated statements of operations. Payment terms per the stocking and distribution agreement with Tiger are 30 days from receipt of invoice. Modal Manufacturing, LLC Modal is a manufacturer of medical devices owned and controlled by Mr. Brooks. During the years ended December 31, 2021 and 2020, the Company purchased approximately $766,640 and $508,597 respectively, in Orthopedic Implants and medical instruments from Modal, which is reflected within inventories, net on the Company’s accompanying consolidated balance sheets. Payment terms per the stocking and distribution agreement are 30 days from receipt of invoice. As of December 31, 2021, the Company owes Modal a balance of $709,234. Payment terms per the stocking and distribution agreement with Modal are 30 days from receipt of invoice.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2021
Subsequent Events [Abstract]
Subsequent Events	Note 13. Subsequent Events Severe Weather Conditions . During February 2022, the state of Texas experienced severe winter weather which resulted in dangerous road conditions. The Company’s executive management team immediately focused on the health and wellbeing of the Company’s employees, while also working to minimize the impact on its customers. Subsequently, the Company resumed full operations and are currently working to address the Cases, sales support, and administrative functions backlog. Generally, surgical cases have been rescheduled to subsequent weeks. (For more information, see Item 1A. “Risk Factors—Risks Related to Our Business and Industry”). The Company’s management concluded there are no other material events or transactions for potential recognition or disclosure.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries, CPM and Maxim. Intercompany transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of the consolidated financial statements in accordance with generally accepted accounting principles in the United States of America (GAAP), requires the Company’s management to make estimates and assumptions that affect the Company’s reported amounts in the consolidated financial statements. Actual results could differ from those estimates. Significant estimates on the accompanying consolidated financial statements include the allowances for doubtful accounts, valuation of inventories, the Company’s effective income tax rate and the fair value calculations of stock-based compensation, goodwill, finite lived intangibles and the earn-out liability.
Segment Reporting	Segment Reporting In accordance with Accounting Standards Update (“ASU”) No. 280, “Segment Reporting,” the Company uses the management approach for determining its reportable segments. The management approach is based upon the way that management reviews performance and allocates resources. The Company’s Chief Executive Officer serves as the Company’s chief operating decision maker, and his management team reviews operating results on a consolidated basis for purposes of allocating resources and evaluating the financial performance of the Company. The Company has integrated the operations of both CPM and Maxim. Accordingly, the Company has determined that it has one operating segment and, therefore, one reporting segment.
Reclassification	Reclassification Long term accounts receivable, net of allowance was previously reported as a component of current assets as accounts receivable, net of allowance, in the Company’s accompanying consolidated balance sheets. Long term accounts receivable reflects Cases where the patient has obtained a letter of protection, (“LOP”). A LOP is a contract that provides that the medical providers will be paid from any proceeds received from settlement of litigation of the underlying cause of action with respect to the event that necessitated medical goods and services. Once the medical provider receives payment, then the medical provider pays the Company’s invoice which payment is generally greater than 365 days from date of service. The LOP provides medical providers with greater certainty of full payment. This reclassification had no effect on the previously reported total assets or net loss.
Loss Per Common Share	Loss Per Common Share Loss per common share, basic is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of Common Stock, outstanding during the period, without consideration of Common Stock equivalents. Shares of restricted stock are included in the basic weighted-average number of Common Stock outstanding from the time they vest. Diluted loss per common share is computed by dividing net income/(loss) by the weighted-average number of Common Stock equivalents outstanding for the period determined using the treasury stock method. For the years ended December 31, 2021 and 2020, the Company excluded the effects of outstanding stock options, convertible notes and, to the extent in the money, restricted stock as their effects were antidilutive due to the Company’s operating loss during these periods. (See Note 10, “Stockholders’ Equity” for the terms and conditions of restricted stock).
Fair Value Measurements	Fair Value Measurements Fair value is the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants. The Company classifies assets and liabilities recorded at fair value under the fair value hierarchy based upon the observability of inputs used in valuation techniques. Observable inputs (highest level) reflect market data obtained from independent sources, while unobservable inputs (lowest level) reflect internally developed market assumptions. The fair value measurements are classified under the following hierarchy: Level 1—Observable inputs that reflect quoted market prices (unadjusted) for identical assets and liabilities in active markets; Level 2—Observable inputs, other than quoted market prices, that are either directly or indirectly observable in the marketplace for identical or similar assets and liabilities, quoted prices in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets and liabilities; and Level 3—Unobservable inputs that are supported by little or no market activity that are significant to the fair value of assets or liabilities. In connection with the CPM Acquisition, the Company initially recorded a $19,244,543 liability related to the Earn-Out portion of the purchase consideration. The Company has classified the Earn-Out liability as a Level 3 liability and the fair value of the Earn-Out liability will be evaluated each reporting period and changes in its fair value will be included in the Company’s earnings. The Earn-Out payments are based on the financial performance of the Company between the period of January 1, 2018, and December 31, 2034. The base amount of the Earn-Out is $16,000,000 with an additional bonus payment of $10,000,000. The payments of the base and bonus Earn-Out amounts are subject to the Company meeting certain earnings thresholds as detailed in the CPM Acquisition Agreement. The Earn-Out payments during the Earn-Out period specified above, ranges from $0 to $26,000,000. The fair value of the Earn-Out liability was calculated using the Monte Carlo simulation, which was then applied to estimated Earn-Out payments with a discount rate of three percent (3%). To determine the fair value of the Earn-Out liability, the Company’s management evaluates assumptions that require significant judgement. Significant assumptions used for estimating the Earn-Out liability included: (i) Earnings before interest, taxes, depreciation, and amortization (“EBITDA”) margins increasing from one percent (1%) to ten percent (10%) over the next four years; and (ii) revenue growth of between approximately six percent (6%) to eleven percent (11%) over the next five years, and between approximately two percent (2%) and four percent (4%) thereafter. The Earn-Out liability, which represented contingent consideration associated with the CPM Acquisition, is recorded as a liability. This liability is subject to re-measurement to fair value at each reporting date until the contingency is resolved and the changes in fair value are recognized in the consolidated statements of operations at each reporting period. For the year ended December 31, 2021 and 2020, the Company has determined the earnings threshold as detailed in the CPM Acquisition Agreement was not met and therefore no payments for either the base or bonus Earn-Out tranches would be achieved, based on the Company’s 2021 and 2020 financial performance. The Earn-Out was remeasured to fair value under the probability weighted income approach. As a result, the fair value of the Earn-Out liability was decreased by $342,168 from $11,936,000 to $ 11,593,832 The estimated fair value of certain financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued expenses are carried at historical cost basis, which approximates their fair values because of the short-term nature of these instruments. The recorded values of notes payable approximate their respective fair values based upon their effective interest rates.
Financial Instruments	Financial Instruments The estimated fair value of certain financial instruments, including cash and cash equivalents, accounts receivable, accounts payable and accrued expenses are carried at historical cost basis, which approximates their fair values because of the short-term nature of these instruments. The recorded values of notes payable approximate their respective fair values based upon their effective interest rates.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers highly liquid investments with maturities of three months or less at the time of purchase to be cash equivalents. There were no cash equivalents as of December 31, 2021, and December 31, 2020. The Company’s cash is concentrated in one large financial institution. The amount of cash held at that financial institution may at times exceed federally insured limits of $250,000 per financial institution. The Company has not experienced any financial institution losses from inception through December 31, 2021. As of December 31, 2021 and 2020, there were deposits of $594,536 and $761,671, respectively, which were greater than federally insured limits.
Accounts Receivable, net	Accounts Receivable, net Accounts receivable are non-interest bearing and are stated at gross invoice amounts less an allowance for doubtful accounts receivable and an allowance for contractual discount pricing. Credit is extended to customers based on an evaluation of their financial condition, industry reputation, and other judgmental factors considered by the Company’s management. The Company generally does not require collateral or other security interest to support accounts receivable. Based on trends and specific factors, the customer’s credit terms may be modified, including required payment upon delivery. The Company performs regular on-going credit evaluations of its customers as deemed relevant. As events, trends, and circumstance warrant, the Company’s management estimates the amounts that are more likely than not to be uncollectible. These amounts are recognized as bad debt expense and are reflected within selling, general, administrative and other expenses on the Company’s accompanying consolidated statement of operations. When accounts are deemed uncollectible, they are often referred to the Company’s outside legal firm for litigation. Accounts deemed uncollectible are written-off in the period when the Company has exhausted its efforts to collect overdue and unpaid receivables or otherwise has evaluated other circumstances that indicate that the Company should abandon such efforts. Accounts deemed uncollectible are removed from the Company’s accounts receivable portfolio, with a corresponding offset to the allowance for doubtful accounts receivable. The Company may record additional allowances for doubtful accounts based on known trends and expectations to ensure the Company’s accounts receivable portfolio is recorded at net realizable value. Specific allowances are re-evaluated and adjusted as additional facts and information become available. Previously written-off accounts receivable subsequently collected are recognized as a reduction of bad debt expense when funds are received. The Company’s management estimates its allowance for contractual discount pricing, by evaluating specific accounts where information indicates the customer is offered contractual pricing and discount allowances. In these arrangements, the Company’s management uses assumptions and judgement, based on the best available facts and circumstances to record a specific allowance for the amounts due from those customers. The allowance is offset by a corresponding reduction to revenue. These specific allowances are re-evaluated, analyzed, and adjusted as additional information becomes available to determine the total amount of the allowance. The Company may record additional allowances based on trends and expectations to ensure the Company’s accounts receivable portfolio is recorded at net realizable value.
Inventories	Inventories Inventories are stated at the lower of cost or net realizable value (first-in, first-out) less an allowance for slow-moving inventory, expired inventory, and inventory obsolescence. Inventories consist entirely of finished goods and include internal and external fixation products; upper and lower extremity plating and total joint reconstruction; soft tissue fixation and augmentation for sports medicine procedures; spinal implants for trauma, degenerative disc disease, and deformity indications (collectively, Orthopedic Implants) and osteo-biologics and regenerative tissue which include human allografts, substitute bone materials and tendons, as well as regenerative tissues (collectively, Biologics). The Company reviews the market value of inventories whenever events and circumstances indicate that the carrying value of inventories may not be recoverable from the estimated future sales price less cost of disposal and normal gross profit. In cases where the market values are less than the carrying value, a write-down is recognized equal to an amount by which the carrying value exceeds the net realizable value of inventories. During 2020, the Company revised its estimate for slow moving and obsolete inventory. As a result, the Company’s management decreased the inventory reserve for slow moving and obsolescence by $728,002 to a balance of $3,077,728. In 2021 based on sales activity for the year and inventory on hand at the end of the year, the Company decreased the reserve by $586,545 to a balance of $2,491,183, which is reflected in inventory and cost of revenues on the Company’s consolidated balance sheets and statements of operations, respectively.
Property and Equipment	Property and Equipment Property and equipment are recorded at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets per the following table. Expenditures for additions and improvements are capitalized, while repairs and maintenance are expensed as incurred. The Company reviews long-lived assets for impairment annually or whenever changes in circumstances indicate that the carrying amount of an asset might not be recoverable. Category Amortization Period Computer equipment 3 years Furniture and fixtures 3 years Office equipment 3 years Software 3 years Upon the retirement or disposition of property and equipment, the related cost and accumulated depreciation is removed. A gain is recorded when consideration received is more than the disposed asset’s cost, net of depreciation, and a loss is recorded when consideration received is less than the disposed asset’s cost, net of depreciation.
Long-Lived Assets	Long-Lived Assets The Company reviews other long-lived assets for indicators of impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. The evaluation is performed at the lowest level of identifiable cash flows, which is at the individual asset level or the asset group level. The undiscounted cash flows expected to be generated by the related assets are estimated over their useful life based on updated projections. If the evaluation indicates that the carrying amount of the assets may not be recoverable, any potential impairment is measured based upon the fair value of the related assets or asset group as determined by an appropriate market appraisal or other valuation technique. Assets classified as held for sale, if any, are recorded at the lower of carrying amount or fair value less costs to sell.
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets Goodwill is determined based on an acquisition purchase price in excess of the fair value of identified net assets acquired. Intangible assets with lives restricted by contractual, legal or other means are amortized over their useful lives. Goodwill is not amortized but is tested in the fourth quarter each year for impairment, or more frequently if an event occurs or circumstances change that would more likely than not reduce the fair value of the reporting unit below its carrying amount. The Company performs its annual, or interim, goodwill impairment test by comparing the fair value of a reporting unit with its carrying amount. If the carrying value of a reporting unit exceeds its fair value, an impairment charge is recognized for the amount by which the carrying amount exceeds the reporting unit’s fair value. For the years ended December 31, 2021 and 2020 no impairment charge was recognized. Accounting Standards Codification (“ASC”) 350-30-35-18, intangibles assets not subject to amortization, indicates that an intangible asset that is not subject to amortization shall be tested for impairment annually and more frequently if events or changes in circumstances indicate that it is more likely than not that the asset is impaired. The Company’s 510(k) intangible asset has an indefinite life. The Company does not believe that triggering event has occurred as of December 31, 2021. The Company’s intangible assets subject to amortization consist primarily of acquired non-compete agreements and customer relationships. Amortization expense is calculated using the straight-line method over the asset’s expected useful life.
Revenue Recognition	Revenue Recognition The Company’s revenues are generated from the sales of Orthopedic Implants and Biologics to support orthopedic surgeries. The Company obtains purchase orders from its customers for the sale of its products which sets forth the general terms and conditions including line item pricing and payment terms (generally due upon receipt). The Company recognizes revenue when its customers obtain control over the assets (generally when the title passes upon shipment or when a product is utilized in a surgery), and it is probable that the Company will collect substantially all the amounts due. Individual promised goods are the Company’s only performance obligation. Due to the nature of its products, the Company’s product returns have been historically immaterial. The Company includes shipping and handling fees in net revenues. Shipping and handling costs associated with outbound freight after control over a product has transferred to a customer are accounted for as a fulfillment cost and are included in cost of goods sold on the Company’s accompanying consolidated statements of operations. Revenue Differentiation The Company measures sales volume based on medical procedures in which the Company’s products are sold and used (Cases). The Company considers Cases resulting from direct sales to medical facilities to be Retail Cases and Cases resulting from sales to third-parties, such as non-medical facilities, distributors, or sub-distributors, to be Wholesale Cases. Some of the Company’s sales for Wholesale Cases are on a consignment basis with a third-party. When consigned, the revenue is not recorded until the device is implanted in a patient during surgery. In the Company’s industry, Retail Cases are typically sold at higher price points than Wholesale Cases, resulting in greater revenue and gross profit per Case. Year Ended December 31, 2021 December 31, 2020 Category Retail $ 18,749,685 $ 19,092,800 Wholesale 1,664,583 2,306,136 Total $ 20,414,268 $ 21,398,936
Cost of Revenues	Cost of Revenues Cost of revenues consists of (i) cost of goods sold, (ii) freight and shipping costs for items sold to customers, (iii) cost of storage, (iv) investment in medical instruments, which are expensed when acquired, (v) inventory shrink, and (vi) an estimate for slow-moving inventory, expired inventory, and inventory obsolescence.
Income Taxes	Income Taxes As a result of the CPM Acquisition, the Company became the sole managing member of CPM and as a result, began consolidating the financial results of CPM. CPM is treated as a disregarded entity for U.S. federal and most applicable state and local income tax purposes. As a disregarded entity, CPM is not subject to U.S. federal and most applicable state and local income tax purposes. Any taxable income or loss generated by CPM is included in the taxable income or loss of the Company. As a result of the Maxim Acquisition, the Company and Maxim will elect to file a consolidated tax return for the period after acquisition. The Company uses the asset and liability method to compute the differences between the tax basis of assets and liabilities and the related financial amounts. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that more likely than not will be realized. The Company has deferred tax assets and liabilities that reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Deferred tax assets are subject to periodic recoverability assessments. Realization of the deferred tax assets, net of deferred tax liabilities, is principally dependent upon achievement of projected future taxable income. The Company records a liability for uncertain tax positions when it is probable that a loss has been incurred and the amount can be reasonably estimated. As of December 31, 2021 and 2020, the Company had no liabilities for uncertain tax positions. The Company's policy is to recognize interest and penalties related to income tax matters as a component of income tax expense. The Company continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law, and new authoritative rulings.
Stock-Based Compensation	Stock-Based Compensation Stock-based compensation expense is measured at the grant date fair value of the award and is expensed over the requisite service period. For employee stock-based awards, the Company calculates the fair value of the award on the date of grant using the Black-Scholes option pricing model. Determining the fair value of stock-based awards at the grant date under this model requires judgment, including estimating volatility, employee stock option exercise behaviors and forfeiture rates. The assumptions used in calculating the fair value of stock-based awards represent the Company's best estimates, but these estimates involve inherent uncertainties and the application of management judgment. For non-employee stock-based awards, the Company calculates the fair value of the award on the date of grant in the same manner as employee awards, however, the awards are revalued at the end of each reporting period and the pro-rata compensation expense is adjusted accordingly until such time the non-employee award is fully vested, at which time the total compensation recognized to date shall equal the fair value of the stock-based award as calculated on the measurement date, which is the date at which the award recipient’s performance is complete. The estimation of stock-based awards that will ultimately vest requires judgment, and to the extent actual results or updated estimates differ from original estimates, such amounts are recorded as a cumulative adjustment in the period estimates are revised.
Recent Accounting Pronouncements	Recent Accounting Pronouncements The Company considers the applicability and impact of all Accounting Standard Updates (“ASU”) issued, both effective and not yet effective. In February 2016, the Financial Accounting Standards Board (the “FASB”) issued ASU No. 2016-02, “ Leases Other recent accounting pronouncements issued by the FASB, including its Emerging Issues Task Force, the American Institute of Certified Public Accountants, and the SEC did not or are not believed by the Company’s management to have a material impact on the Company's present or future consolidated financial statements.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2021
Accounting Policies [Abstract]
Estimated Useful Lives of Assets	Category Amortization Period Computer equipment 3 years Furniture and fixtures 3 years Office equipment 3 years Software 3 years
Schedule of Revenue Differentiation	The Company measures sales volume based on medical procedures in which the Company’s products are sold and used (Cases). The Company considers Cases resulting from direct sales to medical facilities to be Retail Cases and Cases resulting from sales to third-parties, such as non-medical facilities, distributors, or sub-distributors, to be Wholesale Cases. Some of the Company’s sales for Wholesale Cases are on a consignment basis with a third-party. When consigned, the revenue is not recorded until the device is implanted in a patient during surgery. In the Company’s industry, Retail Cases are typically sold at higher price points than Wholesale Cases, resulting in greater revenue and gross profit per Case. Year Ended December 31, 2021 December 31, 2020 Category Retail $ 18,749,685 $ 19,092,800 Wholesale 1,664,583 2,306,136 Total $ 20,414,268 $ 21,398,936

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2021
Property Plant And Equipment [Abstract]
Summary of Property and Equipment	Property and equipment consisted of the following as of December 31, 2021 and 2020: December 31, 2021 December 31, 2020 Computer equipment and software $ 20,249 $ 49,918 Office equipment - - Property and equipment costs 20,249 49,918 Less: accumulated depreciation (12,998 ) (32,127 ) Property and equipment, net $ 7,251 $ 17,791

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2021
Goodwill And Intangible Assets Disclosure [Abstract]
Schedule of Goodwill and Other Intangible Assets	The following table summarizes the Company’s goodwill and other intangible assets: December 31, 2021 December 31, 2020 Amortization period (years) Intangible assets: 510k product technology $ 704,380 $ 704,380 Indefinite Customer relationships 555,819 555,819 11 CNH Credit Agreement 236,358 - 3 Total intangible assets 1,496,557 1,260,199 Less: accumulated amortization (179,216 ) (122,119 ) Intangible assets, net 1,317,341 1,138,080 Goodwill $ 1,972,886 $ 1,972,886 Indefinite
Schedule of Future Amortization Expense Related to Finite-Lived Intangible Assets	The following is a schedule by year of the Company’s future amortization expense related to the finite-live intangible assets as of December 31, 2021: Year Ended December 31, 2022 $ 129,318 2023 129,318 2024 122,752 2025 50,532 2026 50,530 Beyond 130,511 $ 612,961

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2021
Commitments And Contingencies Disclosure [Abstract]
Summary of Operating Leases	The following is a schedule by years of future minimum rental payments required under operating leases that have initial or remaining noncancelable lease terms in excess of one year as of December 31, 2021: Year Ended December 31, 2022 $ 7,425 2023 7,425 2024 720 2025 - 2026 - $ 15,570

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2021
Stockholders Equity Deficit Tables [Abstract]
Summary of Stock Option Activity	A summary of the Company’s stock option activity during the year ended December 31, 2021 is presented below: No. of Shares Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Balance outstanding at December 31, 2020 2,595,000 $ 0.65 5.92 $ 56,000 Granted - - - $ - Exercised 100,000 0.11 Forfeited 150,000 — Expired 600,000 — Balance outstanding at December 31, 2021 1,745,000 $ 0.86 6.73 $ 12,000 Exercisable at December 31, 2021 1,495,000 $ 0.90 6.65 $ 8,000
Summary of Restricted Stock Awards Activity	The following table summarizes the RSAs activity for the year ended December 31, 2021: Number of Shares Fair Value Weighted Average Grant Date Fair Value Non-vested, December 31, 2020 2,902,892 $ 1,382,800 $ 0.48 Granted 147,058 100,000 0.68 Vested - - - Forfeited (475,723 ) (150,700 ) 0.32 Non-vested, December 31, 2021 2,574,227 1,332,100 $ 0.52

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Components of Income Tax Expense (Benefit)	The components of income tax expense (benefit) are as follows: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Current: Federal $ - $ - State 17,723 18,993 17,723 18,993 Deferred: Federal - - State - - - - Total Income tax expense $ 17,723 $ 18,993
Significant Components of Deferred Income Tax Assets and Liabilities	Significant components of the Company’s deferred income tax assets and liabilities are as follows: December 31, 2021 December 31, 2020 Deferred tax assets: Net operating loss carryforward $ 1,262,269 $ 786,751 Accounts receivable 104,635 165,431 Compensation 555,936 480,774 Inventory 523,131 588,966 Other 1,244 5,083 Total deferred tax assets 2,447,215 2,027,005 Deferred tax liabilities: Intangibles (198,801 ) (206,723 ) Property and equipment (1,522 ) (3,736 ) Total deferred tax liabilities (200,323 ) (210,459 ) Deferred tax assets, net 2,246,892 1,816,546 Valuation allowance: Beginning of year (1,816,546 ) (1,529,584 ) Increase during year (430,346 ) (286,962 ) Ending balance (2,246,892 ) (1,816,546 ) Net deferred tax asset $ - $ -
Reconciliation of Income Tax Computed at U.S. Statutory Rate to Effective Income Tax Rate	A reconciliation of income tax computed at the U.S. statutory rate to the effective income tax rate is as follows: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Statutory U.S. federal income tax rate 21.0 % 21.0 % Gain on Payroll Protection Program Loan 4.5 % 0.0 % Other reconciling items 0.0 % 4.2 % Permanent differences 0.0 % 0.0 % State income taxes, net of federal tax benefit -0.8 % -1.3 % Deferred tax asset valuation allowance -25.8 % -25.6 % Effective income tax rate -1.1 % -1.7 %

Concentrations (Tables)

Concentrations (Tables)	12 Months Ended
	Dec. 31, 2021
Revenues [Member]
Concentration Risk [Line Items]
Concentration of Revenues, Accounts Receivable and Suppliers	For the years ended December 31, 2021 and 2020, the following significant customers had an individual percentage of total revenue of approximately ten percent (10%) or greater: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Top customer 8.73 % 12.63 % Totals 8.73 % 12.63 %
Accounts Receivable [Member]
Concentration Risk [Line Items]
Concentration of Revenues, Accounts Receivable and Suppliers	For the years ended December 31, 2021 and 2020, the following significant customers had a concentration of total accounts receivables of approximately ten percent (10%) or greater: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Customer 1 13.46 % 8.80 % Customer 2 11.20 % 7.70 % Totals 24.66 % 16.50 %
Goods Purchased [Member]
Concentration Risk [Line Items]
Concentration of Revenues, Accounts Receivable and Suppliers	For the years ended December 31, 2021 and 2020, the following significant suppliers represented ten percent (10%) or greater of goods purchased: For the Year Ended December 31, 2021 For the Year Ended December 31, 2020 Supplier 1 20.40 % 25.60 % Supplier 2 11.00 % 8.30 % Totals 31.40 % 33.90 %

Nature of Operations (Details N

Nature of Operations (Details Narrative)	Aug. 01, 2018	Dec. 31, 2017	Dec. 31, 2021
Nature Of Operations And Going Concern [Line Items]
Percentage of common stock issued			61.40%
Percentage of common stock outstanding			61.40%
CPM [Member]
Nature Of Operations And Going Concern [Line Items]
Date of acquisition agreement		Dec. 31, 2017
Maxim Surgical, LLC [Member]
Nature Of Operations And Going Concern [Line Items]
Date of acquisition agreement	Aug. 1, 2018

Significant Accounting Polici_4

Significant Accounting Policies (Details Narrative)	12 Months Ended
	Dec. 31, 2021USD ($)Segment	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2017USD ($)
Significant Accounting Policies [Line Items]
Number of operating segments | Segment	1
Number of reportable segments | Segment	1
Earn-out liability	$ 11,593,832	$ 11,936,000	$ 11,645,365
Amount of earn-out liability increased/reduced	342,168	290,635
Cash equivalents	0	0
FDIC insurance limit	250,000
Deposits greater than federally insured limit	594,536	761,671
Goodwill impairment charge	0	0
Liabilities for uncertain tax positions, current	0	0
liabilities for uncertain tax positions, noncurrent	$ 0	0
ASU 2016-02 [Member]
Significant Accounting Policies [Line Items]
Change in Accounting Principle, Accounting Standards Update, Adopted [true false]	true
Change in Accounting Principle, Accounting Standards Update, Adoption Date	Jan. 1, 2020
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false]	true
Minimum [Member] | Cost of Revenue [Member]
Significant Accounting Policies [Line Items]
Inventory write-down	$ 586,545	728,002
Maximum [Member] | Cost of Revenue [Member]
Significant Accounting Policies [Line Items]
Inventory write-down	$ 2,491,183	$ 3,077,728
CPM [Member]
Significant Accounting Policies [Line Items]
Earn-out liability				$ 19,244,543
Earn-out payment start date	Jan. 1, 2018
Earn-out payment end date	Dec. 31, 2034
Earn-out payment base amount	$ 16,000,000
Earn-out payment additional bonus amount	$ 10,000,000
Discount rate on fair value earn-out liability	3.00%
Estimated earn out liability growth period	5 years
CPM [Member] | Minimum [Member]
Significant Accounting Policies [Line Items]
Earn-out payment during earn-out period	$ 0
Average EBITDA margin included in earn-out liability	1.00%
Estimated earn out liability growth period	4 years
Earn out liability revenue growth	6.00%
Earn out liability revenue growth thereafter	2.00%
CPM [Member] | Maximum [Member]
Significant Accounting Policies [Line Items]
Earn-out payment during earn-out period	$ 26,000,000
Average EBITDA margin included in earn-out liability	10.00%
Earn out liability revenue growth	11.00%
Earn out liability revenue growth thereafter	4.00%

Significant Accounting Polici_5

Significant Accounting Policies - Estimated Useful Lives of Assets (Details)	12 Months Ended
	Dec. 31, 2021
Computer equipment [Member]
Property Plant And Equipment [Line Items]
Estimated useful lives of the assets	3 years
Furniture and fixtures [Member]
Property Plant And Equipment [Line Items]
Estimated useful lives of the assets	3 years
Office equipment [Member]
Property Plant And Equipment [Line Items]
Estimated useful lives of the assets	3 years
Software [Member]
Property Plant And Equipment [Line Items]
Estimated useful lives of the assets	3 years

Significant Accounting Polici_6

Significant Accounting Policies - Schedule of Revenue Differentiation (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Disaggregation Of Revenue [Line Items]
Net revenues	$ 20,414,268	$ 21,398,936
Retail [Member]
Disaggregation Of Revenue [Line Items]
Net revenues	18,749,685	19,092,800
Wholesale [Member]
Disaggregation Of Revenue [Line Items]
Net revenues	$ 1,664,583	$ 2,306,136

Property and Equipment - Summar

Property and Equipment - Summary of Property and Equipment (Details) - USD ($)	Dec. 31, 2021	Dec. 31, 2020
Property Plant And Equipment [Line Items]
Property and equipment costs	$ 20,249	$ 49,918
Less: accumulated depreciation	(12,998)	(32,127)
Property and equipment, net	7,251	17,791
Computer Equipment and Software [Member]
Property Plant And Equipment [Line Items]
Property and equipment costs	$ 20,249	$ 49,918

Property and Equipment (Details

Property and Equipment (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Property Plant And Equipment [Abstract]
Depreciation expense	$ 10,540	$ 35,605
Fully depreciated assets retired	$ 29,669

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Schedule of Goodwill and Other Intangible Assets (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Schedule Of Finite And Indefinite Lived Intangible Assets [Line Items]
Total intangible assets	$ 1,496,557	$ 1,260,199
Less: accumulated amortization	(179,216)	(122,119)
Intangible assets, net	1,317,341	1,138,080
Goodwill	1,972,886	1,972,886
510(k) Product Technology [Member]
Schedule Of Finite And Indefinite Lived Intangible Assets [Line Items]
Indefinite lived intangible assets	$ 704,380	704,380
Intangible assets, amortization period	Indefinite
Goodwill [Member]
Schedule Of Finite And Indefinite Lived Intangible Assets [Line Items]
Intangible assets, amortization period	Indefinite
Customer Relationships [Member]
Schedule Of Finite And Indefinite Lived Intangible Assets [Line Items]
Finite lived intangible assets	$ 555,819	$ 555,819
Intangible assets, amortization period	11 years
CNH Credit Agreement [Member]
Schedule Of Finite And Indefinite Lived Intangible Assets [Line Items]
Finite lived intangible assets	$ 236,358
Intangible assets, amortization period	3 years

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Goodwill And Intangible Assets Disclosure [Abstract]
Amortization expense	$ 57,097	$ 68,538
Goodwill impairment charge	$ 0	$ 0

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Future Amortization Expense Related to Finite-Live Intangible Assets (Details)	Dec. 31, 2021USD ($)
Goodwill And Intangible Assets Disclosure [Abstract]
2022	$ 129,318
2023	129,318
2024	122,752
2025	50,532
2026	50,530
Beyond	130,511
Finite-live intangible assets	$ 612,961

Senior Secured Revolving Cred_2

Senior Secured Revolving Credit Facility (Details Narrative) - USD ($)

Dec. 14, 2021

Nov. 04, 2021

May 04, 2021

Nov. 12, 2020

May 21, 2020

May 06, 2020

Dec. 18, 2019

May 09, 2019

Nov. 19, 2018

Dec. 31, 2017

Dec. 29, 2017

Mar. 31, 2020

Dec. 31, 2019

Sep. 30, 2019

Jun. 30, 2019

Mar. 31, 2019

Dec. 31, 2018

Sep. 30, 2018

Sep. 30, 2020

Dec. 31, 2021

Dec. 31, 2020

RLOC [Member] | 0.25% Promissory Notes [Member]

Debt Instrument [Line Items]

Subordinated debt from affiliates

$ 200,000

Maturity date

May 6, 2022

Interest rate percentage

0.25%

Interest rate per annum after maturity date

10.00%

RLOC [Member] | 0.25% Promissory Notes [Member] | NC 143 [Member]

Debt Instrument [Line Items]

Borrowed from related parties

$ 180,000

RLOC [Member] | 0.25% Promissory Notes [Member] | RMI [Member]

Debt Instrument [Line Items]

Borrowed from related parties

$ 20,000

RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Fifth Amendment [Member]

Debt Instrument [Line Items]

Line of credit facility, expiration date

Nov. 4, 2020

Description of financial covenants

amended the financial covenants to state that the Company will not permit EBITDA to be less than $25,000 for the six months ended September 30, 2020

Minimum net profit required for compliance

$ 25,000

RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Sixth Amendment [Member]

Debt Instrument [Line Items]

Line of credit facility, expiration date

May 4, 2021

RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Seventh Amendment [Member]

Debt Instrument [Line Items]

Line of credit facility, expiration date

Nov. 4, 2021

RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Eighth Amendment [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 2,550,000

Line of credit facility, expiration date

Feb. 4, 2022

RLOC [Member] | CNH Finance Fund [Member] | Credit and Security Agreement [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 5,000,000

Minimum fixed charge coverage ratio

1.00%

Description of financial covenants

the last day of each calendar month (i) a current ratio of not less than 1.0 to 1.0, (ii) a fixed charge coverage ratio of not less than 1.0 to 1.0, (iii) a loan turnover rate of not greater than 60, and (iv) minimum liquidity of not less than $175,000, provided that if the Borrowers comply with the fixed charge coverage ratio for twelve consecutive months, the minimum liquidity covenant shall cease to be effective.

Maturity date

Jan. 1, 2025

Line of credit outstanding balance amount

$ 2,432,770

Interest expense

6,013

Accrued interest

6,013

Minimum current ratio

1.00%

Minimum liquidity amount

$ 175,000

Interest costs incurred

236,358

RLOC [Member] | CNH Finance Fund [Member] | Credit and Security Agreement [Member] | Prime Rate [Member]

Debt Instrument [Line Items]

Interest rate

1.75

CPM [Member]

Debt Instrument [Line Items]

Date of acquisition agreement

Dec. 31, 2017

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member]

Debt Instrument [Line Items]

Date of acquisition agreement

Dec. 29, 2017

Line of credit maximum borrowing capacity

$ 5,000,000

Percentage of guarantees of outstanding loan amount

50.00%

Line of credit outstanding balance amount

0

$ 913,352

Interest expense

39,883

61,036

Accrued interest

$ 0

$ 2,947

Effective interest rate

4.18%

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | First Amendment [Member]

Debt Instrument [Line Items]

Minimum net income to achieve

$ 700,000

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Second Amendment [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 4,000,000

Line of credit facility, expiration date

Nov. 4, 2019

Variable rate, description

the one-month LIBOR rate plus four percent

Variable rate

4.00%

Minimum fixed charge coverage ratio

1.25%

Description of financial covenants

the Fixed Charge Coverage Ratio of any calendar quarter end from and after the quarter ending June 30, 2019, to be less than 1.25 to 1.00; EBITDA to be less than $700,000 for the fiscal quarter ending December 31, 2018, and $100,000 for the fiscal quarter ending March 31, 2019

Minimum net profit required for compliance

$ 100,000

$ 700,000

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Third Amendment [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 3,500,000

Line of credit facility, expiration date

May 9, 2019

Description of financial covenants

amended the financial covenants to state that the Company will not permit EBITDA to be less than $100,000 for the fiscal quarter ending June 30, 2019 and $500,000 for the fiscal quarter ending September 30, 2019

Minimum net profit required for compliance

$ 500,000

$ 100,000

Line of credit component of inventory percentage

30.00%

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Fourth Amendment [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 2,750,000

Percentage of guarantees of outstanding loan amount

100.00%

Line of credit facility, expiration date

May 4, 2020

Description of financial covenants

amended the financial covenants to state that the Company will not permit EBITDA to be less than $600,000 for the fiscal quarter ending December 31, 2019 and $125,000 for the fiscal quarter ending March 31, 2020

Minimum net profit required for compliance

$ 125,000

$ 600,000

CPM [Member] | RLOC [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Fourth Amendment [Member] | Mr. Brooks [Member]

Debt Instrument [Line Items]

Maximum annual salary of chairman of board and president

$ 550,000

CPM [Member] | Credit Card Exposure [Member] | ZB, N.A. (d/b/a Amegy Bank) [Member] | Third Amendment [Member]

Debt Instrument [Line Items]

Line of credit maximum borrowing capacity

$ 500,000

Notes Payable - Related Parti_2

Notes Payable - Related Parties (Details Narrative) - USD ($)	Mar. 25, 2022	May 06, 2020	Oct. 31, 2016	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2017
Debt Instrument [Line Items]
Interest expense on notes payable				$ 27,501	$ 27,407
Accrued expenses [Member]
Debt Instrument [Line Items]
Accrued interest				$ 141,004	$ 113,503
10% Promissory Notes [Member] | NC 143 Family Holdings, LP and RMI [Member]
Debt Instrument [Line Items]
Convertible notes payable - related parties			$ 150,000
Interest rate of promissory notes			10.00%			18.00%
Debt Instrument, description				principal and interest balance into shares of the Company’s Common Stock at a conversion price of $0.08 per share.
Conversion price of common stock			$ 0.08
RLOC [Member] | 0.25% Promissory Notes [Member]
Debt Instrument [Line Items]
Interest rate percentage		0.25%
Maturity date		May 6, 2022
Interest rate per annum after maturity date		10.00%
RLOC [Member] | 0.25% Promissory Notes [Member] | NC 143 [Member]
Debt Instrument [Line Items]
Borrowed from related parties		$ 180,000
RLOC [Member] | 0.25% Promissory Notes [Member] | RMI [Member]
Debt Instrument [Line Items]
Borrowed from related parties		$ 20,000
RLOC [Member] | Subsequent Event [Member] | 0.25% Promissory Notes [Member]
Debt Instrument [Line Items]
Maturity date	May 6, 2023

Paycheck Protection Program L_2

Paycheck Protection Program Loan (Details Narrative) - Paycheck Protection Program [Member] - USD ($)	Apr. 11, 2020	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Gain on interest expense		$ 2,720
Interest expense			$ 2,720
CARES Act [Member]
Debt Instrument [Line Items]
Promissory note principal amount	$ 361,400
Maturity date	Apr. 11, 2022
Interest rate percentage	1.00%

Economic Injury Disaster Loan (

Economic Injury Disaster Loan (Details Narrative) - USD ($)	Sep. 24, 2021	May 12, 2020	Dec. 31, 2021	Dec. 31, 2020
Accrued expenses [Member]
Debt Instrument [Line Items]
Accrued interest			$ 141,004	$ 113,503
Economic Injury Disaster Loan Assistance Program [Member]
Debt Instrument [Line Items]
Interest expense			7,554	3,791
Economic Injury Disaster Loan Assistance Program [Member] | Accrued expenses [Member]
Debt Instrument [Line Items]
Accrued interest			$ 0	$ 3,791
CARES Act [Member] | Economic Injury Disaster Loan Assistance Program [Member]
Debt Instrument [Line Items]
Loan principal amount	$ 500,000	$ 150,000
Interest rate percentage	3.75%	3.75%
Debt instrument frequency of periodic payment			monthly
Debt instrument date of first required payment	May 12, 2022	May 12, 2021
Installment payments including principal and interest	$ 2,515	$ 731
Loan principal and interest payable term	30 years	30 years
Increased loan amount	$ 350,000
CARES Act [Member] | Economic Injury Disaster Loan Assistance Program [Member] | Selling, General, Administrative and Other Expenses [Member]
Debt Instrument [Line Items]
Advance extinguished reflected offset in expenses		$ 10,000

Commitments and Contingencies_2

Commitments and Contingencies (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Commitments And Contingencies [Line Items]
Lease termination date	Dec. 31, 2017
Operating lease requires monthly payments	$ 14,000
Office Equipment One [Member]
Commitments And Contingencies [Line Items]
Operating lease expiration description	March 2021, and continued on a month to month basis,
Office Equipment Two [Member]
Commitments And Contingencies [Line Items]
Operating lease expiration month and year	2024-03
Office Equipment Leases [Member]
Commitments And Contingencies [Line Items]
Operating lease requires monthly payments	$ 875
Selling, General, Administrative and Other Expenses [Member]
Commitments And Contingencies [Line Items]
Rent expense	168,000	$ 168,000
Selling, General, Administrative and Other Expenses [Member] | Office Equipment Leases [Member]
Commitments And Contingencies [Line Items]
Rent expense	$ 10,500	$ 10,000

Commitments and Contingencies -

Commitments and Contingencies - Summary of Operating Leases (Details)	Dec. 31, 2021USD ($)
Commitments And Contingencies Disclosure [Abstract]
2022	$ 7,425
2023	7,425
2024	720
Total	$ 15,570

Stockholders' Equity (Details N

Stockholders' Equity (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Non-Qualified Stock Option Awards [Member]
Class Of Stock [Line Items]
Stock options, granted	0	0
Unrecognized compensation expenses on stock options	$ 22,852
Non-Qualified Stock Option Awards [Member] | Selling, General, Administrative and Other Expenses [Member]
Class Of Stock [Line Items]
Share-based compensation expense	257,913	$ 553,184
Restricted Common Stock [Member]
Class Of Stock [Line Items]
Share-based compensation expense	$ 0	$ 0

Stockholders' Equity - Summary

Stockholders' Equity - Summary of Stock Option Activity (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
No. of Shares, Abstract
No. of Shares, Beginning Balance	2,595,000
Exercised, No. of Shares	100,000
Forfeited, No. of Shares	150,000
Expired, No. of Shares	600,000
No. of Shares, Ending Balance	1,745,000	2,595,000
Exercisable, No. of Shares	1,495,000
Weighted Average Exercise Price, Abstract
Weighted Average Exercise Price, Beginning Balance	$ 0.65
Exercised, Weighted Average Exercise Price	0.11
Weighted Average Exercise Price, Ending Balance	0.86	$ 0.65
Exercisable, Weighted Average Exercise Price	$ 0.90
Weighted Average Remaining Contractual Term, Abstract
Weighted Average Remaining Contractual Term, Balance outstanding	6 years 8 months 23 days	5 years 11 months 1 day
Weighted Average Remaining Contractual Term, Exercisable	6 years 7 months 24 days
Aggregate Intrinsic Value, Abstract
Aggregate Intrinsic Value, Balance outstanding	$ 12,000	$ 56,000
Aggregate Intrinsic Value, Exercisable	$ 8,000

Stockholders' Equity - Summar_2

Stockholders' Equity - Summary of Restricted Stock Awards Activity (Details) - Restricted Stock Awards [Member]	12 Months Ended
	Dec. 31, 2021USD ($)$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Number of Shares, Non-vested, Balance	2,902,892
Number of Shares, Granted	147,058
Number of Shares, Vested	0
Number of Shares, Forfeited	(475,723)
Number of Shares, Non-vested, Balance	2,574,227
Share-based Compensation Arrangement by Share Based Payment Award, Equity Instruments Other than Options, Nonvested, Fair Value [Abstract]
Fair Value, Non-vested, Balance | $	$ 1,382,800
Fair Value, Granted | $	100,000
Fair Value, Forfeited | $	(150,700)
Fair Value, Non-vested, Balance | $	$ 1,332,100
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Weighted Average Grant Date Fair Value, Non-vested, Balance | $ / shares	$ 0.48
Weighted Average Grant Date Fair Value, Granted | $ / shares	0.68
Weighted Average Grant Date Fair Value, Forfeited | $ / shares	0.32
Weighted Average Grant Date Fair Value, Non-vested, Balance | $ / shares	$ 0.52

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Benefit) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Current:
Federal	$ 0	$ 0
State	17,723	18,993
Income tax expense (benefit)	17,723	18,993
Deferred:
Federal	0	0
State	0	0
Income tax expense (benefit)	0	0
Total Income tax expense	$ 17,723	$ 18,993

Income Taxes - Significant Comp

Income Taxes - Significant Components of Deferred Income Tax Assets and Liabilities (Details) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Deferred tax assets:
Net operating loss carryforward	$ 1,262,269	$ 786,751
Accounts receivable	104,635	165,431
Compensation	555,936	480,774
Inventory	523,131	588,966
Other	1,244	5,083
Total deferred tax assets	2,447,215	2,027,005
Deferred tax liabilities:
Intangibles	(198,801)	(206,723)
Property and equipment	(1,522)	(3,736)
Total deferred tax liabilities	(200,323)	(210,459)
Deferred tax assets, net	2,246,892	1,816,546
Valuation allowance:
Beginning of year	(1,816,546)	(1,529,584)
Increase during year	(430,346)	(286,962)
Ending balance	(2,246,892)	(1,816,546)
Net deferred tax asset	$ 0	$ 0

Income Taxes (Details Narrative

Income Taxes (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Operating Loss Carryforwards [Line Items]
Valuation allowance	$ 430,346	$ 286,962
Deferred tax assets, valuation allowance	2,246,892	$ 1,816,546	$ 1,529,584
Net operating loss carryforwards	$ 6,010,806
Net operating loss carryforwards earliest expiration year	2021
Net operating loss carryforwards latest expiration year	2037
Effective income tax rates	(1.10%)	(1.70%)
IRC Section 382 [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 2,963,968
Operating Carryforwards Expiration Date from 2021 to 2037 [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 3,863,299

Income Taxes - Reconciliation o

Income Taxes - Reconciliation of Income Tax Computed at U.S. Statutory Rate to Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Statutory U.S. federal income tax rate	21.00%	21.00%
Gain on Payroll Protection Program Loan	4.50%	0.00%
Other reconciling items	0.00%	4.20%
Permanent differences	0.00%	0.00%
State income taxes, net of federal tax benefit	(0.80%)	(1.30%)
Deferred tax asset valuation allowance	(25.80%)	(25.60%)
Effective income tax rate	(1.10%)	(1.70%)

Concentrations - Significant Cu

Concentrations - Significant Customers with Individual Percentage of Total Revenues Equaling Ten Percent (10%) or Greater (Details) - Revenues [Member] - Customer Concentration Risk [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Top Customer [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	8.73%	12.63%
Group Of Customers [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	8.73%	12.63%

Concentrations - Significant _2

Concentrations - Significant Customers with Concentration of Accounts Receivable Representing Ten Percent (10%) or Greater of Accounts Receivable (Details) - Accounts Receivable [Member] - Customer Concentration Risk [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Customer 1 [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	13.46%	8.80%
Customer 2 [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	11.20%	7.70%
Group Of Customers [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	24.66%	16.50%

Concentrations - Significant Su

Concentrations - Significant Suppliers Represented Ten Percent (10%) or Greater of Goods Purchased (Details) - Goods Purchased [Member] - Supplier Concentration Risk [Member]	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Supplier 1 [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	20.40%	25.60%
Supplier 2 [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	11.00%	8.30%
Group Of Suppliers [Member]
Concentration Risk [Line Items]
Concentration risk, percentage	31.40%	33.90%

Related Party Transactions (Det

Related Party Transactions (Details Narrative)	12 Months Ended
	Dec. 31, 2021USD ($)ft²FullTimeEquivalent	Dec. 31, 2020USD ($)
Related Party Transaction [Line Items]
Lease termination date	Dec. 31, 2017
Selling, General, Administrative and Other Expenses [Member]
Related Party Transaction [Line Items]
Rent expense	$ 168,000	$ 168,000
1565 North Central Expressway, LP [Member]
Related Party Transaction [Line Items]
Area of leased property | ft²	11,500
Lease termination date	Dec. 31, 2017
1565 North Central Expressway, LP [Member] | Selling, General, Administrative and Other Expenses [Member]
Related Party Transaction [Line Items]
Rent expense	$ 168,000	168,000
AmBio [Member]
Related Party Transaction [Line Items]
Number of full time equivalents | FullTimeEquivalent	42
Number of full time equivalents directly support company | FullTimeEquivalent	36
Number of full time equivalents support operations of other companies | FullTimeEquivalent	5
Number of full time equivalents shared between company and other companies | FullTimeEquivalent	1
AmBio [Member] | Account Payables [Member]
Related Party Transaction [Line Items]
Due to related parties	$ 170,784	154,051
AmBio [Member] | Selling, General, Administrative and Other Expenses [Member]
Related Party Transaction [Line Items]
Administrative fees	195,093	172,221
MedUSA Group, LLC [Member]
Related Party Transaction [Line Items]
Net revenues from related parties	1,400	29,822
MedUSA Group, LLC [Member] | Account Receivables [Member]
Related Party Transaction [Line Items]
Due from related parties	63,498	398,151
MedUSA Group, LLC [Member] | Commission [Member]
Related Party Transaction [Line Items]
Expense incurred on behalf of related parties	3,696,583	3,527,783
MedUSA Group, LLC [Member] | Commission [Member] | Accrued expenses [Member]
Related Party Transaction [Line Items]
Due to related parties	923,960	960,932
Texas Overlord, LLC [Member] | Commission [Member]
Related Party Transaction [Line Items]
Due to related parties	40,000	20,000
Expense incurred on behalf of related parties	240,000	190,000
N.B.M.J., Inc. [Member]
Related Party Transaction [Line Items]
Net revenues from related parties	74,501	24,708
Due from related parties	2,080	2,080
Bass Bone And Spine Specialists [Member]
Related Party Transaction [Line Items]
Net revenues from related parties	35,065	81,350
Bass Bone And Spine Specialists [Member] | Account Receivables [Member]
Related Party Transaction [Line Items]
Due from related parties	8,413	20,117
Bass Bone And Spine Specialists [Member] | Commission [Member]
Related Party Transaction [Line Items]
Expense incurred on behalf of related parties	0	16,885
Sintu L L C | Commission [Member]
Related Party Transaction [Line Items]
Due to related parties	557,228	163,567
Expense incurred on behalf of related parties	583,218	575,918
Tiger Orthopedics, LLC [Member]
Related Party Transaction [Line Items]
Net revenues from related parties	502	39,922
Modal Manufacturing, LLC [Member]
Related Party Transaction [Line Items]
Due to related parties	709,234
Modal Manufacturing, LLC [Member] | Inventory Net
Related Party Transaction [Line Items]
Purchases from related parties	$ 766,640	$ 508,597