X0306 4 2018-09-17 0 0001453593 Xtant Medical Holdings, Inc. XTNT 0001732521 Eggenberg Michael 664 CRUISER LANE BELGRADE MT 59714 1 0 1 0 Common Stock, $0.000001 par value 5890884 I See footnotes Common Stock, $0.000001 par value 3316128 I See footnotes Warrant (right to buy) 0.01 2018-09-17 4 A 0 765992 0 A 2018-09-17 2028-08-01 Common Stock 765992 765992 I See footnotes Warrant (right to buy) 0.01 2018-09-17 4 A 0 434008 0 A 2018-09-17 2028-08-01 Common Stock 434008 434008 I See footnotes These securities are held of record by ROS Acquisition Offshore LP ("ROS Acquisition"). OrbiMed Advisors LLC ("Advisors"), a registered adviser under the Investment Advisors Act of 1940, as amended, is the investment manager of ROS Acquisition. Advisors is also the investment manager of Royalty Opportunities S.a r.l., of which ROS Acquisition is a wholly-owned subsidiary. By virtue of such relationships, Advisors may be deemed to have voting and investment power with respect to the securities held by ROS Acquisition noted above and as a result may be deemed to have beneficial ownership over such securities. The Reporting Person is an employee of Advisors. These securities are held of record by OrbiMed Royalty Opportunities II, LP ("ORO II"). OrbiMed ROF II LLC ("ROF II") is the sole general partner of ORO II, and Advisors is the sole managing member of ROF II. By virtue of such relationships, Advisors may be deemed to have voting and investment power with respect to the securities held by ORO II noted above and as a result may be deemed to have beneficial ownership over such securities. Each of ROS Acquisition, ORO II, Advisors and the Reporting Person disclaims beneficial ownership of the securities reported herein for purposes of Rule 16a-1(a) under the Securities Exchange Act of 1934, as amended (the "Exchange Act"), except to the extent of its or his pecuniary interest therein, if any. This report shall not be deemed an admission that any such entity or person is a beneficial owner of such securities for the purposes of Section 16 of the Exchange Act, or for any other purposes. This warrant was acquired from Xtant Medical Holdings, Inc. in connection with and as a condition to the effectiveness of that certain Twenty-Fifth Amendment to the Amended and Restated Credit Agreement, effective as of August 1, 2018. /s/ Amy Culbert, attorney-in-fact 2018-09-19