Xtant Medical Holdings, Inc. Canaccord Genuity's 46th Annual Growth Conference

Great. Thank you, Caitlin. Xtant Medical. We are a global medical technology company focused on the design, manufacturing, and commercialization of regenerative biologics and spinal implant systems. What does that mean? As an investor, what it means is this, is that we have got really six key elements to what we are doing here. One, huge market opportunity that we manage today. Our core business goes after about a $3 billion domestic opportunity. We just did a deal that I will be speaking a lot about with Dilon Technologies, which is in the hemostasis world, which is another billion-dollar market opportunity. When you look at all the other adjacent markets we touch, there is several million more that we are hitting. Moreover, when you look at what we have been able to do from a vertical integration of taking the products that we once sourced, now we manufacture internally.

It has not only improved our sourcing, but the products are substantially better, and of course, the margins are substantially better. When you look at this transformational U.S. distribution agreement that we have done, this is with a group called Dilon Technologies. Again, they have the HEMOBLAST hemostasis product. Great product. Clinically, I think the best thing that is out there. The biggest thing, though, for us, though, as a business, is that one of the things about Xtant as a corporation overall, we have been wildly over-leveraged in our commercial business. Last year, we had essentially just four domestic reps selling our product for us. We added four more in that time, and we also just brought on 17 more with this Dilon deal. Not to mention we also added a couple of business development people.

We are now all in, chips are in on growing our business. When you look at the broad commercial reach we have, not only did I mention about the commercial reach that we have just gotten, but from the IDN and GPO contracts that we have access through, there is over 450 of those that we have today. Moreover, when you look at what we have in way of independent agents that we work with in the orthobiologic space, it is over 650. Part of the issue we had previously is with four reps, you could get to maybe 100 of these 650. With now 25 reps, we can touch them all. That is part of what I think one of the big benefits to this deal that we have done.

Moreover, when you look at the balance sheet over the course of the last two years, we were able to actually monetize two things. One, we had Q Codes and amnio product that we were happily selling as an OEM provider into the advanced wound care world. We did very well on that. Also selling off our non-core businesses such as our Paradigm businesses out of OUS, as well as Coflex business here domestically, and getting those off of our balance sheets and just getting those off from a business perspective, not only did it free up cash, but also when we sold it, we actually put money on the balance sheet. Last but not least, the innovative.

When you look at all the new product lines, and we will talk about this going forward, but you will see the number of new product lines that we have launched in the last two years with more to come. We have a hell of a lot happening. I am super excited about it. When you look at the product lines that we have, the focus of our business is almost primarily on the left-hand side, which is the biologics space. When you look at the offering from a regenerative biologics offering, I cannot think of another company out there that has as broad a breadth of a bag as we do today, and it is our intention to continue to expand that bag. When you look to the right-hand side, that is our fixation business.

This is a nice $20 million business that is holding serve, and it is something that is, again, a bit of a legacy thing that we had bought from years past. When you look at the market opportunity, I mentioned this before. Moreover, I think it is the 5% CAGR that I think is interesting. When you look at domestically the markets that we serve and how big they are, especially when you talk about the orthobiologic space, it is about a $3 billion market. When you throw in the hemostatic biologics, it is another billion. We have a very nice market for which we are going after. When you look at our growth over these years, we have had really outstanding growth. I got here in the end of 2019, where in 2020 we were $50 million, or a little over $50 million. Last year, we did over 134.

But as I mentioned, we divested of a $23 million Coflex and Paradigm business. We also had to replace roughly $18 million in OEM/royalty dollars. From a business perspective, we see ourselves hitting a midpoint of about 101, so anywhere from 99 to 103, with a midpoint of 101 is where we expect to hit. This is something that is new for us as of this morning. When you think about our focus, Xtant's focus really comes down to three things. Our core and what we wake up in the morning dreaming about and thinking about and figuring out how we can get better is our biologics business. Secondarily, we do want to be a very diversified provider of biologics, and there are reasons for that.

Last but not least, profitability. When you think about us as a business, previously, we only used to manufacture those boxes, those circles, the demineralized bone, and allograft. That is all we used to manufacture. We used to source the other four balloons of the synthetics, the growth factor product, the viable bone matrix, as well as the amnio products. Today, we manufacture all that. Those are all things that we brought in-house, and what it meant for us was not only were we able to secure really great sourcing ourselves versus some of the guys we were working with before that were not so reliable, but also better products and way substantially higher margins. This is the core of where our growth is today. Moreover, when we look at that demineralized bone world, we said, "Could we do something better here?

Something that is better for our patients, better for our surgeons, handles better, just characteristics within the product itself." We created a product line, this enhanced DBM product line called Trivium. Trivium has been a huge hit for us, and it is something that we are going to continue to ride. Again, this innovation is a big part of where we are heading. When you think about where our business and what we have done over the course of the last couple of years, heck, just looking at the last, from really 2024 into 2025, we rolled out basically seven new products. Of those were four brand-new categories. Just brand-new categories altogether. The growth factor, the amnio, the stem cells, and then never mind what we do with Trivium, and of course, Collagen X. Collagen X is a product line that today we are sourcing from another organization.

Our plan is that we are going to be leaving the Collagen X to actually roll out our own, which will be called E-Matrix. A far, far superior collagen than really anything else that is out in the market. It is bioactive. It has got a number of great properties to it that we are really excited about it. When you look at the development pipeline that is coming out, we have already rolled out Trivium Shaped, and I should say Trivium Shaped, and that has already been rolled out. But the rest of this year, we are looking at an OsteoSelect fiber that will be coming out, which will be a flowable fiber. We will be doing our Collagen X Pro, and we will be rolling out both the E-Matrix product, which is again, part of that collagen world.

We also bought the HEMOBLAST, which the HEMOBLAST is part of our continuing offering to order, or I should say, provide a full complement of regenerative biologics for our customers, our hospital customers. When you look at the diversity, and this is one of the things that we are trying to do is diversify into other high-impact, high-value adjacent markets. The reason for this is that we do think that if we just stayed within the orthobiologic space, it is just a world that, unfortunately, from a hospital perspective, that is just one segment, primarily a segment in spine. But if we could advance and be more relevant in sports medicine, in surgical repair, advanced wound care, get ourselves into hemostatic biologics, we believe that the hospitals themselves will be looking to guys like us as they continue to consolidate contracts and consolidate vendors.

From our side, this is a long-term play of not only making sure that we can serve the needs of our surgeons but also serve the economic needs of our hospitals. When we think about profitability, we will continue to really focus on operating leverage. That is something that over the course of time, you can look at our track record. We have been very good because there is one thing you can manage and manage without fail, and that is expenses. We do that, I think, fairly well. The other big thing is that one of the bigger pieces and bigger opportunities we have as a business, and this is where these 17 new reps and the four new ones that we added on top of our four, so getting greater penetration within our independent agent network, huge opportunity for us.

We find that when an IA or an independent agent sells more than one of our products, they are a heck of a lot stickier. Today we have quite a few of our independent agents that sell just the one product. Our goal is to get greater traction where possible. Then, of course, the more we sell our Xtant-branded products, for instance, when you think about if we have our own Xtant versus some of the OEM business that we have, we are making about half as much money on an OEM deal as we would on our Xtant-branded product. We want to make sure that not only are we driving our own brand, but we are also driving the profitability and the top-line dollars that come with it. Then when and if we have excess capacity, we will look to do OEM deals.