The existence and further duration of the COVID-19 pandemic may also further exacerbate certain risks as described in "Part II- Item 1A - Risk Factors" below.

Factors Affecting Results of Operations and Key Performance Indicators

Increase surgeon activity and training

In addition to utilizing our traditional method of hands-on cadaveric and dry-lab training for surgeons and mid-level practitioners, we are using the SI-BONE SImulator - a portable, radiation-free, haptics and computer-based simulator for training purposes. Starting in July 2020 we began deploying the SImulators to cover all US regions and European subsidiaries and had 25 SImulators in our offices and the field as of the date of this report.

We made significant progress in the number of covered lives for minimally invasive sacroiliac fusion in the U.S.

As of June 30, 2022, substantially all U.S. payors reimburse for sacroiliac joint fusion. As of June 30, 2022, a significant number of U.S. payors have issued positive coverage policies exclusive to our patented design of triangular titanium implants for sacroiliac joint fusion because of the clinical evidence.

Components of Results of Operations

Cost of Goods Sold, Gross Profit, and Gross Margin

Interest income is primarily related to our investments of excess cash in money market funds and marketable securities.

Interest expense is primarily related to borrowings, amortization of debt issuance costs and accretion of final fees on the Solar and SVB Term Loans.

Other income (expense), net consists primarily of net foreign exchange gains and losses on foreign transactions.

We derive the majority of our revenue from sales to customers in the U.S. Revenue by geography is based on billing address of the customer. The table below summarizes our revenue by geography:

Comparison of the Three Months Ended June 30, 2022 and 2021

Revenue, Cost of Goods Sold, Gross Profit, and Gross Margin:

Interest and Other Income (Expense), Net:

Total interest and other expense, net $ (632) $ (1,016)

Other Income (Expense), Net. Other income, net decreased for the three months ended June 30, 2022 compared to the three months ended June 30, 2021 due to foreign currency fluctuations.

Comparison of the Six Months Ended June 30, 2022 and 2021

Revenue, Cost of Goods Sold, Gross Profit, and Gross Margin:

Interest and Other Income (Expense), Net:

Total interest and other expense, net $ (1,174) $ (1,683)

Other Income (Expense), Net. Other income, net decreased for the six months ended June 30, 2022 compared to the six months ended June 30, 2021 due to foreign currency fluctuations.

In May 29, 2020, we entered into a term loan with Solar Capital Partners ("Solar"). Pursuant to the Loan and Security Agreement, Solar provided an aggregate principal amount of $40.0 million term loan (the "Solar Term Loan"). We paid in full and terminated the Solar Term Loan in August 2021.

This compared to $48.4 million of contractual obligations as of December 31, 2021 .

The following table sets forth the primary sources and uses of cash for each of the periods presented below:

Net decrease in cash and cash equivalents $ (39,100) $ (5,456) $ (33,644)

Cash Used in Operating Activities

Cash Provided by Financing Activities

Critical Accounting Policies, Significant Judgments, and Use of Estimates

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