Document And Entity Information	6 Months Ended
Document And Entity Information	Jun. 30, 2015	Aug. 06, 2015
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2015
Document Fiscal Year Focus	2015
Document Fiscal Period Focus	Q2
Entity Registrant Name	Xtant Medical Holdings, Inc.
Entity Central Index Key	0001453593
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Trading Symbol	BONE
Entity Common Stock, Shares Outstanding		11,746,051

CONDENSED CONSOLIDATED BALANCE SHEETS (USD $)	Jun. 30, 2015	Dec. 31, 2014
Current Assets:
Cash and cash equivalents	$ 2,026,108	$ 4,468,208
Trade accounts receivable, net of allowance for doubtful accounts of $1,322,569 and $1,392,989, respectively	5,574,285	4,427,081
Inventories, net	9,392,150	9,558,648
Prepaid and other current assets	1,033,605	654,140
Total current assets	18,026,148	19,108,077
Non-current inventories	1,839,971	1,934,258
Property and equipment, net	4,430,038	4,654,527
Intangible assets, net	609,348	655,490
Other assets	1,446,515	1,598,539
Total Assets	26,352,020	27,950,891
Current Liabilities:
Accounts payable	4,577,488	3,876,760
Accounts payable - related party	293,565	250,629
Accrued liabilities	2,399,599	1,921,301
Warrant derivative liability	1,796,660	1,320,371
Current portion of capital lease obligations	42,761	61,970
Current portion of royalty liability	1,169,500	1,000,750
Current portion of long-term debt	52,374	50,671
Total current liabilities	10,331,947	8,482,452
Long-term Liabilities:
Capital lease obligation, less current portion	37,496	11,808
Long-term royalty liability, less current portion	6,139,374	6,361,216
Long-term debt, less current portion	21,691,674	20,870,330
Total Liabilities	38,200,491	35,725,806
Commitments and Contingencies
Stockholders' (Deficit) Equity
Preferred stock, $0.000001 par value; 5,000,000 shares authorized; no shares issued and outstanding	0	0
Common stock, $0.000001 par value; 95,000,000 shares authorized; 7,464,085 shares issued and outstanding as of June 30, 2015 and 6,679,646 shares issued and outstanding as of December 31, 2014	7	7
Additional paid-in capital	66,091,741	63,091,620
Accumulated deficit	(77,940,219)	(70,866,542)
Total Stockholders’ Deficit	(11,848,471)	(7,774,915)
Total Liabilities & Stockholders’ Deficit	$ 26,352,020	$ 27,950,891

CONDENSED CONSOLIDATED BALANCE SHEETS [Parenthetical] (USD $)	Jun. 30, 2015	Dec. 31, 2014
Trade accounts receivable, allowance for doubtful accounts (in dollars)	$ 1,322,569	$ 1,392,989
Preferred stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.000001	$ 0.000001
Common stock, shares authorized	95,000,000	95,000,000
Common stock, shares issued	7,464,085	6,679,646
Common Stock, shares outstanding	7,464,085	6,679,646

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (USD $)	3 Months Ended		6 Months Ended
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (USD $)	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Revenue
Tissue sales	$ 9,732,909	$ 8,714,915	$ 19,009,956	$ 17,466,260
Royalties and other	159,706	169,017	385,773	330,642
Total Revenue	9,892,615	8,883,932	19,395,729	17,796,902
Cost of sales	3,375,288	3,290,512	6,847,766	6,701,218
Gross Profit	6,517,327	5,593,420	12,547,963	11,095,684
Operating Expenses
General and administrative	2,399,133	2,093,792	4,824,300	4,382,595
Sales and marketing	5,035,577	4,405,227	9,749,249	8,460,431
Research and development	291,171	322,277	724,732	576,860
Depreciation and amortization	100,663	82,432	224,774	157,580
Non-cash consulting expense	74,074	21,701	140,869	42,228
Total Operating Expenses	7,900,618	6,925,429	15,663,924	13,619,694
Loss from Operations	(1,383,291)	(1,332,009)	(3,115,961)	(2,524,010)
Other Income (Expense)
Interest expense	(1,383,642)	(1,441,989)	(2,819,220)	(2,717,601)
Change in warrant derivative liability	(14,081)	870,494	(476,289)	(615,235)
Non-cash consideration associated stock agreement	0	0	(558,185)	0
Other income (expense)	(114,963)	3,074	(103,126)	(183,839)
Total Other Income (Expense)	(1,512,686)	(568,421)	(3,956,820)	(3,516,675)
Net Loss from Operations	$ (2,895,977)	$ (1,900,430)	$ (7,072,781)	$ (6,040,685)
Net loss per share:
Basic	$ (0.41)	$ (0.35)	$ (1.02)	$ (1.11)
Dilutive	$ (0.41)	$ (0.35)	$ (1.02)	$ (1.11)
Shares used in the computation:
Basic	7,137,391	5,514,694	6,914,698	5,447,204
Dilutive	7,137,391	5,514,694	6,914,698	5,447,204

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	6 Months Ended
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	Jun. 30, 2015	Jun. 30, 2014
Operating activities:
Net loss	$ (7,072,781)	$ (6,040,685)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	446,799	345,580
Non-cash interest	363,375	0
Non-cash consideration associated with stock purchase agreement	558,185	0
Gain on sale of fixed assets	(17,215)	(13,285)
Amortization of debt discount	848,773	739,127
Non-cash consulting expense/stock option expense	444,395	668,876
Provision for losses on accounts receivable and inventory	(19,394)	338,720
Change in derivative warrant liability	476,289	615,235
Changes in operating assets and liabilities:
Accounts receivable	(1,076,784)	(220,453)
Inventories	209,760	306,863
Prepaid and other assets	(352,704)	(274,825)
Accounts payable	742,767	1,040,469
Accrued liabilities	358,298	(1,376,180)
Net cash used in operating activities	(4,090,237)	(3,870,558)
Investing activities:
Purchases of property and equipment and intangible assets	(70,441)	(115,202)
Proceeds from sale of fixed assets	16,415	36,071
Net cash used in investing activities	(54,026)	(79,131)
Financing activities:
Proceeds from issuance of debt	0	4,000,000
Payments on long-term debt	(25,727)	(24,242)
Payments on capital leases	(64,442)	(82,987)
Payment on royalty obligation	(325,228)	0
Net proceeds from issuance of stock	2,117,560	0
Net cash provided by financing activities	1,702,163	3,892,771
Net change in cash and cash equivalents	(2,442,100)	(56,918)
Cash and cash equivalents at beginning of period	4,468,208	3,046,340
Cash and cash equivalents at end of period	$ 2,026,108	$ 2,989,422

Business Description and Summary of Significant Accounting Policies

6 Months Ended

Jun. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description and Summary of Significant Accounting Policies

(1) Business Description and Summary of Significant Accounting Policies

Business Description

The accompanying consolidated financial statements include the accounts of Xtant Medical Holdings, Inc. (“Xtant”) formerly known as Bacterin International Holdings, Inc., a Delaware corporation, and its wholly owned subsidiary, Bacterin International, Inc., (“Bacterin”) a Nevada corporation (Xtant and Bacterin are jointly referred to herein as, the “Company”). All intercompany balances and transactions have been eliminated in consolidation. Bacterin develops, manufactures and markets biologic products to domestic and international markets. Bacterin’s proprietary methods are used to process human derived allografts into scaffolds that promote bone and other tissue growth. These products are used in a variety of applications including enhancing fusion in spine surgery, relief of back pain with a facet joint stabilization, promotion of bone growth in foot and ankle surgery, promotion of skull healing following neurosurgery and regeneration in knee and other joint surgeries.

Bacterin also previously developed and licensed coatings for various medical device applications. As of December 31, 2014, Bacterin made a strategic decision to discontinue the medical device coatings business which resulted in an impairment of related assets. (See Note 4, “Impairment of Assets”).

An operating segment is a component of an enterprise whose operating results are regularly reviewed by the enterprise’s chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance. The primary performance measure used by management is net income or loss. Up until December 31, 2014, the Company operated two distinct lines of business consisting of the biologics and the device divisions; however, due to immaterial revenue from the device division, the Company has reported as one segment.

On July 31, 2015, Xtant acquired all of the outstanding capital stock of X-spine Systems, Inc. (“X-spine”) for approximately $60 million in cash, repayment of approximately $13 million of X-spine debt, and approximately 4.24 million shares of Xtant common stock. (See Note 15 Subsequent Events) X-spine is engaged in the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries. Financial statements of X-spine are not included in this report because the acquisition occurred after the end of the second quarter.

The markets in which the Company competes are highly competitive and rapidly changing. Significant technological advances, changes in customer requirements, or the emergence of competitive products with new capabilities or technologies could adversely affect the Company's operating results. The Company's business could be harmed by a decline in demand for, or in the prices of, its products or as a result of, among other factors, any change in pricing or distribution methods, increased price competition, changes in government regulations or a failure by the Company to keep up with technological change. Further, a decline in available tissue donors could have an adverse impact on our business.

The accompanying interim condensed consolidated financial statements of the Company for the six months ended June 30, 2015 and 2014 are unaudited and are prepared in accordance with accounting principles generally accepted in the United States of America. They do not include all disclosures required by generally accepted accounting principles for annual financial statements, but in the opinion of management, include all adjustments, consisting only of normal recurring items, necessary for a fair presentation. Interim results are not necessarily indicative of results which may be achieved in the future for the full year ending December 31, 2015.

These financial statements should be read in conjunction with the financial statements and notes thereto which are included in our Annual Report on Form 10-K for the year ended December 31, 2014. The accounting policies set forth in those annual financial statements are the same as the accounting policies utilized in the preparation of these financial statements, except as modified for appropriate interim financial statement presentation.

Reverse Stock Split

Xtant completed a 1:10 reverse split of its common stock, effective at the close of business on Friday, July 25, 2014 and in effect for trading purposes on Monday, July 28, 2014. The reverse stock split was approved by Xtant shareholders at the 2014 Annual Meeting of Shareholders on June 11, 2014. All references to common stock, stock options, restricted stock units, warrants, and per share amounts have been retroactively adjusted to reflect the reverse stock split for all periods presented.

Public Offering

In August 2014, Xtant offered 1,143,000 shares of its common stock at $5.70 per share and warrants to purchase 571,500 shares of its common stock at an exercise price of $7.12 per share to the public. Gross proceeds of the offering were approximately $6.5 million. Net proceeds from the offering were approximately $5.9 million and were used for working capital and general corporate purposes. The offering closed on August 6, 2014. The warrants have a five year term and expire on August 6, 2019. We utilize a valuation model to determine the fair market value and account for these warrants as a derivative liability (see "Derivative Instruments" below). (Also, see Note 10, "Warrants" below).

Aspire Capital Transaction

We entered into a Common Stock Purchase Agreement on March 16, 2015, as amended and restated on April 17, 2015 (the “Purchase Agreement”), with Aspire Capital Fund, LLC (“Aspire Capital”), which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $10.0 million of our shares of common stock over the approximately 24-month term of the Purchase Agreement. Pursuant to the terms of the Purchase Agreement, in the first quarter of 2015 we issued 207,182 shares of our common stock to Aspire Capital for $750,000 in aggregate proceeds, along with 154,189 shares of our common stock which were valued at $3.62 per share and included as $558,185 on the Statement of Operations to Aspire Capital as a commitment fee. In the second quarter of 2015, following the effectiveness of our Registration Statement on Form S-1, we issued 417,000 shares of our common stock to Aspire Capital for $1,387,439 in aggregate proceeds, which were used for working capital and general corporate purposes. (See Note 2, “Equity” below).

Concentrations and Credit Risk

The Company’s accounts receivable are due from a variety of health care organizations and distributors throughout the world. Approximately 97% and 98% of sales were in the United States respectively for the six months ended 2015 and 2014. No single customer accounted for more than 10% of revenue or accounts receivable for the comparable periods. The Company provides for uncollectible amounts when specific credit issues arise. Management’s estimates for uncollectible amounts have been adequate during prior periods, and management believes that all significant credit risks have been identified at June 30, 2015.

Revenue by geographical region is as follows:

	Six Months Ended June 30,
	2015		2014
United States	$	18,831,197	$	17,509,988
Rest of World		564,532		286,914
	$	19,395,729	$	17,796,902

Use of Estimates

The preparation of the financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment and intangible assets; valuation allowances for trade receivables and deferred income tax assets; valuation of the warrant derivative liability; inventory reserve; royalty liability; and estimates for the fair value of stock options grants and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.

Long-Lived Assets

Long-lived assets, including intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future net cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets. See Note 4, “Impairment of Assets”.

Revenue Recognition

Revenue is recognized when all of the following criteria are met: a) the Company has entered into a legally binding agreement with the customer; b) the products or services have been delivered; c) the Company's fee for providing the products and services is fixed or determinable; and d) collection of the Company’s fee is probable.

The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. If an arrangement includes a right of acceptance or a right to cancel, revenue is recognized when acceptance is received or the right to cancel has expired.

The Company ships to certain customers under consignment arrangements whereby the Company’s product is stored by the customer. The customer is required to report the use to the Company and upon such notice, the Company invoices the customer and revenue is recognized when above criteria have been met.

The Company also receives royalty revenue from third parties related to licensing agreements. The Company has royalty agreements with RyMed and Bard Access Systems. Revenue under these agreements represented less than 0.5% of total revenue for the six months ended June 30, 2015 and 2014.

Advertising Costs

The Company expenses advertising costs as incurred. The Company had advertising expense of $3,688 and $27,914 for the six months ended June 30, 2015 and 2014, respectively.

Research and Development

Research and development costs, which are principally related to internal costs for the development of new allograft technologies and processes are expensed as incurred.

Net Loss Per Share

Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of common shares outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net income (loss) per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive common shares outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net loss per share was the same as basic net loss per share for the three and six months ended June 30, 2015 and 2014, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net losses incurred for those periods. Dilutive earnings per share are not reported as their effects of including 2,142,257 and 1,784,107 outstanding stock options and warrants for the six months ended June 30, 2015 and 2014, respectively, are anti-dilutive.

Fair Value of Financial Instruments

The carrying values of financial instruments, including trade accounts receivable, accounts payable, other accrued expenses and long-term debt, approximate their fair values based on terms and related interest rates.

The Company follows a framework for measuring fair value. The framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below:

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument's level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. During the three and six months ended June 30, 2015 and 2014, there was no reclassification in financial assets or liabilities between Level 1, 2 or 3 categories.

The following table sets forth by level, within the fair value hierarchy, our liabilities as of June 30, 2015 and December 31, 2014 that are measured at fair value on a recurring basis:

Warrant derivative liability

	As of June 30, 2015		As of December 31, 2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,796,660	$	1,320,371

The valuation technique used to measure fair value of the warrant liability is based on a valuation model and significant assumptions and inputs determined by us (See Note 10, “Warrants” below).

Level 3 Changes

The following is a reconciliation of the beginning and ending balances for liabilities measured at fair value on a recurring basis using significant unobservable inputs (Level 3) during the six months ended June 30, 2015:

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first quarter of 2015		462,208
Balance at March 31, 2015		1,782,579
Loss recognized in earnings in second quarter of 2015		14,081
Balance at June 30, 2015	$	1,796,660

During the first six months ended June 30, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value.

Recent Accounting Pronouncements

In November 2014, FASB issued ASU No. 2014-08, Presentation of Financial Statements (Topic 201) and Property, Plant and Equipment (Topic 360) - Reporting Discontinued Operations and Disclosures of Disposals of Components of an Entity. The amendments in this Update are effective for the annual period ending after December 15, 2014, and interim periods within those years. Early adoption is permitted only for disposals (or classifications as held for sale) that have not been reported in financial statements previously issued or available for issuance. ASU 2014-08 is not expected to have a material impact on our consolidated financial position, results of operations, or cash flows.

In April 2015, the FASB issued ASU 2015-3, to simplify the presentation of debt issuance costs. This update requires that debt issuance costs be presented in the balance sheet as a direct deduction from the carrying amount of the associated debt liability, consistent with the required presentation for debt discounts. This update is effective for interim and annual periods beginning after December 15, 2015. ASU 2015-3 is not expected to have a material impact.

Equity

6 Months Ended

Jun. 30, 2015

Equity [Abstract]

Equity

(2) Equity

During the first quarter of 2014, the Company issued 150,000 shares of common stock to an affiliate of ROS Acquisition Offshore LP (“ROS”) pursuant to a Sixth Amendment to our Credit Agreement with ROS whereby we borrowed an additional $4 million under our Credit Agreement. This issuance has been accounted for as a debt discount and will be amortized over the life of the loan. (See Note 8, “Long-term Debt” below).

In August 2014, the Company offered 1,143,000 shares of its common stock at $5.70 per share and warrants to purchase 571,500 shares of its common stock at an exercise price of $7.12 per share to the public. Gross proceeds of the offering were approximately $6.5 million. Net proceeds from the offering were approximately $5.9 million and were used for working capital and general corporate purposes. The offering closed on August 6, 2014. The warrants have a five year term and expire on August 6, 2019. The Company utilizes a valuation model to determine the fair market value and accounts for these warrants as a derivative liability (See Note 1, “Fair Value of Financial Instruments" above). (Also, see Note 10, "Warrants" below).

We entered into a Purchase Agreement on March 16, 2015, as amended and restated April 17, 2015, with Aspire Capital which provides that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital is committed to purchase up to an aggregate of $10.0 million in shares of our common stock over the 24-month term. The stock purchase transactions are at the Company’s option. Pursuant to the terms and conditions in the Purchase Agreement, in the first quarter of 2015, we issued 207,182 shares of our common stock for $750,000 in aggregate proceeds, along with 154,189 shares of our common stock as a commitment fee. In the second quarter of 2015, following the effectiveness of our Registration Statement on Form S-1, we issued 417,000 shares of our common stock to Aspire Capital for $1,387,439 in aggregate proceeds, which were used for working capital and general corporate purposes.

Under the Purchase Agreement, we have the right, at our sole discretion, to present Aspire Capital with purchase notices, directing Aspire Capital (as principal) to purchase up to 50,000 shares of our common stock, per trading day, provided that the aggregate price of each such purchase shall not exceed $500,000 per trading day, at a per share price equal to the lesser of:

•

the lowest sale price of our common stock on the purchase date; or

•

the arithmetic average of the three lowest closing sale prices for our common stock during the ten consecutive trading days ending on the trading day immediately preceding the purchase date.

In addition, we also have the right to present Aspire Capital with volume-weighted average price purchase notices directing Aspire Capital to purchase an amount of our common stock equal to up to 30% of the aggregate shares of our common stock traded on the OTCQX marketplace on the next trading day, subject to the terms, conditions and limitations in the Purchase Agreement.

The Purchase Agreement may be terminated by us at any time, at our discretion, without any penalty or cost to us. The Purchase Agreement also provides for customary events of default, upon the occurrence of which Aspire Capital may terminate the Purchase Agreement. Aspire Capital has agreed that neither it nor any of its agents, representatives or affiliates shall engage in any direct or indirect short-selling or hedging of our common stock during any time prior to the termination of the Purchase Agreement. Any proceeds we receive under the Purchase Agreement are expected to be used for working capital and general corporate purposes.

Impairment of Assets

6 Months Ended

Jun. 30, 2015

Impairment or Disposal of Tangible Assets Disclosure [Abstract]

Impairment of Assets

(4) Impairment of Assets

During the fourth quarter of 2014, management decided to dispose of a group of components because of a shift in strategy for the Company. The component groups are the inventory and fixed assets associated with the Device Coatings and Cranial Maxillofacial Fixation (CMF) lines of business.

Sales for these product lines represented less than 1% of total revenue in both the first six months of 2015 and 2014. Gross profit associated with these product lines were less than 1% of total gross profit for both periods.

Total assets associated with the two lines at December 31, 2014 included $80,042 of related fixed assets, net of depreciation, and related inventory of $832,507 for a total value of $912,549. These assets were transferred to Assets held for Sale and are classified on the balance sheet at December 31, 2014 as part of “Prepaid and other current assets”. After the impairment provision, the net balance of the Assets Held for Sale was $0 at December 31, 2014.

The sale of the CMF inventory occurred during the first quarter of 2015 and did not result in any tangible payment to the Company. The sale of the Device Coatings line of business occurred subsequent to June 30, 2015. (See Note 15, “Subsequent Event” below). The terms of the sale call for an initial payment to the Company of approximately $250,000, and an additional contingent payment of $100,000, both of which are secured by promissory notes.

Property and Equipment, Net

6 Months Ended

Jun. 30, 2015

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

(5) Property and Equipment, Net

Property and equipment, net are as follows:

	June 30,		December 31,
	2015		2014
Buildings	$	1,657,579	$	1,657,579
Equipment		4,800,284		4,724,608
Computer equipment		225,009		225,009
Computer software		360,171		345,039
Furniture and fixtures		153,834		153,834
Leasehold improvements		2,381,413		2,380,617
Vehicles		10,000		41,099
Total cost		9,588,290		9,527,785
Less: accumulated depreciation		(5,158,252)		(4,873,258)
	$	4,430,038	$	4,654,527

The Company leases certain equipment under capital leases. For financial reporting purposes, minimum lease payments relating to the assets have been capitalized. As of June 30, 2015, the Company has recorded $537,480 gross assets in Equipment, and $212,568 of accumulated depreciation relating to assets under capital leases.

Maintenance and repairs expense for the six months of 2015 and 2014 was $173,443 and $140,504, respectively. Depreciation expense related to property and equipment, including property under capital lease for the first six months of 2015 and 2014 was $336,913 and $307,747, respectively.

Intangible Assets

6 Months Ended

Jun. 30, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets

(6) Intangible Assets

Bacterin has applied for various patents with regards to processes for its products.

The following table sets forth information regarding intangible assets:

	June 30, 2015		December 31, 2014
Intellectual Property
Gross carrying value	$	1,032,724	$	1,036,580
Accumulated amortization		(423,376)		(381,090)
Net carrying value	$	609,348	$	655,490

Aggregate amortization expense:	$	75,860	$	77,022

The following is a summary of estimated future amortization expense for intangible assets as of June 30, 2015:

Remainder of 2015	$	45,093
2016		59,343
2017		59,343
2018		59,154
2019		55,565
Thereafter		330,850
Total	$	609,348

Long-term Debt

6 Months Ended

Jun. 30, 2015

Debt Disclosure [Abstract]

Long-term Debt

(8) Long-term Debt

On March 6, 2014, we entered into a Sixth Amendment to our Credit Agreement with ROS whereby we borrowed an additional $4.0 million under our Credit Agreement with ROS and agreed to issue 150,000 shares to an affiliate of ROS. We used the proceeds for working capital and general corporate purposes.

Long-term debt consists of the following:

	June 30, 2015		December 31, 2014
Loan payable to ROS Acquisition Offshore, LIBOR plus 12.13% maturing August 2019	$	24,000,000	$	24,000,000
Adjustment fee payable to ROS Acquisition Offshore, due in August 2019		700,000		700,000
6.00% loan payable to Valley Bank of Belgrade, $10,746 monthly payments including interest, maturing December 24, 2030; secured by building		1,300,087		1,325,814
		26,000,087		26,025,814
Less: current portion		(52,374)		(50,671)
Debt discount		(4,256,039)		(5,104,813)
Long-term debt	$	21,691,674	$	20,870,330

The following is a summary of maturities due on the debt as of June 30, 2015:

Remainder of 2015	$	24,882
2016		2,112,064
2017		8,290,378
2018		8,293,897
2019		6,239,295
Thereafter		1,039,571
Total	$	26,000,087

The following is a summary of estimated future royalty payments as of June 30, 2015:

2015	$	525,000
2016		1,229,250
2017		1,360,250
2018		1,462,750
2019		1,575,250
Thereafter		5,626,325
Total	$	11,778,825

Subsequent to June 30, 2015, the Company issued $65 million in convertible notes and borrowed additional amounts pursuant to an Amended and Restated Credit Agreement with ROS, both of which will have a material impact on long-term debt. (See Note 15, “Subsequent Event” below).

Stock-Based Compensation

6 Months Ended

Jun. 30, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Stock-Based Compensation

(9) Stock-Based Compensation

The Second Amended and Restated Bacterin International Equity Incentive Plan ("The Plan") which was approved at the annual stockholder meeting on June 24, 2015 provides for stock awards, including options and performance stock awards, to be granted to employees, consultants, independent contractors, officers and directors. The purpose of the Plan is to enable us to attract, retain and motivate key employees, directors and, on occasion, independent consultants, by providing them with stock options and restricted stock grants. Stock options granted under the Plan may be either incentive stock options to employees, as defined in Section 422A of the Internal Revenue Code of 1986, or non-qualified stock options. The Plan is administered by the compensation committee of our Board of Directors. Stock options granted under the Plan are generally not transferable, vest in installments over the requisite service period and are exercisable during the stated contractual term of the option only by such optionee. The exercise price of all incentive stock options granted under the Plan must be at least equal to the fair market value of the shares of common stock on the date of the grant. 1,400,000 shares are authorized under the Plan and at June 30, 2015, we had approximately 580,000 shares available for issuance which are authorized, but unissued or reacquired shares.

Stock compensation expense recognized in the statement of operations for the six months ended June 30, 2015 and 2014 is based on awards ultimately expected to vest and reflects an estimate of awards that will be forfeited. ASC 718 requires forfeitures to be estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates.

The estimated fair value of stock options granted is done using the Black-Sholes-Merton method applied to individual grants. Key assumptions used to estimate the fair value of stock awards are as follows:

	Six Months Ended			Six Months Ended
	June 30, 2015			June 30, 2014
Risk-free interest rate		1.75	%		1.76	%
Expected volatility		80	%		63	%
Expected term		6.3 Years			5.51 Years
Expected forfeiture rate		20	%		20	%
Dividend yield		0	%		0	%

In July 2014, the Company granted our President an option to purchase 55,000 shares of our common stock outside of the Plan, and in August 2013, the Company granted our Chief Executive Officer an option to purchase 200,000 shares of our common stock outside of the Plan (collectively the “Non-Plan Grants”).

Stock option activity, including options granted under the Plan and the Non-Plan Grants, was as follows:

	2015						2014
					Weighted						Weighted
			Weighted		Average Fair				Weighted		Average Fair
			Average Exercise		Value at Grant				Average Exercise		Value at Grant
	Shares		Price		Date		Shares		Price		Date
Outstanding at January 1		695,336	$	11.09	$	5.35		758,328	$	14.90	$	8.60
Granted		45,000		4.00		2.81		15,200		7.10		5.00
Exercised		-		-		-		(6,666)		1.00		-
Cancelled or expired		(28,480)		12.86		5.67		(66,576)		18.30		9.20
Outstanding at June 30		711,857	$	10.57	$	5.31		700,286	$	14.60	$	7.10
Exercisable at June 30		340,189	$	14.41	$	6.80		331,498	$	17.90	$	6.50

The aggregate intrinsic value of options outstanding as of June 30, 2015 was approximately $28,750. The aggregate intrinsic value of exercisable options as of June 30, 2015 was approximately $28,750. As of June 30, 2015, there were 371,668 unvested options with a weighted average fair value at the grant date of $3.94 per option. As of June 30, 2015, we had approximately $903,096 in compensation expense related to unvested awards not yet recognized.

From time to time we may grant stock options and stock grants to consultants. We account for consultant stock options in accordance with ASC 505-50. Consulting expense for the grant of stock options to consultants is determined based on the estimated fair value of the stock options at the measurement date as defined in ASC 505-50 and is recognized over the vesting period.

The Company recognized non-cash consulting expense for the six months ended June 30, 2015 and 2014 as $140,869 and $42,228 respectively.

Total share based compensation recognized for employees, directors and consultants was $444,352 and $688,876 for the six months ended June 30, 2015 and 2014, respectively.

On November 10, 2014, the company issued 39,312 shares of restricted stock to the independent Directors of the Company. These restricted shares vested on July 1, 2015 and were issued when the stock price was $4.07 per share. The total expense of $160,000 was recognized ratably over the period in General and Administrative expense.

Warrants

6 Months Ended

Jun. 30, 2015

Warrants and Rights Note Disclosure [Abstract]

Warrants

(10) Warrants

The following table summarizes our warrant activities for the period ended June 30, 2015:

			Weighted
			Average
			Exercise
	Shares		Price
Outstanding as of January 1, 2014		1,087,820	$	16.20
Issued		571,500		7.12
Expired		(4,000)		20.00
Outstanding at January 1, 2015		1,655,320	$	13.06
Issued		-		-
Expired		(224,920)		18.52
Outstanding at June 30, 2015		1,430,400	$	12.20

We utilize a valuation model to determine the fair market value of the warrants accounted for as liabilities. The valuation model accommodates the probability of exercise price adjustment features as outlined in the warrant agreements. We recorded an unrealized loss of $14,081 resulting from the change in the fair value of the warrant derivative liability for first the first six months of 2015. Under the terms of some of our warrant agreements, at any time while the warrant is outstanding, the exercise price per share can be reduced to the price per share of future subsequent equity sales of our common stock or a common stock equivalent that is lower than the exercise price per share as stated in the warrant agreement.

The estimated fair value was derived using the valuation model with the following weighted-average assumptions:

	Six Months ended
	June 30,
	2015			2014
Value of underlying common stock (per share)	$	3.50		$	6.80
Risk free interest rate		1.60	%		1.76	%
Expected term		4.50 years			5.51 years
Volatility		80	%		63	%
Dividend yield		0	%		0	%

The following table summarizes our activities related to warrants accounted for as a derivative liability for the six months ended June 30, 2015 and 2014:

	2015		2014
Balance at January 1,		1,171,692		600,192
Derivative warrants issued		-		-
Derivative warrants exercised		-		-
Balance at June 30,		1,171,692		600,192

Commitments and Contingencies

6 Months Ended

Jun. 30, 2015

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(11) Commitments and Contingencies

Operating Leases

We lease two office facilities under non-cancelable operating lease agreements with expiration dates in 2019 and 2023. We have the option to extend both the leases for another ten year term and for one facility, we have the right of first refusal on any sale. We lease additional office space under a month-to-month arrangement. Future minimum payments for the next five years and thereafter as of June 30, 2015, under these leases, are as follows:

Remainder of 2015	$	193,900
2016		347,498
2017		280,527
2018		286,754
2019		166,940
Thereafter		559,000
Total	$	1,834,619

Rent expense was $182,739 and $158,066 for the six months ended June 30, 2015 and 2014, respectively. Rent expense is determined using the straight-line method of the minimum expected rent paid over the term of the agreement. We have no contingent rent agreements.

Indemnifications

Our arrangements generally include limited warranties and certain provisions for indemnifying customers against liabilities if our products or services infringe a third-party's intellectual property rights. To date, we have not incurred any material costs as a result of such warranties or indemnification provisions and have not accrued any liabilities related to such obligations in the accompanying financial statements.

We have also agreed to indemnify our directors and executive officers for costs associated with any fees, expenses, judgments, fines and settlement amounts incurred by any of these persons in any action or proceeding to which any of those persons is, or is threatened to be, made a party by reason of the person's service as a director or officer, including any action by us, arising out of that person's services as our director or officer or that person's services provided to any other company or enterprise at our request.

Pending and Threatened Litigation

On March 17, 2014, a complaint was served on the Company in the following state court action in the District Court for the County of Arapahoe, State of Colorado: Robert Taggart v. Guy Cook, Bacterin International, Inc., a Nevada Corporation and Bacterin International Holdings, Inc., a Delaware corporation, Civil Action No. 14CV30401. The complaint involves claims under an employment agreement between plaintiff and the Company seeking commissions on Company sales, a commission on funds obtained by the Company as a result of a reverse merger and vesting of certain stock options. Plaintiff seeks damages in excess of $5 million. The Company believes this case lacks legal merit and has filed counterclaims for plaintiff’s breach of his employment agreement and breach of his duty of loyalty to the Company, asserting the right to recover all compensation paid to Plaintiff during his employment as well as other damages.

Income Taxes

6 Months Ended

Jun. 30, 2015

Income Tax Disclosure [Abstract]

Income Taxes

(12) Income Taxes

In evaluating the realizability of the net deferred tax assets, we take into account a number of factors, primarily relating to the ability to generate taxable income. Where it is determined that it is likely that we will be unable to realize deferred tax assets, a valuation allowance is established against the portion of the deferred tax asset. Because it cannot be accurately determined when or if we will become profitable, a valuation allowance was provided against the entire deferred income tax asset balance.

The 2011 through 2014 tax years remain open to examination by the Internal Revenue Service and the 2009 to 2014 tax years remain open to the Montana Department of Revenue. These taxing authorities have the authority to examine those tax years until the applicable statute of limitations expire.

The Company did not recognize any interest or penalties related to income taxes for the six months ended June 30, 2015 and 2014.

Related Party Transactions

6 Months Ended

Jun. 30, 2015

Related Party Transactions

(14) Related Party Transactions

Darrel Holmes, our Chief Operating Officer, and Mitchell Godfrey, a former director, serve on the board of American Donor Services Inc. (“ADS”), and Mr. Godfrey also serves as secretary and treasurer for ADS. Mssrs. Godfrey and Holmes each receive $5,000 per year for their service to ADS. ADS recovers tissue from donors and we reimburse ADS for its recovery fees, which are comprised primarily of labor costs. The approximate aggregate amount of all transactions with ADS for the six months ended June 30, 2015 and 2014 was $827,797 and $1,897,489 respectively. Our relationship with ADS has benefited us, as ADS provides us with current donors and a pipeline for future donors, which is necessary to our success.

Unless delegated to the Compensation Committee by the Board of Directors, the Audit Committee or the disinterested members of the full Board of Directors reviews and approves all related party transactions.

Subsequent Events

6 Months Ended

Jun. 30, 2015

Subsequent Events [Abstract]

Subsequent Events

(15) Subsequent Events

In July 2015, the Company sold its coatings and device business to Harland Medical Systems, Inc. for $350,000 pursuant to the terms of an Asset Purchase Agreement. Payment is secured by two promissory notes, both of which bear interest at a rate of 5%. One note is for $250,000 payable over approximately three years with the first payment due in September 2015. The second note is for $100,000, which is also payable over approximately three years with the first payment due March 31, 2016. Payment on the second note is contingent on Harland receiving FDA approval on its 510(k) submission for certain related products.

On July 31, 2015 the Company acquired all of the outstanding capital stock of X-spine for approximately $60 million in cash, repayment of approximately $13 million of X-spine debt, and approximately 4.24 million shares of Xtant common stock. The acquisition combines Bacterin's strength in orthobiologics with X-spine's expertise in hardware, offering complementary product lines focused on orthopedic and spine surgical procedures.

The stock purchase agreement contains customary representations and warranties by each of the parties, as well as indemnification for breaches of the warranties and covenants by X-spine and the selling shareholders. To secure the indemnification obligations, $6 million of the cash consideration and all of the shares of Xtant common stock were placed into escrow and may be used to settle indemnification claims.

Pursuant to the stock purchase agreement, X-spine’s president, David Kirschman, was appointed as a Class II member of Xtant’s Board of Directors.

The X-spine acquisition is considered the acquisition of a business and was accounted for under the purchase method of accounting. At the date of purchase of all identifiable tangible and intangible assets and liabilities purchased in the acquisition have been recognized at their estimated fair value.

The following reflects the allocation of the consideration to the net tangible and identifiable intangible assets of the Seller, based upon their estimated fair values:

Assets and Liabilities at Fair Value

Assets
Intangible assets
Tradename		$	4,543,300
Technology			28,698,700
Non-Compete Agreement			40,500
Customer Relationship			9,911,000
Total intangible assets			43,193,500

Goodwill			22,816,088

Cash			3,000
Accounts Receivable			6,972,764
Inventory			12,861,550
Prepaid Expenses			204,167
Property, Plant & Equipment			7,533,106
Total Assets Acquired			93,584,175

Liabilities
Accounts Payable			3,703,097
Accrued Liabilities			2,164,179
Revolving Line of Credit
Total liabilities			5,867,276

Consideration
Cash Consideration	72,867,606
Stock Consideration	14,849,293
Total Consideration		$	87,716,899

As noted above in the table, we acquired accounts receivables as part of the asset acquisition of X-Spine. As of the date of the acquisition, the estimated fair value and the contractual value of the receivables were the same. As of the date of the acquisition we did not determine that any of the receivables would ultimately become uncollectible. After the specific identification of net tangible and identifiable intangible assets of the sellers and allocation of the acquisition cost, the Company is expected to recognize approximately $23 million of goodwill. At this time, none of the goodwill is expected to be deductible for tax purposes.

Convertible Notes

Concurrent with the acquisition of X-spine, the Company completed an offering of $65.0 million aggregate principal amount of its 6.00% convertible senior unsecured notes due 2021 (the “Notes”) in a private offering to qualified institutional buyers, as defined in Rule 144A under the Securities Act of 1933, as amended. Certain private investment funds for which OrbiMed Advisors LLC, one of the Company’s existing stockholders, serves as the investment manager, purchased $52.0 million aggregate principal amount of the Notes directly from the Company in the offering. The Company has granted the investment bank acting as initial purchaser in the offering a 30-day option to purchase up to an additional $9.75 million aggregate principal amount of Notes from the Company. On August 10, 2015, the initial purchaser exercised its option with respect to an additional $3 million aggregate principal amount of Notes, reserving its right to subsequently exercise its right to purchase additional Notes during the remainder of the option period.

The Notes bear interest at a rate equal to 6.00% per year. Following the first interest payment date, which will be on April 15, 2016, interest on the Notes will be payable semiannually in arrears on January 15 and July 15 of each year. Interest will accrue on the Notes from the last date to which interest has been paid or duly provided for or, if no interest has been paid or duly provided for, from July 31, 2015. Unless earlier converted or repurchased, the Notes will mature on July 15, 2021.

At any time prior to the close of business on the second business day immediately preceding the maturity date, holders may convert their Notes into shares of Xtant common stock (together with cash in lieu of fractional shares) at an initial conversion rate of 257.5163 shares per $1,000 principal amount of Notes (which represents an initial conversion price of approximately $3.88 per share). However, a Note will not be convertible to the extent that such convertibility or conversion would result in the holder of that Note or any of its affiliates being deemed to beneficially own in excess of 9.99% of the then-outstanding shares of Xtant common stock. The conversion rate will be subject to adjustment as described in the Indenture. In addition, Xtant will, in certain circumstances, increase the conversion rate for holders who convert their Notes in connection with a “make-whole fundamental change” (as defined in the Indenture). No sinking fund is provided for the Notes. Xtant may not redeem the Notes at its option prior to their maturity. If a “fundamental change” (as defined in the Indenture) occurs, holders will have the right, at their option, to require us to repurchase their Notes at a cash price equal to 100% of the principal amount of the Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date, subject to the right of holders of Notes on a record date to receive accrued and unpaid interest.

The Notes are Xtant’s senior, unsecured obligations, rank equal in right of payment with its existing and future unsecured indebtedness that is not junior to the Notes, are senior in right of payment to any of its existing and future indebtedness that is expressly subordinated to the Notes, and are effectively subordinated to its existing and future secured indebtedness to the extent of the value of the collateral securing such indebtedness. The Notes are structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, and (to the extent Xtant is not a holder thereof) preferred equity, if any, of its subsidiaries.

Amended and Restated Credit Agreement

On July 31, 2015, Bacterin refinanced approximately $24 million in existing term loans and borrowed an additional $18 million pursuant to an Amended and Restated Credit Agreement with ROS (the “New Facility”). The maturity date of the New Facility will be July 31, 2020 (the “Maturity Date”). Interest under the New Facility will be bifurcated into a “cash pay” portion and a “payment-in-kind” portion. Until June 30, 2018 (the “First Period”), interest on loans outstanding under the New Facility will accrue at a rate equal to the sum of (a) 9% per annum, which portion of interest will be payable in cash, plus (b) additional interest (“PIK Interest”) in an amount equal to (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 9% per annum, which portion of interest will be payable “in kind.” During the portion of the First Period before December 31, 2015 (the “Optional PIK Period”), we may elect at our option to have all or any portion of interest on loans outstanding under the New Facility to accrue during the Optional PIK Period at a rate equal to the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, which portion of interest will be payable “in kind.” On or after June 30, 2018 until the New Facility is repaid in full (the “Second Period”), interest on loans outstanding under the New Facility will accrue at a rate equal to the sum of (a) 12% per annum, which portion of interest will be payable in cash, plus (b) PIK Interest in an amount equal to the difference of (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 12% per annum, which portion of interest will be payable “in kind.” In both the First Period and the Second Period, the portion of accrued interest constituting PIK Interest will not be payable in cash but will instead be added to the principal amount outstanding under the New Facility. However, at our option, we may choose to make any “payment-in-kind” interest payment in cash. Until the third anniversary of the closing date of the New Facility, we will not be allowed to voluntarily prepay the New Facility. Whenever loans outstanding under the New Facility are prepaid or paid, whether voluntarily, involuntarily or on the Maturity Date, a fee of 7.5% on the amount paid will be due and payable. The New Facility contains financial and other covenant requirements, including, but not limited to, financial covenants that require the Company to maintain revenue and liquidity at levels set forth in the New Facility and ensure that the Company’s senior consolidated leverage ratio does not exceed levels set forth in the New Facility. The New Facility also restricts the Company from making any payment or distribution with respect to, or purchasing, redeeming, defeasing, retiring or acquiring, the Notes other than payments of scheduled interest on the Notes, issuance of shares of our common stock upon conversion of the Notes, and payment of cash in lieu of fractional shares. The loans under the New Facility are guaranteed by Xtant and its current and future subsidiaries and are secured by substantially all of the current and future assets of Xtant and its subsidiaries. The additional amount borrowed under the New Facility was used to pay a portion of the X-spine acquisition, with the balance being available for general corporate purposes.

The accounting treatment for the Notes and for the New Facility with ROS have been done in accordance with ASC Subtopic 470-50, Debt Modifications and Extinguishments, and ASC Subtopic 470-60, Troubled Debt Restructurings by Debtors.

Approximately $4.8 million of expenses were incurred in conjunction with the acquisition, the issuance of convertible debt and the amendment and restatement of our credit facility with ROS. Of that amount, approximately $2.2 million of debt issuance costs will be capitalized and amortized over the life of the debt and approximately $2.6 million will be expensed in Q3 2015 related to the acquisition itself.

After payment of the consideration and expenses related to the acquisition and the related financing transactions, our cash on hand increased by approximately $5.6 million which will be used to fund the ongoing business of the combined entities.

Name Change

Following the closing of the acquisition, on July 31, 2015, Bacterin International Holdings, Inc. changed its name to Xtant Medical Holdings, Inc.

New Subsidiary

On August 6, 2015 Xtant formed a new wholly owned subsidiary, Xtant Medical, Inc., a Delaware corporation.

Business Description and Summary of Significant Accounting Policies (Policies)

6 Months Ended

Jun. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description

Business Description

Reverse Stock Split

Reverse Stock Split

Public Offering

Public Offering

Aspire Capital Transaction

Aspire Capital Transaction

Concentrations and Credit Risk

Concentrations and Credit Risk

Revenue by geographical region is as follows:

	Six Months Ended June 30,
	2015		2014
United States	$	18,831,197	$	17,509,988
Rest of World		564,532		286,914
	$	19,395,729	$	17,796,902

Use of Estimates

Use of Estimates

Long-Lived Assets

Long-Lived Assets

Revenue Recognition

Revenue Recognition

Advertising Costs

Advertising Costs

The Company expenses advertising costs as incurred. The Company had advertising expense of $3,688 and $27,914 for the six months ended June 30, 2015 and 2014, respectively.

Research and Development

Research and Development

Research and development costs, which are principally related to internal costs for the development of new allograft technologies and processes are expensed as incurred.

Net Loss Per Share

Net Loss Per Share

Fair Value of Financial Instruments

Fair Value of Financial Instruments

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

The following table sets forth by level, within the fair value hierarchy, our liabilities as of June 30, 2015 and December 31, 2014 that are measured at fair value on a recurring basis:

Warrant derivative liability

	As of June 30, 2015		As of December 31, 2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,796,660	$	1,320,371

The valuation technique used to measure fair value of the warrant liability is based on a valuation model and significant assumptions and inputs determined by us (See Note 10, “Warrants” below).

Level 3 Changes

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first quarter of 2015		462,208
Balance at March 31, 2015		1,782,579
Loss recognized in earnings in second quarter of 2015		14,081
Balance at June 30, 2015	$	1,796,660

During the first six months ended June 30, 2015, the Company did not change any of the valuation techniques used to measure its liabilities at fair value.

Recent Accounting Pronouncements

Recent Accounting Pronouncements

Business Description and Summary of Significant Accounting Policies (Tables)

6 Months Ended

Jun. 30, 2015

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Revenues by Geographic Region

Revenue by geographical region is as follows:

	Six Months Ended June 30,
	2015		2014
United States	$	18,831,197	$	17,509,988
Rest of World		564,532		286,914
	$	19,395,729	$	17,796,902

Schedule of Assets and Liabilities Measured on Recurring Basis

Warrant derivative liability

	As of June 30, 2015		As of December 31, 2014
Level 1		-		-
Level 2		-		-
Level 3	$	1,796,660	$	1,320,371

Schedule of Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation

Warrant derivative liability

Balance at January 1, 2015	$	1,320,371
Loss recognized in earnings in first quarter of 2015		462,208
Balance at March 31, 2015		1,782,579
Loss recognized in earnings in second quarter of 2015		14,081
Balance at June 30, 2015	$	1,796,660

Inventories (Tables)

6 Months Ended

Jun. 30, 2015

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories consist of the following:

	June 30,		December 31,
	2015		2014
Current inventories
Raw materials	$	4,219,024	$	3,836,635
Work in process		2,407,919		2,484,635
Finished goods		5,131,354		5,163,458
		11,758,297		11,484,728
Reserve for obsolescence		(2,366,147)		(1,926,080)
Current inventories, total		9,392,150		9,558,648
Non-current inventories
Finished goods		2,376,919		2,860,248
Reserve for obsolescence		(536,948)		(925,990)
Non-current inventories, total		1,839,971		1,934,258
Total inventories	$	11,232,121	$	11,492,906

Intangible Assets (Tables)

6 Months Ended

Jun. 30, 2015

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible Assets

The following table sets forth information regarding intangible assets:

	June 30, 2015		December 31, 2014
Intellectual Property
Gross carrying value	$	1,032,724	$	1,036,580
Accumulated amortization		(423,376)		(381,090)
Net carrying value	$	609,348	$	655,490

Aggregate amortization expense:	$	75,860	$	77,022

Schedule of Estimated Amortization Expense for Intangible Assets

The following is a summary of estimated future amortization expense for intangible assets as of June 30, 2015:

Remainder of 2015	$	45,093
2016		59,343
2017		59,343
2018		59,154
2019		55,565
Thereafter		330,850
Total	$	609,348

Long-term Debt (Tables)

6 Months Ended

Jun. 30, 2015

Debt Disclosure [Abstract]

Schedule of Long-term Debt

Long-term debt consists of the following:

	June 30, 2015		December 31, 2014
Loan payable to ROS Acquisition Offshore, LIBOR plus 12.13% maturing August 2019	$	24,000,000	$	24,000,000
Adjustment fee payable to ROS Acquisition Offshore, due in August 2019		700,000		700,000
6.00% loan payable to Valley Bank of Belgrade, $10,746 monthly payments including interest, maturing December 24, 2030; secured by building		1,300,087		1,325,814
		26,000,087		26,025,814
Less: current portion		(52,374)		(50,671)
Debt discount		(4,256,039)		(5,104,813)
Long-term debt	$	21,691,674	$	20,870,330

Schedule of Maturities of Long-term Debt

The following is a summary of maturities due on the debt as of June 30, 2015:

Remainder of 2015	$	24,882
2016		2,112,064
2017		8,290,378
2018		8,293,897
2019		6,239,295
Thereafter		1,039,571
Total	$	26,000,087

Schedule of Royalty Payments

The following is a summary of estimated future royalty payments as of June 30, 2015:

2015	$	525,000
2016		1,229,250
2017		1,360,250
2018		1,462,750
2019		1,575,250
Thereafter		5,626,325
Total	$	11,778,825

Stock-Based Compensation (Tables)

6 Months Ended

Jun. 30, 2015

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions

Key assumptions used to estimate the fair value of stock awards are as follows:

	Six Months Ended			Six Months Ended
	June 30, 2015			June 30, 2014
Risk-free interest rate		1.75	%		1.76	%
Expected volatility		80	%		63	%
Expected term		6.3 Years			5.51 Years
Expected forfeiture rate		20	%		20	%
Dividend yield		0	%		0	%

Schedule of Share-based Compensation, Stock Options, Activity

Stock option activity, including options granted under the Plan and the Non-Plan Grants, was as follows:

	2015						2014
					Weighted						Weighted
			Weighted		Average Fair				Weighted		Average Fair
			Average Exercise		Value at Grant				Average Exercise		Value at Grant
	Shares		Price		Date		Shares		Price		Date
Outstanding at January 1		695,336	$	11.09	$	5.35		758,328	$	14.90	$	8.60
Granted		45,000		4.00		2.81		15,200		7.10		5.00
Exercised		-		-		-		(6,666)		1.00		-
Cancelled or expired		(28,480)		12.86		5.67		(66,576)		18.30		9.20
Outstanding at June 30		711,857	$	10.57	$	5.31		700,286	$	14.60	$	7.10
Exercisable at June 30		340,189	$	14.41	$	6.80		331,498	$	17.90	$	6.50

Warrants (Tables)

6 Months Ended

Jun. 30, 2015

Warrants and Rights Note Disclosure [Abstract]

Schedule of Warrant Activity

The following table summarizes our warrant activities for the period ended June 30, 2015:

			Weighted
			Average
			Exercise
	Shares		Price
Outstanding as of January 1, 2014		1,087,820	$	16.20
Issued		571,500		7.12
Expired		(4,000)		20.00
Outstanding at January 1, 2015		1,655,320	$	13.06
Issued		-		-
Expired		(224,920)		18.52
Outstanding at June 30, 2015		1,430,400	$	12.20

Schedule of Warrant Valuation Assumptions

The estimated fair value was derived using the valuation model with the following weighted-average assumptions:

	Six Months ended
	June 30,
	2015			2014
Value of underlying common stock (per share)	$	3.50		$	6.80
Risk free interest rate		1.60	%		1.76	%
Expected term		4.50 years			5.51 years
Volatility		80	%		63	%
Dividend yield		0	%		0	%

Schedule of Warrants Activities Used In Derivative Liability

The following table summarizes our activities related to warrants accounted for as a derivative liability for the six months ended June 30, 2015 and 2014:

	2015		2014
Balance at January 1,		1,171,692		600,192
Derivative warrants issued		-		-
Derivative warrants exercised		-		-
Balance at June 30,		1,171,692		600,192

Subsequent Events (Tables)

6 Months Ended

Jun. 30, 2015

Subsequent Events [Abstract]

Consideration to net tangible and identifiable intangible assets on estimated fair values

The following reflects the allocation of the consideration to the net tangible and identifiable intangible assets of the Seller, based upon their estimated fair values:

Assets and Liabilities at Fair Value

Assets
Intangible assets
Tradename		$	4,543,300
Technology			28,698,700
Non-Compete Agreement			40,500
Customer Relationship			9,911,000
Total intangible assets			43,193,500

Goodwill			22,816,088

Cash			3,000
Accounts Receivable			6,972,764
Inventory			12,861,550
Prepaid Expenses			204,167
Property, Plant & Equipment			7,533,106
Total Assets Acquired			93,584,175

Liabilities
Accounts Payable			3,703,097
Accrued Liabilities			2,164,179
Revolving Line of Credit
Total liabilities			5,867,276

Consideration
Cash Consideration	72,867,606
Stock Consideration	14,849,293
Total Consideration		$	87,716,899

Business Description and Summary of Significant Accounting Policies (Details 1) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,796,660	$ 1,320,371
Fair Value, Inputs, Level 1 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 2 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	0	0
Fair Value, Inputs, Level 3 [Member] \| Fair Value, Measurements, Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant derivative liability	$ 1,796,660	$ 1,320,371

Business Description and Summary of Significant Accounting Policies (Details 2) (Warrant [Member], Derivative [Member], USD $)	3 Months Ended	6 Months Ended
	Mar. 31, 2015	Jun. 30, 2015
Warrant [Member] \| Derivative [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Balance at January 1, 2015	$ 1,320,371	$ 1,320,371
Loss recognized in earnings	462,208	14,081
Balance at June 30, 2015	$ 1,782,579	$ 1,796,660

Business Description and Summary of Significant Accounting Policies (Details Textual) (USD $)	0 Months Ended		3 Months Ended			6 Months Ended				1 Months Ended		3 Months Ended			0 Months Ended	1 Months Ended	0 Months Ended	6 Months Ended
	Aug. 06, 2014	Jul. 28, 2014	Jun. 30, 2015	Jun. 30, 2014	Mar. 31, 2014	Jun. 30, 2015	Jun. 30, 2014	Dec. 31, 2014	Dec. 31, 2013	Jul. 31, 2015 Subsequent Event [Member]	Jul. 31, 2015 Debt [Member] Subsequent Event [Member]	Jun. 30, 2015 Aspire Capital Fund LLC [Member]	Mar. 31, 2015 Aspire Capital Fund LLC [Member]	Mar. 16, 2015 Aspire Capital Fund LLC [Member]	Aug. 06, 2014 Common Stock [Member]	Jul. 31, 2015 Common Stock [Member] Subsequent Event [Member]	Aug. 06, 2014 August 2014 Warrants [Member]	Jun. 30, 2015 Geographic Concentration Risk [Member] Sales Revenue, Net [Member] US [Member]	Jun. 30, 2014 Geographic Concentration Risk [Member] Sales Revenue, Net [Member] US [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Concentration Risk, Percentage																		97.00%	98.00%
Advertising Expense						$ 3,688	$ 27,914
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount						2,142,257	1,784,107
Royalty Revenue Description						The Company also receives royalty revenue from third parties related to licensing agreements. The Company has royalty agreements with RyMed and Bard Access Systems. Revenue under these agreements represented less than 0.5% of total revenue for the six months ended June 30, 2015 and 2014.	The Company also receives royalty revenue from third parties related to licensing agreements. The Company has royalty agreements with RyMed and Bard Access Systems. Revenue under these agreements represented less than 0.5% of total revenue for the six months ended June 30, 2015 and 2014.
Proceeds From Issuance Or Sale Of Equity Gross	6,500,000
Stock Issued During Period, Shares, New Issues					150,000							417,000	207,182		1,143,000
Shares Issued, Price Per Share															$ 5.70
Class of Warrant or Right, Number of Securities Called by Warrants or Rights																	571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights			$ 12.2			$ 12.2		$ 13.06	$ 16.2								$ 7.12
Proceeds from Issuance or Sale of Equity, Total	5,900,000
Class Of Warrant Or Right Term	5 years																5 years
Stockholders' Equity, Reverse Stock Split		1:10 reverse split
Common Stock To Be Issued For Commitment Fee													154,189
Common Stock, Shares Subscribed but Unissued														10,000,000
Stock Issued During Period, Value, New Issues												1,387,439	750,000
Share Price													$ 3.62
Other Non Cash Expense Associated With Stock Purchase Agreement			0	0		558,185	0						558,185
Business Combination, Consideration Transferred						87,716,899				60,000,000
Other Payments to Acquire Businesses											$ 13,000,000
Business Acquisition Number Of Shares Acquired																4,240,000

Equity (Details Textual) (USD $)	0 Months Ended	3 Months Ended				0 Months Ended		1 Months Ended	3 Months Ended
Equity (Details Textual) (USD $)	Aug. 06, 2014	Mar. 31, 2014	Jun. 30, 2015	Dec. 31, 2014	Dec. 31, 2013	Aug. 06, 2014 Common Stock [Member]	Aug. 06, 2014 August 2014 Warrants [Member]	Mar. 16, 2015 Aspire Capital Fund LLC [Member]	Jun. 30, 2015 Aspire Capital Fund LLC [Member]	Mar. 31, 2015 Aspire Capital Fund LLC [Member]
Schedule of Equity Method Investments [Line Items]
Stock issued (in shares)		150,000				1,143,000			417,000	207,182
Proceeds from Issuance or Sale of Equity, Total	$ 5,900,000
Proceeds From Issuance Or Sale Of Equity Gross	6,500,000
Shares Issued, Price Per Share						$ 5.70
Proceeds from Lines of Credit		4,000,000
Class of Warrant or Right, Number of Securities Called by Warrants or Rights							571,500
Class of Warrant or Right, Exercise Price of Warrants or Rights			$ 12.2	$ 13.06	$ 16.2		$ 7.12
Common Stock, Shares Subscribed but Unissued								10,000,000
Stock Issued During Period, Value, New Issues									1,387,439	750,000
Common Stock To Be Issued For Commitment Fee										154,189
Maximum Common Stock To Be Issued Per Trading Day								50,000
Maximum Common Stock Value To Be Issued Per Trading Day								$ 500,000
Maximum Percentage Of Common Stock Weighted Average Price								0.00%
Class Of Warrant Or Right Term	5 years						5 years

Inventories (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Current inventories
Raw materials	$ 4,219,024	$ 3,836,635
Work in process	2,407,919	2,484,635
Finished goods	5,131,354	5,163,458
Inventory, Gross	11,758,297	11,484,728
Reserve for obsolescence	(2,366,147)	(1,926,080)
Current inventories, total	9,392,150	9,558,648
Non-current inventories
Finished goods	2,376,919	2,860,248
Reserve for obsolescence	(536,948)	(925,990)
Non-current inventories, total	1,839,971	1,934,258
Total inventories	$ 11,232,121	$ 11,492,906

Impairment of Assets (Details Textual) (USD $)	6 Months Ended	12 Months Ended	6 Months Ended
Impairment of Assets (Details Textual) (USD $)	Jun. 30, 2015	Dec. 31, 2014	Jun. 30, 2015 Gross Profit [Member] Maximum [Member]	Jun. 30, 2014 Gross Profit [Member] Maximum [Member]	Jun. 30, 2015 Sales Revenue, Net [Member] Maximum [Member]	Jun. 30, 2014 Sales Revenue, Net [Member] Maximum [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Concentration Risk, Percentage			1.00%	1.00%	1.00%	1.00%
Disposal Group, Including Discontinued Operation, Property, Plant and Equipment		$ 80,042
Disposal Group, Including Discontinued Operation, Inventory		832,507
Disposal Group, Including Discontinued Operation, Assets		0
Asset Impairment Charges		912,549
Payments to Acquire Businesses, Gross	250,000
Contingent Payment	$ 100,000

Property and Equipment, Net (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Total cost	$ 9,588,290	$ 9,527,785
Less: accumulated depreciation	(5,158,252)	(4,873,258)
Property and equipment, net	4,430,038	4,654,527
Building [Member]
Property, Plant and Equipment [Line Items]
Total cost	1,657,579	1,657,579
Equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	4,800,284	4,724,608
Computer equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	225,009	225,009
Computer software[Member]
Property, Plant and Equipment [Line Items]
Total cost	360,171	345,039
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Total cost	153,834	153,834
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total cost	2,381,413	2,380,617
Vehicles [Member]
Property, Plant and Equipment [Line Items]
Total cost	$ 10,000	$ 41,099

Property and Equipment, Net (Details Textual) (USD $)	6 Months Ended
Property and Equipment, Net (Details Textual) (USD $)	Jun. 30, 2015	Jun. 30, 2014
Property, Plant and Equipment [Line Items]
Capital Leased Assets, Gross	$ 537,480
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation	212,568
Cost of Property Repairs and Maintenance	173,443	140,504
Depreciation	$ 336,913	$ 307,747

Intangible Assets (Details) (USD $)	6 Months Ended	12 Months Ended
Intangible Assets (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Intellectual Property
Gross carrying value	$ 1,032,724	$ 1,036,580
Accumulated amortization	(423,376)	(381,090)
Net carrying value	609,348	655,490
Aggregate amortization expense:	$ 75,860	$ 77,022

Intangible Assets (Details 1) (USD $)	Jun. 30, 2015
Estimated amortization expense:
Remainder of 2015	$ 45,093
2016	59,343
2017	59,343
2018	59,154
2019	55,565
Thereafter	330,850
Total	$ 609,348

Accrued Liabilities (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Accrued Liabilities [Line Items]
Accrued stock compensation	$ 120,000	$ 0
Wages/commissions payable	1,565,827	1,434,743
Other accrued expenses	713,772	486,558
Accrued Liabilities Current	$ 2,399,599	$ 1,921,301

Long-term Debt (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Loan Payable	$ 26,000,087	$ 26,025,814
Less: current portion	(52,374)	(50,671)
Debt discount	(4,256,039)	(5,104,813)
Long-term debt	21,691,674	20,870,330
Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Loan Payable	24,000,000	24,000,000
Adjustment fee payable to ROS Acquisition Offshore, due in August 2019	700,000	700,000
Valley Bank Of Belgrade [Member]
Debt Instrument [Line Items]
Loan Payable	$ 1,300,087	$ 1,325,814

Long-term Debt (Details 1) (USD $)	Jun. 30, 2015
Schedule of maturities due on debt [Line Items]
Remainder of 2015	$ 24,882
2016	2,112,064
2017	8,290,378
2018	8,293,897
2019	6,239,295
Thereafter	1,039,571
Total	$ 26,000,087

Long-term Debt (Details 2) (USD $)	Jun. 30, 2015
Estimated future royalty payments [Line Items]
2015	$ 525,000
2016	1,229,250
2017	1,360,250
2018	1,462,750
2019	1,575,250
Thereafter	5,626,325
Total	$ 11,778,825

Long-term Debt (Details Textual) (USD $)	3 Months Ended	6 Months Ended		0 Months Ended	6 Months Ended
Long-term Debt (Details Textual) (USD $)	Mar. 31, 2014	Jun. 30, 2015 Convertible Notes Payable [Member]	Jun. 30, 2015 Valley Bank Of Belgrade [Member]	Mar. 06, 2014 Ros Acquisition Offshore [Member]	Jun. 30, 2015 Ros Acquisition Offshore [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage			6.00%
Debt Instrument, Periodic Payment			$ 10,746
Line of Credit Facility, Description					LIBOR plus 12.13% maturing August 2019
Debt Instrument, Description of Variable Rate Basis			December 24, 2030
Debt Conversion, Converted Instrument, Shares Issued				150,000
Proceeds from Lines of Credit	$ 4,000,000	$ 65,000,000		$ 4,000,000

Stock-Based Compensation (Details)	6 Months Ended
Stock-Based Compensation (Details)	Jun. 30, 2015	Jun. 30, 2014
Risk-free interest rate	1.75%	1.76%
Expected volatility	80.00%	63.00%
Expected term	6 years 3 months 18 days	5 years 6 months 4 days
Expected forfeiture rate	20.00%	20.00%
Dividend yield	0.00%	0.00%

Stock-Based Compensation (Details 1) (Stock Option, USD $)	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Stock Option
Schedule of activity under stock option plans [Line Items]
Outstanding at January 1, 2015 Shares	695,336	758,328
Granted, Shares	45,000	15,200
Exercised, Shares	0	(6,666)
Cancelled or expired, Shares	(28,480)	(66,576)
Outstanding at June 30, 2015 Shares	711,857	700,286
Exercisable at June 30, 2015 Shares	340,189	331,498
Outstanding at January 1, 2015 Weighted Average Exercise Price	$ 11.09	$ 14.9
Granted, Weighted Average Exercise Price	$ 4	$ 7.1
Exercised, Weighted Average Exercise Price	$ 0	$ 1
Cancelled or expired, Weighted Average Exercise Price	$ 12.86	$ 18.3
Outstanding at June 30, 2015 Weighted Average Exercise Price	$ 10.57	$ 14.6
Exercisable at June 30, 2015 Weighted Average Exercise Price	$ 14.41	$ 17.90
Outstanding at January 1, 2015 Weighted Average Fair Value At Grant Date	$ 5.35	$ 8.6
Granted, Weighted Average Fair Value At Grant Date	$ 2.81	$ 5
Exercised, Weighted Average Fair Value At Grant Date	$ 0	$ 0
Cancelled or expired, Weighted Average Fair Value At Grant Date	$ 5.67	$ 9.2
Outstanding at June 30, 2015 Weighted Average Fair Value At Grant Date	$ 5.31	$ 7.1
Exercisable at June 30, 2015 Weighted Average Fair Value At Grant Date	$ 6.80	$ 6.50

Stock-Based Compensation (Details Textual) (USD $)	6 Months Ended		1 Months Ended			0 Months Ended	6 Months Ended
Stock-Based Compensation (Details Textual) (USD $)	Jun. 30, 2015	Jun. 30, 2014	Aug. 31, 2013 Chief Executive Officer [Member]	Jul. 31, 2014 President [Member]	Jun. 30, 2015 Employee Stock Option [Member]	Nov. 10, 2014 Restricted Stock [Member]	Jun. 30, 2015 Restricted Stock [Member]	Jun. 30, 2014 Restricted Stock [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Shares authorized under the Plan	1,400,000
Aggregate intrinsic value of options outstanding	580,000
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Intrinsic Value					$ 28,750
Share-based Compensation Arrangement by Share-based Payment Award, Options, Exercisable, Intrinsic Value					28,750
Allocated Share-based Compensation Expense	444,352	688,876					140,869	42,228
Employee Service Share-based Compensation, Nonvested Awards, Total Compensation Cost Not yet Recognized, Stock Options					903,096
Share-Based Compensation Arrangement By Share-Based Payment Award, Equity Instruments Other Than Options, Grants In Period						39,312
Employee Service Share-based Compensation, Nonvested Awards, Compensation Not yet Recognized, Share-based Awards Other than Options						$ 160,000
Share Based Compensation Arrangement By Share Based Payment Award Equity Instruments Other Than Options Issue Price On Grand Date						$ 4.07
Options granted			200,000	55,000
Number of Unvested options					371,668
Weighted average grant date fair value of unvested options					$ 3.94

Warrants (Details) (USD $)	6 Months Ended	12 Months Ended
Warrants (Details) (USD $)	Jun. 30, 2015	Dec. 31, 2014
Warrant activity [Line Items]
Outstanding	1,655,320	1,087,820
Issued, Shares	0	571,500
Expired, Shares	(224,920)	(4,000)
Outstanding	1,430,400	1,655,320
Outstanding Weighted Average Exercise Price	$ 13.06	$ 16.2
Issued, Weighted Average Exercise Price	$ 0	$ 7.12
Expired, Weighted Average Exercise Price	$ 18.52	$ 20
Outstanding Weighted Average Exercise Price	$ 12.2	$ 13.06

Warrants (Details 1) (Warrant [Member], USD $)	6 Months Ended
Warrants (Details 1) (Warrant [Member], USD $)	Jun. 30, 2015	Jun. 30, 2014
Warrant [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Value of underlying common stock (per share)	$ 3.5	$ 6.8
Risk free interest rate	1.60%	1.76%
Expected term	4 years 6 months	5 years 6 months 4 days
Volatility	80.00%	63.00%
Dividend yield	0.00%	0.00%

Warrants (Details 2)	6 Months Ended	12 Months Ended	6 Months Ended
Warrants (Details 2)	Jun. 30, 2015	Dec. 31, 2014	Jun. 30, 2015 Warrant [Member]	Jun. 30, 2014 Warrant [Member]
Class of Warrant or Right [Line Items]
Outstanding	1,655,320	1,087,820	1,171,692	600,192
Derivative warrants issued	0	571,500	0	0
Derivative warrants exercised			0	0
Outstanding	1,430,400	1,655,320	1,171,692	600,192

Commitments and Contingencies (Details) (USD $)	Jun. 30, 2015
Schedule of future minimum payments by operating lease [Line Items]
Remainder of 2015	$ 193,900
2016	347,498
2017	280,527
2018	286,754
2019	166,940
Thereafter	559,000
Total	$ 1,834,619

Commitments and Contingencies (Details Textual) (USD $)	6 Months Ended				1 Months Ended
Commitments and Contingencies (Details Textual) (USD $)	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015 Maximum [Member]	Jun. 30, 2015 Minimum [Member]	Mar. 17, 2014 Robert Taggart V Guy Cook Bacterin International Inc [Member]
Schedule of commitment and contingencies [Line Items]
Operating Leases, Rent Expense, Net	$ 182,739	$ 158,066
Loss Contingency, Damages Sought, Value					$ 5,000,000
Lease Expiration Date			Dec. 31, 2023	Dec. 31, 2019

Supplemental Disclosure of Cash Flow Information (Details) (USD $)	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Cash paid during the period for:
Interest	$ 1,610,291	$ 1,730,188
Non-cash activities:
Issuance of shares related to debt issuance	0	1,094,999
Issuance of capital leases	$ 70,020	$ 0

Subsequent Events (Details) (USD $)	6 Months Ended
Subsequent Events (Details) (USD $)	Jun. 30, 2015
Business Acquisition [Line Items]
Total intangible assets	$ 43,193,500
Goodwill	22,816,088
Cash	3,000
Accounts Receivable	6,972,764
Inventory	12,861,550
Prepaid Expenses	204,167
Property, Plant & Equipment	7,533,106
Total Assets Acquired	93,584,175
Accounts Payable	3,703,097
Accrued Liabilities	2,164,179
Revolving Line of Credit
Total liabilities	5,867,276
Cash Consideration	72,867,606
Stock Consideration	14,849,293
Total Consideration	87,716,899
Trade Names [Member]
Business Acquisition [Line Items]
Total intangible assets	4,543,300
Technology [Member]
Business Acquisition [Line Items]
Total intangible assets	28,698,700
Non Compete Agreement [Member]
Business Acquisition [Line Items]
Total intangible assets	40,500
Customer Relationships [Member]
Business Acquisition [Line Items]
Total intangible assets	$ 9,911,000

Subsequent Events (Details Textual) (USD $)	6 Months Ended	1 Months Ended		0 Months Ended	1 Months Ended								6 Months Ended
Subsequent Events (Details Textual) (USD $)	Jun. 30, 2015	Jul. 31, 2015 Subsequent Event [Member]	Jul. 31, 2015 Subsequent Event [Member] Term Loan [Member]	Aug. 10, 2015 Subsequent Event [Member] Convertible Notes Payable [Member]	Jul. 31, 2015 Subsequent Event [Member] Convertible Notes Payable [Member]	Jul. 31, 2015 Subsequent Event [Member] Debt [Member]	Jul. 31, 2015 Subsequent Event [Member] Promissory Note One [Member]	Jul. 31, 2015 Subsequent Event [Member] Promissory Note Two [Member]	Jul. 31, 2015 Subsequent Event [Member] Cash Pay [Member]	Jul. 31, 2015 Subsequent Event [Member] New Facility [Member]	Jul. 31, 2015 Subsequent Event [Member] Common Stock [Member]	Jul. 31, 2015 Harland Medical Systems Inc [Member] Subsequent Event [Member]	Jun. 30, 2015 Xspine [Member]
Subsequent Event [Line Items]
Payments to Acquire Businesses, Gross	$ 250,000	$ 350,000					$ 250,000	$ 100,000
Description For Stock Purchase Agreement Representations And Warranties													Indemnity for breaches of representations and warranties is generally subject to a $100,000 deductible basket and a cap of $6 million for basic representations, the full escrow amount for intermediate representations, and the full purchase price for fundamental representations.
Business Acquisition, Percentage of Voting Interests Acquired		100.00%
Debt Instrument, Face Amount		65,000,000			52,000,000
Debt Instrument, Maturity Date		Jul. 15, 2021								Jul. 15, 2020
Debt Instrument, Interest Rate, Stated Percentage												5.00%
Total Consideration	87,716,899	60,000,000							60,000,000
Goodwill													23,000,000
Business Combination Conjunction Related Expenses		4,800,000
Business Combination Expenses Related To Future Acquisition		2,600,000
Business Combination Increase In Cash		5,600,000
Payments of Debt Issuance Costs		2,200,000
Other Payments to Acquire Businesses						13,000,000
Business Acquisition Number Of Shares Acquired											4,240,000
Debt Instrument, Interest Rate During Period		6.00%			6.00%
Business Acquisitions Contingent Consideration At Fair Value Current											6,000,000
Conversion of Stock, Shares Converted					257.5163
Debt Instrument, Convertible, Conversion Price					$ 3.88
Line of Credit Facility, Maximum Borrowing Capacity			24,000,000		9,750,000
Line of Credit Facility, Current Borrowing Capacity										18,000,000
Debt Instrument, Interest Rate Terms										(a) 9% per annum, which portion of interest will be payable in cash, plus (b) additional interest (“PIK Interest”) in an amount equal to (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 9% per annum, which portion of interest will be payable “in kind.” During the portion of the First Period before December 31, 2015 (the ‘‘Optional PIK Period’’)
Conversion of Stock, Amount Converted					1,000
Line of Credit Facility, Interest Rate Description										New Facility to accrue during the Optional PIK Period at a rate equal to the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, which portion of interest will be payable ‘‘in kind.’’ On or after June 30, 2018 until the New Facility is repaid in full (the “Second Period”), interest on loans outstanding under the New Facility will accrue at a rate equal to the sum of (a) 12% per annum, which portion of interest will be payable in cash, plus (b) PIK Interest in an amount equal to the difference of (i) the sum of 14% per annum, plus the higher of (x) LIBOR and (y) 1% per annum, minus (ii) 12% per annum, which portion of interest will be payable “in kind.” In both the First Period and the Second Period, the portion of accrued interest constituting PIK Interest will not be payable in cash but will instead be added to the principal amount outstanding under the New Facility. However, at the Borrower’s option, it may choose to make any “payment-in-kind” interest payment in cash. Until the third anniversary of the closing date of the New Facility, the Borrower will not be allowed to voluntarily prepay the New Facility. Whenever loans outstanding under the New Facility are prepaid or paid, whether voluntarily, involuntarily or on the Maturity Date, a fee of 7.5% on the amount paid will be due and payable.
Debt Instrument, Term								3 years
Debt Instrument Purchase Of Additonal Notes				$ 3,000,000

Warrants (Details Textual) (USD $)	6 Months Ended
Warrants (Details Textual) (USD $)	Jun. 30, 2015
Class of Warrant or Right [Line Items]
Unrealized Loss On Warranty Derivative Liability	$ 14,081

Related Party Transactions (Details Textual) (USD $)	6 Months Ended
Related Party Transactions (Details Textual) (USD $)	Jun. 30, 2015	Jun. 30, 2014
Chief Operating Officer [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 5,000
American Donor Services [Member]
Related Party Transaction [Line Items]
Amount of related party transaction	$ 827,797	$ 1,897,489