# EDGAR Filing Document

**Accession Number:** 0001453593
**File Stem:** 0001387131-23-002090
**Filing Date:** 2023-2
**Character Count:** 28239
**Document Hash:** 880054306d91980343c4d6f5b49d27e2
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001387131-23-002090.hdr.sgml**: 20230214

**ACCESSION NUMBER**: 0001387131-23-002090

**CONFORMED SUBMISSION TYPE**: SC 13G/A

**PUBLIC DOCUMENT COUNT**: 2

**FILED AS OF DATE**: 20230214

**DATE AS OF CHANGE**: 20230214

**GROUP MEMBERS**: ALTIUM GROWTH FUND, LP

**GROUP MEMBERS**: ALTIUM GROWTH GP, LLC

**SUBJECT COMPANY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Xtant Medical Holdings, Inc.
- **CENTRAL INDEX KEY:** 0001453593
- **STANDARD INDUSTRIAL CLASSIFICATION:** BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
- **IRS NUMBER:** 205313323
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SC 13G/A
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 005-86224
- **FILM NUMBER:** 23630912

**BUSINESS ADDRESS:**
- **STREET 1:** 664 CRUISER LANE
- **CITY:** BELGRADE
- **STATE:** MT
- **ZIP:** 59714
- **BUSINESS PHONE:** 406-388-0480

**MAIL ADDRESS:**
- **STREET 1:** 664 CRUISER LANE
- **CITY:** BELGRADE
- **STATE:** MT
- **ZIP:** 59714

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** Bacterin International Holdings, Inc.
- **DATE OF NAME CHANGE:** 20100615

**FORMER COMPANY:**
- **FORMER CONFORMED NAME:** K KITZ INC
- **DATE OF NAME CHANGE:** 20090108
**FILED BY**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Altium Capital Management LP
- **CENTRAL INDEX KEY:** 0001746382
- **IRS NUMBER:** 822066653
- **STATE OF INCORPORATION:** DE
- **FISCAL YEAR END:** 1231

**FILING VALUES:**
- **FORM TYPE:** SC 13G/A

**BUSINESS ADDRESS:**
- **STREET 1:** 152 W 57 ST FL20
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10019
- **BUSINESS PHONE:** 2124842711

**MAIL ADDRESS:**
- **STREET 1:** 152 W 57 ST FL20
- **CITY:** NEW YORK
- **STATE:** NY
- **ZIP:** 10019

**UNITED STATES**

**SECURITIES AND EXCHANGE COMMISSION**

**Washington, D.C. 20549**

**SCHEDULE 13G/A**

**Under the Securities Exchange Act of 1934**

**(Amendment No. 2)\***

**Xtant Medical Holdings, Inc.**

(Name of Issuer)

**Common Stock, par value $0.000001 per share**

(Title of Class of Securities)

**98420P308**

(CUSIP Number)

**December 31, 2022**

(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

☐ Rule 13d-1(b)

☒ Rule 13d-1(c)

☐ Rule 13d-1(d)

\* The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

Page **2** of **9**

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| | |
|:---|:---|
| **CUSIP No**. | **98420P308** |

---

---

| | | | | |
|:---|:---|:---|:---|:---|
| **1** | NAME OF REPORTING PERSONS<br> Altium Capital Management, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2066653 | NAME OF REPORTING PERSONS<br> Altium Capital Management, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2066653 | NAME OF REPORTING PERSONS<br> Altium Capital Management, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2066653 |  |
| **2** | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | (a) ☐<br> (b) ☒ |
| **3** | SEC USE ONLY | SEC USE ONLY | SEC USE ONLY |  |
| **4** | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **5** | SOLE VOTING<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **6** | SHARED VOTING POWER<br> 6,246,291 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **7** | SOLE DISPOSITIVE POWER<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **8** | SHARED DISPOSITIVE POWER<br> 6,246,291 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **9** | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 6,246,291 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 6,246,291 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 6,246,291 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **10** | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | ☐ |
| **11** | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 5.7%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 5.7%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 5.7%<sup>(1)(2)</sup> |  |
| **12** | TYPE OF REPORTING PERSON<br> IA, PN | TYPE OF REPORTING PERSON<br> IA, PN | TYPE OF REPORTING PERSON<br> IA, PN |  |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) As
 more fully described in Item 4, the Warrants are subject to a 4.99% blocker. However,
 as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show
 the number of shares of Common Stock that would be issuable upon full conversion and
 exercise of such reported securities and do not give effect to such blockers. Therefore,
 the actual number of shares of Common Stock beneficially owned by each such Reporting
 Person, after giving effect to such blockers, is less than the number of securities reported
 in rows (6), (8) and (9).

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) Based
 on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's
 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November
 3, 2022.

Page **3** of **9**

---

| | |
|:---|:---|
| **CUSIP No**. | **98420P308** |

---

---

| | | | | |
|:---|:---|:---|:---|:---|
| **1** | NAME OF REPORTING PERSONS<br> Altium Growth Fund, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2105101 | NAME OF REPORTING PERSONS<br> Altium Growth Fund, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2105101 | NAME OF REPORTING PERSONS<br> Altium Growth Fund, LP<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2105101 |  |
| **2** | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | (a) ☐<br> (b) ☒ |
| **3** | SEC USE ONLY | SEC USE ONLY | SEC USE ONLY |  |
| **4** | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **5** | SOLE VOTING<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **6** | SHARED VOTING POWER<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **7** | SOLE DISPOSITIVE POWER<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **8** | SHARED DISPOSITIVE POWER<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **9** | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **10** | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | ☐ |
| **11** | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> |  |
| **12** | TYPE OF REPORTING PERSON<br> PN | TYPE OF REPORTING PERSON<br> PN | TYPE OF REPORTING PERSON<br> PN |  |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) As
 more fully described in Item 4, the Warrants are subject to a 4.99% blocker. However,
 as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show
 the number of shares of Common Stock that would be issuable upon full conversion and
 exercise of such reported securities and do not give effect to such blockers. Therefore,
 the actual number of shares of Common Stock beneficially owned by each such Reporting
 Person, after giving effect to such blockers, is less than the number of securities reported
 in rows (6), (8) and (9).

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) Based
 on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's
 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November
 3, 2022.

Page **4** of **9**

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| | |
|:---|:---|
| **CUSIP No**. | **98420P308** |

---

---

| | | | | |
|:---|:---|:---|:---|:---|
| **1** | NAME OF REPORTING PERSONS<br> Altium Growth GP, LLC<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2086430 | NAME OF REPORTING PERSONS<br> Altium Growth GP, LLC<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2086430 | NAME OF REPORTING PERSONS<br> Altium Growth GP, LLC<br>I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS<br> (ENTITIES ONLY) EIN: 82-2086430 |  |
| **2** | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | (a) ☐<br> (b) ☒ |
| **3** | SEC USE ONLY | SEC USE ONLY | SEC USE ONLY |  |
| **4** | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America | CITIZENSHIP OR PLACE OF ORGANIZATION<br> Delaware, United States of America |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **5** | SOLE VOTING<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **6** | SHARED VOTING POWER<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **7** | SOLE DISPOSITIVE POWER<br> 0 |  |
| NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | NUMBER OF<br> SHARES<br> BENEFICIALLY<br> OWNED BY<br> EACH<br> REPORTING<br> PERSON<br> WITH: | **8** | SHARED DISPOSITIVE POWER<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **9** | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON<br> 3,123,145 shares of Common Stock<br> 6,497,918 shares of Common Stock issuable upon exercise of Warrants<sup>(1)</sup> |  |
| **10** | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW 9 EXCLUDES CERTAIN SHARES | ☐ |
| **11** | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9<br> 4.99%<sup>(1)(2)</sup> |  |
| **12** | TYPE OF REPORTING PERSON<br> OO | TYPE OF REPORTING PERSON<br> OO | TYPE OF REPORTING PERSON<br> OO |  |

---

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(1) As
 more fully described in Item 4, the Warrants are subject to a 4.99% blocker. However,
 as more fully described in Item 4, the securities reported in rows (6), (8) and (9) show
 the number of shares of Common Stock that would be issuable upon full conversion and
 exercise of such reported securities and do not give effect to such blockers. Therefore,
 the actual number of shares of Common Stock beneficially owned by each such Reporting
 Person, after giving effect to such blockers, is less than the number of securities reported
 in rows (6), (8) and (9).

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;(2) Based
 on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's
 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November
 3, 2022.

Page **5** of **9**

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| | |
|:---|:---|
| **CUSIP No.** | **98420P308** |

---

---

| | |
|:---|:---|
| **Item 1(a).** | **Name of Issuer:** Xtant Medical Holdings, Inc. (the "Issuer") |
| **Item 1(b).** | &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;**Address of Issuer's Principal Executive Offices:** 664 Cruiser Lane<br> Belgrade, Montana 59714 |
| **Item 2(a).** | **Name of Person Filing:** <br> This statement is being filed jointly and on behalf of by Altium Capital Management, LP, ("Altium") a Delaware Limited Partnership and investment adviser exempt from registration with the Securities and Exchange Commission, Altium Growth Fund, LP (the "Fund") a Delaware Limited Partnership, and Altium Growth GP, LLC (the "General Partner") a Delaware Limited Liability Company. The Fund is the record and direct beneficial owner of 3,123,146 shares of Common Stock and Warrants, that if exercised, would result in the direct beneficial ownership of an additional 6,497,918 shares of Common Stock covered by this statement. Altium Capital Management, LP is the investment adviser of, and may be deemed to beneficially own securities, owned by, the Fund. Altium Growth GP, LLC is the general partner of, and may be deemed to beneficially own securities owned by, the Fund. Altium has indirect beneficial ownership of 3,123,146 shares of Common Stock on behalf of its advisory client which are also covered by this statement.<br>Each reporting person declares that neither the filing of this statement nor anything herein shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act or any other purpose, the beneficial owner of any securities covered by this statement.<br>Each of the reporting persons may be deemed to be a member of a group with respect to the Issuer or securities of the Issuer for the purposes of Section 13(d) or 13(g) of the Act. Each of the reporting persons declares that neither the filing of this statement nor anything herein shall be construed as an admission that such person is, for the purposes of Section 13(d) or 13(g) of the Act or any other purpose, (i) acting (or has agreed or is agreeing to act together with any other person) as a partnership, limited partnership, syndicate, or other group for the purpose of acquiring, holding, or disposing of securities of the Issuer or otherwise with respect to the Issuer or any securities of the Issuer or (ii) a member of any group with respect to the Issuer or any securities of the Issuer. |
| **Item 2(b).** | **Address of Principal Business Office or, if None, Residence:** |
|  | The address of the principal business office of each of the reporting persons is<br> 152 West 57th Street, FL 20, New York, NY 10019 |
| **Item 2(c).** | **Citizenship:** |
|  | See Item 4 on the cover page(s) hereto. |
| **Item 2(d).** | **Title of Class of Securities:** |
|  | Common Stock, par value $0.000001 per share ("Common Stock") |
| **Item 2(e).** | **CUSIP Number:** 98420P308 |

---

---

| | | | |
|:---|:---|:---|:---|
| **Item 3.** | **If This Statement is Filed Pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), Check Whether the Person Filing is a:** | **If This Statement is Filed Pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), Check Whether the Person Filing is a:** | **If This Statement is Filed Pursuant to §§240.13d-1(b), or 240.13d-2(b) or (c), Check Whether the Person Filing is a:** |
|  | (a) | ☐ | Broker or dealer registered under Section 15 of the Act (15 U.S.C. 78o). |
|  | (b) | ☐ | Bank as defined in Section 3(a)(6) of the Act (15 U.S.C. 78c). |

---

Page **6** of **9**

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| | |
|:---|:---|
| **CUSIP No.** | **98420P308** |

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(c) ☐ Insurance company as defined in Section 3(a)(19)
 of the Act (15 U.S.C. 78c).

(d) ☐ Investment company registered under Section
 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).

(e) ☐ An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);

---

| | | | |
|:---|:---|:---|:---|
|  | (f) | ☐ | An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F); |
|  | (g) | ☐ | A parent holding company or control person in accordance with §240.13d-1(b)(ii)(G); |
|  | (h) | ☐ | A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); |
|  | (i) | ☐ | A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act (15 U.S.C. 80a-3); |
|  | (j) | ☐ | Group, in accordance with §240.13d-1(b)(1)(ii)(J). |
| **Item 4.** | **Ownership.** | **Ownership.** | **Ownership.** |
|  | Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.<br>The information as of the date of the event which requires filing of this statement required by Items 4(a) – (c) is set forth in Rows 5 – 11 of the cover page for each Reporting Person listed above and is incorporated by reference for each such Reporting Person. The percentage set forth in Row 11 of the cover page for each Reporting Person is based on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November 3, 2022.<br>Pursuant to the terms of the securities purchase agreement entered into between the Fund and the Issuer, the Fund purchased Common Stock and Warrants. Neither the Fund nor the General Partner are able to exercise the Warrants to the extent that the Fund would beneficially own, after any such exercise, more than 4.99% of the outstanding shares of Common Stock (the "Warrant Blocker"). The percentage set forth in Row 11 of the cover page for each of the Reporting Persons gives effect to the Warrant Blocker. | Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.<br>The information as of the date of the event which requires filing of this statement required by Items 4(a) – (c) is set forth in Rows 5 – 11 of the cover page for each Reporting Person listed above and is incorporated by reference for each such Reporting Person. The percentage set forth in Row 11 of the cover page for each Reporting Person is based on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November 3, 2022.<br>Pursuant to the terms of the securities purchase agreement entered into between the Fund and the Issuer, the Fund purchased Common Stock and Warrants. Neither the Fund nor the General Partner are able to exercise the Warrants to the extent that the Fund would beneficially own, after any such exercise, more than 4.99% of the outstanding shares of Common Stock (the "Warrant Blocker"). The percentage set forth in Row 11 of the cover page for each of the Reporting Persons gives effect to the Warrant Blocker. | Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.<br>The information as of the date of the event which requires filing of this statement required by Items 4(a) – (c) is set forth in Rows 5 – 11 of the cover page for each Reporting Person listed above and is incorporated by reference for each such Reporting Person. The percentage set forth in Row 11 of the cover page for each Reporting Person is based on 108,659,388 shares, shares of Common Stock outstanding as set forth in the Issuer's 10-Q dated November 1, 2022, filed with the Securities and Exchange Commission on November 3, 2022.<br>Pursuant to the terms of the securities purchase agreement entered into between the Fund and the Issuer, the Fund purchased Common Stock and Warrants. Neither the Fund nor the General Partner are able to exercise the Warrants to the extent that the Fund would beneficially own, after any such exercise, more than 4.99% of the outstanding shares of Common Stock (the "Warrant Blocker"). The percentage set forth in Row 11 of the cover page for each of the Reporting Persons gives effect to the Warrant Blocker. |

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Page **7** of **9**

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| | |
|:---|:---|
| **CUSIP No** . | **98420P308** |

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| | |
|:---|:---|
| **Item 5.** | **Ownership of Five Percent or Less of a Class.** |
|  | If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ] |
| **Item 6.** | **Ownership of More than Five Percent on Behalf of Another Person.** |
|  | Not applicable |
| **Item 7.** | **Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.** |
|  | Not applicable |
| **Item 8.** | **Identification and Classification of Members of the Group.** |
|  | Not applicable |
| **Item 9.** | **Notice of Dissolution of Group.** |
|  | Not applicable |
| **Item 10.** | **Certification.** |

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By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under § 240.14a-11.

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated: February 14, 2023 <br>

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| | |
|:---|:---|
| **Altium Capital Management, LP** | **Altium Capital Management, LP** |
| By: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | CEO |
| **Altium Growth Fund, LP** | **Altium Growth Fund, LP** |
| By: Altium Growth GP, LLC | By: Altium Growth GP, LLC |
| Its: General Partner | Its: General Partner |
| Signature: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | Managing Member of Altium Growth GP, LLC |
| **Altium Growth GP, LLC** | **Altium Growth GP, LLC** |
| By: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | Managing Member |

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Page **8** of **9**

EXHIBIT INDEX

EXHIBIT 1: [Joint Acquisition Statement Pursuant to Section 240.13d-1(k)](ex-1.htm)

Members of Group

## Ex-1

[Altium Capital Management, LP SC 13G/A](xtnt-sc13ga_123122.htm)

Page **9** of **9**

**EXHIBIT 1**

JOINT ACQUISITION STATEMENT

<u>PURSUANT TO SECTION 240.13d-1(k)</u>

The undersigned acknowledge and agree that the foregoing statement on Schedule 13G is filed on behalf of each of the undersigned and that all subsequent amendments to this statement on Schedule 13G shall be filed on behalf of each of the undersigned without the necessity of filing additional joint acquisition statements. The undersigned acknowledge that each shall be responsible for the timely filing of such amendments, and for the completeness and accuracy of the information concerning him, her or it contained therein, but shall not be responsible for the completeness and accuracy of the information concerning the other entities or persons, except to the extent that he, she or it knows or has reason to believe that such information is inaccurate.

Dated: February 14, 2023 <br>

---

| | |
|:---|:---|
| **Altium Capital Management, LP** | **Altium Capital Management, LP** |
| By: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | CEO |
| **Altium Growth Fund, LP** | **Altium Growth Fund, LP** |
| By: Altium Growth GP, LLC | By: Altium Growth GP, LLC |
| Its: General Partner | Its: General Partner |
| Signature: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | Managing Member of Altium Growth GP, LLC |
| **Altium Growth GP, LLC** | **Altium Growth GP, LLC** |
| By: | /s/ Jacob Gottlieb |
| Name: | Jacob Gottlieb |
| Title: | Managing Member |

---