0000947871-18-000043 Sample Contracts

SIXTH AMENDMENT
Sixth Amendment • January 17th, 2018 • Orbimed Advisors LLC • Biological products, (no disgnostic substances) • New York

This SIXTH AMENDMENT (this “Amendment”) is effective as of January 17, 2018 by XTANT MEDICAL HOLDINGS, INC., a Delaware corporation (the “Company”), ROS ACQUISITION OFFSHORE LP, a Cayman Islands Exempted Limited Partnership (“ROS”) and ORBIMED ROYALTY OPPORTUNITIES II, LP, a Delaware limited partnership (“Royalty Opportunities” and, together with ROS, collectively, the “Holders”).

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JOINT FILING AGREEMENT
Joint Filing Agreement • January 17th, 2018 • Orbimed Advisors LLC • Biological products, (no disgnostic substances)

The undersigned hereby agree that the Statement on this Schedule 13D, dated January 17, 2018 (the “Schedule 13D”), with respect to the Shares of Xtant Medical Holdings, Inc. is filed, and all amendments thereto will be filed, on behalf of each of us pursuant to and in accordance with the provisions of Rule 13d-1(k) under the Securities and Exchange Act of 1934, as amended, and that this Agreement shall be included as an Exhibit to this Schedule 13D. Each of the undersigned agrees to be responsible for the timely filing of the Schedule 13D, and for the completeness and accuracy of the information concerning itself contained therein. This Agreement may be executed in any number of counterparts, all of which taken together shall constitute one and the same instrument.

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