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      Quest Diagnostics Reports Third Quarter 2021 Financial Results, Raises Outlook for Full Year 2021

      - Third quarter revenues of $2.77 billion, down 0.4% from 2020

      - Third quarter reported diluted earnings per share ("EPS") of $4.02, down 2.8% from 2020; and adjusted diluted EPS of $3.96, down 7.9% from 2020

      - Year to date cash provided by operations of $1.75 billion, up 19.6% from 2020

      - Raises full year 2021 outlook to reflect higher than anticipated COVID-19 testing volumes and base business performance

      Quest Diagnostics Incorporated logo. (PRNewsFoto/Quest Diagnostics Incorporated)

      News provided by

      Quest Diagnostics

      Oct 21, 2021, 06:45 ET

      Share this article

      Share this article


      SECAUCUS, N.J., Oct. 21, 2021 /PRNewswire/ -- Quest Diagnostics Incorporated (NYSE: DGX), the world's leading provider of diagnostic information services, announced today financial results for the third quarter ended September 30, 2021.

      "We had a strong third quarter, as COVID-19 molecular volumes increased throughout the summer while our base business continued to deliver solid volume growth versus the prior year and 2019," said Steve Rusckowski, Chairman, CEO and President. "In late summer we experienced some softness in the base business across the country, but saw an overall rebound in September. Importantly, our base business continued to improve sequentially in the third quarter which speaks to the ongoing recovery."

      "We have raised our outlook for the remainder of the year based on higher than anticipated COVID-19 volumes as well as the continued progress we expect to see in our base business despite rising labor costs and inflationary pressures. The momentum of our base business positions us to deliver the 2022 outlook we shared at our March investor day."    


      Three Months Ended September 30,


      Nine Months Ended September 30,



      2021


      2020


      Change


      2021


      2020


      Change



      (dollars in millions, except per share data)


      Reported:













      Net revenues

      $

      2,774



      $

      2,786



      (0.4)

      %


      $

      8,044



      $

      6,435



      25.0

      %


      Diagnostic Information Services revenues

      $

      2,703



      $

      2,709



      (0.2)

      %


      $

      7,820



      $

      6,217



      25.8

      %


      Revenue per requisition





      (5.4)

      %






      2.2

      %


      Requisition volume





      5.3

      %






      22.9

      %


        Organic requisition volume





      3.2

      %






      19.2

      %


      Operating income (a)

      $

      652



      $

      718



      (9.3)

      %


      $

      1,845



      $

      1,176



      56.9

      %


      Operating income as a percentage of net revenues (a)

      23.5

      %


      25.8

      %


      (2.3)

      %


      22.9

      %


      18.3

      %


      4.6

      %


      Net income attributable to Quest Diagnostics (a)

      $

      505



      $

      568



      (11.0)

      %


      $

      1,605



      $

      852



      88.4

      %


      Diluted EPS (a) (b)

      $

      4.02



      $

      4.14



      (2.8)

      %


      $

      12.41



      $

      6.25



      98.5

      %


      Cash provided by operations

      $

      561



      $

      862



      (34.9)

      %


      $

      1,752



      $

      1,464



      19.6

      %


      Capital expenditures

      $

      89



      $

      91



      (1.9)

      %


      $

      259



      $

      256



      1.2

      %















      Adjusted (a):













      Operating income

      $

      694



      $

      831



      (16.4)

      %


      $

      1,986



      $

      1,350



      47.1

      %


      Operating income as a percentage of net revenues

      25.0

      %


      29.8

      %


      (4.8)

      %


      24.7

      %


      21.0

      %


      3.7

      %


      Net income attributable to Quest Diagnostics

      $

      498



      $

      591



      (15.7)

      %


      $

      1,411



      $

      912



      54.7

      %


      Diluted EPS (b)

      $

      3.96



      $

      4.31



      (7.9)

      %


      $

      10.91



      $

      6.69



      63.1

      %




      (a)

      For further details impacting the year-over-year comparisons related to operating income, operating income as a percentage of net
      revenues, net income attributable to Quest Diagnostics, and diluted EPS, see note 2 of the financial tables attached below.



      (b)

      The sum of reported and adjusted diluted EPS for the first three quarters of 2021 did not equal the totals for the nine months ended September 30, 2021 due to both quarterly fluctuations in the company's earnings and in the weighted average common shares outstanding throughout the period as a result of the impact of accelerated share repurchase agreements ("ASRs") that the company entered into during April 2021.

      Updated Outlook for Full Year 2021

      The company updates its Full Year 2021 outlook as follows: 


      Updated Outlook


      Previous Outlook


      Low


      High


      Low


      High

      Net revenues

      $10.45 billion


      $10.60 billion


      $9.84 billion


      $10.09 billion

      Net revenues increase

      10.7%


      12.3%


      4.3%


      6.9%

      Reported diluted EPS

      $14.69


      $15.09


      $12.54


      $13.24

      Adjusted diluted EPS

      $13.50


      $13.90


      $11.65


      $12.35

      Cash provided by operations

      Approximately $2.2 billion


      At least $2.0 billion

      Capital expenditures

        Approximately $400 million


        Approximately $400 million

      Note on Non-GAAP Financial Measures

      As used in this press release the term "reported" refers to measures under accounting principles generally accepted in the United States ("GAAP"). The term "adjusted" refers to non-GAAP operating performance measures that exclude special items such as restructuring and integration charges, certain financial impacts resulting from the COVID-19 pandemic, amortization expense, excess tax benefits ("ETB") associated with stock-based compensation, costs associated with donations, contributions, and other financial support through Quest for Health Equity, the company's initiative with the Quest Diagnostics Foundation to reduce health disparities in underserved communities, a gain on sale of an ownership interest in a joint venture, gains associated with changes in the carrying value of our strategic investments, and other items.

      Non-GAAP adjusted measures are presented because management believes those measures are useful adjuncts to GAAP results. Non-GAAP adjusted measures should not be considered as an alternative to the corresponding measures determined under GAAP. Management may use these non-GAAP measures to evaluate our performance period over period and relative to competitors, to analyze the underlying trends in our business, to establish operational budgets and forecasts and for incentive compensation purposes. We believe that these non-GAAP measures are useful to investors and analysts to evaluate our performance period over period and relative to competitors, as well as to analyze the underlying trends in our business and to assess our performance. The additional tables attached below include reconciliations of non-GAAP adjusted measures to GAAP measures.

      Conference Call Information

      Quest Diagnostics will hold its quarterly conference call to discuss financial results beginning at 8:30 a.m. Eastern Time today.  The conference call can be accessed by dialing 888-455-0391 within the U.S. and Canada, or 773-756-0467 internationally, passcode: 7895081; or via live webcast on the company's website at www.QuestDiagnostics.com/investor.  The company suggests participants dial in approximately 10 minutes before the call.

      A replay of the call may be accessed online at www.QuestDiagnostics.com/investor or, from approximately 10:30 a.m. Eastern Time on October 21, 2021 until midnight Eastern Time on November 4, 2021, by phone at 866-360-7722 for domestic callers or 203-369-0174 for international callers.  Anyone listening to the call is encouraged to read the company's periodic reports, on file with the Securities and Exchange Commission, including the discussion of risk factors and historical results of operations and financial condition in those reports.

      About Quest Diagnostics

      Quest Diagnostics empowers people to take action to improve health outcomes.  Derived from the world's largest database of clinical lab results, our diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors and improve health care management.  Quest annually serves one in three adult Americans and half the physicians and hospitals in the United States, and our nearly 50,000 employees understand that, in the right hands and with the right context, our diagnostic insights can inspire actions that transform lives. www.QuestDiagnostics.com.

      Forward Looking Statements

      The statements in this press release which are not historical facts may be forward-looking statements.  Readers are cautioned not to place undue reliance on forward-looking statements, which speak only as of the date that they are made and which reflect management's current estimates, projections, expectations or beliefs and which involve risks and uncertainties that could cause actual results and outcomes to be materially different. Risks and uncertainties that may affect the future results of the company include, but are not limited to, impacts of the COVID-19 pandemic and measures taken in response, adverse results from pending or future government investigations, lawsuits or private actions, the competitive environment, the complexity of billing, reimbursement and revenue recognition for clinical laboratory testing, changes in government regulations, changing relationships with customers, payers, suppliers or strategic partners and other factors discussed in the company's most recently filed Annual Report on Form 10-K and in any of the company's subsequently filed Quarterly Reports on Form 10-Q and Current Reports on Form 8-K, including those discussed in the "Business," "Risk Factors," "Cautionary Factors that May Affect Future Results" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections of those reports.

      This earnings release, including the attached financial tables, is available online in the Newsroom section at www.QuestDiagnostics.com.

      ADDITIONAL TABLES FOLLOW



      Quest Diagnostics Incorporated and Subsidiaries

      Consolidated Statements of Operations

      For the Three and Nine Months Ended September 30, 2021 and 2020

      (in millions, except per share data)

      (unaudited)



      Three Months Ended
      September 30,


      Nine Months Ended
      September 30,


      2021


      2020


      2021


      2020

      Net revenues

      $

      2,774



      $

      2,786



      $

      8,044



      $

      6,435










      Operating costs and expenses and other operating income:








      Cost of services

      1,670



      1,580



      4,861



      4,071


      Selling, general and administrative

      427



      396



      1,263



      1,103


      Amortization of intangible assets

      25



      27



      77



      77


      Other operating expense (income), net

      —



      65



      (2)



      8


      Total operating costs and expenses, net

      2,122



      2,068



      6,199



      5,259










      Operating income

      652



      718



      1,845



      1,176










      Other income (expense):








      Interest expense, net

      (38)



      (42)



      (114)



      (124)


      Other income, net

      40



      77



      366



      74


      Total non-operating income (expense), net

      2



      35



      252



      (50)










      Income before income taxes and equity in earnings of equity method
         investees

      654



      753



      2,097



      1,126


      Income tax expense

      (153)



      (177)



      (483)



      (269)


      Equity in earnings of equity method investees, net of taxes

      26



      15



      53



      33


      Net income

      527



      591



      1,667



      890


      Less: Net income attributable to noncontrolling interests

      22



      23



      62



      38


      Net income attributable to Quest Diagnostics

      $

      505



      $

      568



      $

      1,605



      $

      852










      Earnings per share attributable to Quest Diagnostics' common
         stockholders:








      Basic

      $

      4.11



      $

      4.20



      $

      12.63



      $

      6.33










      Diluted

      $

      4.02



      $

      4.14



      $

      12.41



      $

      6.25










      Weighted average common shares outstanding:








      Basic

      123



      135



      127



      134










      Diluted

      125



      137



      129



      136


      Quest Diagnostics Incorporated and Subsidiaries

      Consolidated Balance Sheets

      September 30, 2021 and December 31, 2020

      (in millions, except per share data)

      (unaudited)



      September 30,
      2021


      December 31,
      2020

      Assets




      Current assets:




      Cash and cash equivalents

      $

      987



      $

      1,158


      Accounts receivable, net

      1,473



      1,520


      Inventories

      205



      223


      Prepaid expenses and other current assets

      189



      157


      Total current assets

      2,854



      3,058


      Property, plant and equipment, net

      1,634



      1,627


      Operating lease right-of-use assets

      596



      604


      Goodwill

      7,057



      6,873


      Intangible assets, net

      1,152



      1,167


      Investments in equity method investees

      124



      521


      Other assets

      155



      176


      Total assets

      $

      13,572



      $

      14,026






      Liabilities and Stockholders' Equity




      Current liabilities:




      Accounts payable and accrued expenses

      $

      1,610



      $

      1,633


      Current portion of long-term debt

      1



      2


      Current portion of long-term operating lease liabilities

      148



      141


      Total current liabilities

      1,759



      1,776


      Long-term debt

      4,006



      4,013


      Long-term operating lease liabilities

      495



      499


      Other liabilities

      801



      847


      Redeemable noncontrolling interest

      79



      82


      Stockholders' equity:




      Quest Diagnostics stockholders' equity:




      Common stock, par value $0.01 per share; 600 shares authorized as of both September 30, 2021 and December 31, 2020; 162 and 217 shares issued as of September 30, 2021 and December 31, 2020, respectively

      2



      2


      Additional paid-in capital

      1,936



      2,841


      Retained earnings

      7,333



      9,303


      Accumulated other comprehensive loss

      (13)



      (21)


      Treasury stock, at cost; 39 and 84 shares as of September 30, 2021 and December 31, 2020, respectively

      (2,866)



      (5,366)


      Total Quest Diagnostics stockholders' equity

      6,392



      6,759


      Noncontrolling interests

      40



      50


      Total stockholders' equity

      6,432



      6,809


      Total liabilities and stockholders' equity

      $

      13,572



      $

      14,026


      Quest Diagnostics Incorporated and Subsidiaries

      Consolidated Statements of Cash Flows

      For the Nine Months Ended September 30, 2021 and 2020

      (in millions)

      (unaudited)



      Nine Months Ended
      September 30,


      2021


      2020

      Cash flows from operating activities:




      Net income

      $

      1,667



      $

      890


      Adjustments to reconcile net income to net cash provided by operating activities:




      Depreciation and amortization

      302



      263


      Provision for credit losses

      3



      18


      Deferred income tax (benefit) provision

      (87)



      12


      Stock-based compensation expense

      60



      63


      Gain on disposition of joint venture

      (314)



      —


      Other, net

      (48)



      (60)


      Changes in operating assets and liabilities:




      Accounts receivable

      45



      (355)


      Accounts payable and accrued expenses

      36



      514


      Income taxes payable

      49



      95


      Termination of interest rate swap agreements

      —



      40


      Other assets and liabilities, net

      39



      (16)


      Net cash provided by operating activities

      1,752



      1,464






      Cash flows from investing activities:




      Business acquisitions, net of cash acquired

      (251)



      (329)


      Capital expenditures

      (259)



      (256)


      Proceeds from disposition of joint venture

      755



      —


      Decrease (Increase) in investments and other assets

      3



      (19)


      Net cash provided by (used in) investing activities

      248



      (604)






      Cash flows from financing activities:




      Proceeds from borrowings

      —



      749


      Repayments of debt

      (2)



      (1,002)


      Purchases of treasury stock

      (1,910)



      (75)


      Exercise of stock options

      108



      144


      Employee payroll tax withholdings on stock issued under stock-based compensation plans

      (22)



      (13)


      Dividends paid

      (232)



      (222)


      Distributions to noncontrolling interest partners

      (75)



      (34)


      Other financing activities, net

      (38)



      6


      Net cash used in financing activities

      (2,171)



      (447)






      Net change in cash and cash equivalents and restricted cash

      (171)



      413


      Cash and cash equivalents and restricted cash, beginning of period

      1,158



      1,192


      Cash and cash equivalents and restricted cash, end of period

      $

      987



      $

      1,605






      Cash paid during the period for:




      Interest

      $

      111



      $

      136


      Income taxes

      $

      522



      $

      168


      Notes to Financial Tables


      1)   The computation of basic and diluted earnings per common share is as follows:



      Three Months Ended
      September 30,


      Nine Months Ended
      September 30,


      2021


      2020


      2021


      2020


      (in millions, except per share data)

      Amounts attributable to Quest Diagnostics' common stockholders:








      Net income attributable to Quest Diagnostics

      $

      505



      $

      568



      $

      1,605



      $

      852


      Less: earnings allocated to participating securities

      2



      2



      6



      3


      Earnings available to Quest Diagnostics' common stockholders - basic and diluted

      $

      503



      $

      566



      $

      1,599



      $

      849










      Weighted average common shares outstanding - basic

      123



      135



      127



      134


      Effect of dilutive securities:








      Stock options and performance share units

      2



      2



      2



      2


      Weighted average common shares outstanding - diluted

      125



      137



      129



      136










      Earnings per share attributable to Quest Diagnostics' common
         stockholders:








      Basic

      $

      4.11



      $

      4.20



      $

      12.63



      $

      6.33


      Diluted

      $

      4.02



      $

      4.14



      $

      12.41



      $

      6.25



      2)   The following tables reconcile reported GAAP results to non-GAAP adjusted results:



      Three Months Ended September 30, 2021


      (dollars in millions, except per share data)


      Operating income


      Operating
      income as a
      percentage of
      net revenues


      Income tax
      expense (f)


      Equity in earnings of equity method investees, net of taxes


      Net income attributable to Quest Diagnostics


      Diluted EPS

      As reported

      $

      652



      23.5

      %


      $

      (153)



      $

      26



      $

      505



      $

      4.02


      Restructuring and
      integration charges (a)

      13



      0.5



      (4)



      —



      9



      0.08


      Other (b)

      4



      0.1



      12



      (3)



      (29)



      (0.25)


      Amortization expense

      25



      0.9



      (6)



      —



      19



      0.15


      ETB

      —



      —



      (6)



      —



      (6)



      (0.04)


      As adjusted

      $

      694



      25.0

      %


      $

      (157)



      $

      23



      $

      498



      $

      3.96





      Nine Months Ended September 30, 2021


      (dollars in millions, except per share data)


      Operating income


      Operating income as a percentage of net revenues


      Income tax expense (f)


      Equity in earnings of equity method investees, net of taxes


      Net income attributable to Quest Diagnostics


      Diluted EPS

      As reported

      $

      1,845



      22.9

      %


      $

      (483)



      $

      53



      $

      1,605



      $

      12.41


      Restructuring and
      integration charges (a)

      51



      0.6



      (13)



      —



      38



      0.30


      Other (b)

      9



      0.1



      8



      5



      (20)



      (0.18)


      Gain on sale of
      ownership in joint
      venture (c)

      —



      —



      55



      —



      (259)



      (2.00)


      COVID-19 impact (d)

      4



      0.1



      (1)



      —



      3



      0.03


      Amortization expense

      77



      1.0



      (20)



      2



      59



      0.46


      ETB

      —



      —



      (15)



      —



      (15)



      (0.11)


      As adjusted

      $

      1,986



      24.7

      %


      $

      (469)



      $

      60



      $

      1,411



      $

      10.91

















      Three Months Ended September 30, 2020


      (dollars in millions, except per share data)


      Operating income


      Operating income as a percentage of net revenues


      Income tax expense (f)


      Equity in earnings of equity method investees, net of taxes


      Net income attributable to Quest Diagnostics


      Diluted EPS

      As reported

      $

      718



      25.8

      %


      $

      (177)



      $

      15



      $

      568



      $

      4.14


      Restructuring and
      integration charges (a)

      18



      0.6



      (4)



      —



      14



      0.10


      COVID-19 impact (d)

      68



      2.5



      (18)



      1



      52



      0.39


      Gain on remeasurement
      of equity interest (e)

      —



      —



      7



      —



      (63)



      (0.46)


      Amortization expense

      27



      0.9



      (7)



      3



      23



      0.16


      ETB

      —



      —



      (3)



      —



      (3)



      (0.02)


      As adjusted

      $

      831



      29.8

      %


      $

      (202)



      $

      19



      $

      591



      $

      4.31





      Nine Months Ended September 30, 2020


      (dollars in millions, except per share data)


      Operating income


      Operating income as a percentage of net revenues


      Income tax expense (f)


      Equity in earnings of equity method investees, net of taxes


      Net income attributable to Quest Diagnostics


      Diluted EPS

      As reported

      $

      1,176



      18.3

      %


      $

      (269)



      $

      33



      $

      852



      $

      6.25


      Restructuring and
      integration charges (a)

      43



      0.7



      (9)



      —



      34



      0.25


      COVID-19 impact (d)

      54



      0.8



      (11)



      (2)



      39



      0.29


      Gain on remeasurement
      of equity interest (e)

      —



      —



      7



      —



      (63)



      (0.46)


      Amortization expense

      77



      1.2



      (21)



      9



      65



      0.47


      ETB

      —



      —



      (15)



      —



      (15)



      (0.11)


      As adjusted

      $

      1,350



      21.0

      %


      $

      (318)



      $

      40



      $

      912



      $

      6.69
















      (a)

      For both the three and nine months ended September 30, 2021 and 2020, represents costs primarily associated with systems conversions and integration incurred in connection with further restructuring and integrating our business.  The following table summarizes the pre-tax impact of restructuring and integration charges on the company's consolidated statements of operations:











      Three Months Ended
      September 30,


      Nine Months Ended
      September 30,











      2021


      2020


      2021


      2020











      (dollars in millions)

      Cost of services










      $

      7



      $

      11



      $

      26



      $

      21


      Selling, general and administrative                        





      6



      7



      25



      22


         Operating income










      $

      13



      $

      18



      $

      51



      $

      43



      (b)

      For the three months ended September 30, 2021, the pre-tax impact primarily represents gains associated with changes in the carrying value of our strategic investments and costs associated with donations, contributions and other financial support through Quest for Health Equity.  For the nine months ended September 30, 2021, the pre-tax impact primarily represents gains associated with changes in the carrying value of our strategic investments, costs associated with donations, contributions and other financial support through Quest for Health Equity, and a non-cash impairment charge to the carrying value of an equity method investment.






      The following table summaries the pre-tax impact of these other items on the company's consolidated statement of operations:


      Three Months Ended
      September 30,


      Nine Months Ended
      September 30,


      2021


      2020


      2021


      2020


      (dollars in millions)

      Selling, general and administrative

      $

      4



      $

      —



      $

      9



      $

      —










      Equity in earnings of equity method investees, net of taxes

      $

      (3)



      $

      —



      $

      5



      $

      —










      Other income, net

      $

      (42)



      $

      —



      $

      (42)



      $

      —



      (c)

      For the nine months ended September 30, 2021, the pre-tax impact represents a gain of $314 million recorded in other income, net following the sale of the company's 40% ownership interest in Q2 Solutions®, its clinical trials central laboratory services joint venture, to IQVIA Holdings, Inc., its joint venture partner, for $760 million in an all-cash transaction. 





      (d)

      For the nine months ended September 30, 2021 and both the three and nine months ended September 30, 2020, the pre-tax impact represents the impact of certain items resulting from the COVID-19 pandemic.  For the nine months ended September 30, 2021, includes incremental costs incurred to protect the health and safety of the company's employees and customers.  For the three months ended September 30, 2020, the pre-tax impact principally includes the reversal of $65 million of income previously recognized during the second quarter of 2020 attributable to the receipt of funds from the government that were appropriated to healthcare providers under the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act"), which funds were returned during the three months ended December 31, 2020 and, to a lesser extent, incremental costs incurred primarily to protect the health and safety of the company's employees and customers.  For the nine months ended September 30, 2020, the pre-tax impact principally includes expense associated with a payment to eligible employees to help offset expenses they incurred as a result of COVID-19, certain asset impairment charges, and incremental costs incurred primarily to protect the health and safety of the company's employees and customers. 






      The following table summarizes the pre-tax impact of these COVID-19 items on the company's consolidated statements of operations:


      Three Months Ended
      September 30,


      Nine Months Ended
      September 30,


      2021


      2020


      2021


      2020


      (dollars in millions)

      Cost of services

      $

      —



      $

      3



      $

      4



      $

      38


      Selling, general and administrative

      —



      —



      —



      8


      Other operating expense (income), net

      —



      65



      —



      8


      Operating income

      $

      —



      $

      68



      $

      4



      $

      54










      Equity in earnings of equity method investees, net of taxes

      $

      —



      $

      1



      $

      —



      $

      (2)










      Net income attributable to noncontrolling interest

      $

      —



      $

      (1)



      $

      —



      $

      2



      (e)

      For the three and nine months ended September 30, 2020, the pre-tax impact represents a gain of $70 million recognized in other income, net based on the difference between the fair value and the carrying value of an equity interest. On August 1, 2020, the company completed its acquisition of the remaining 56% interest in Mid America Clinical Laboratories, LLC ("MACL") from its joint venture partners. As a result of the transaction, the company remeasured its previously held minority interest in MACL to fair value and recognized a gain.





      (f)

      For restructuring and integration charges, COVID-19 impacts, other items and amortization expense, income tax impacts, where recorded, were primarily calculated using combined statutory income tax rates of 25.5% for both 2021 and 2020.  For the gain on sale of ownership in joint venture in 2021, income tax expense on the transaction resulted in an effective income rate of 17.6%.  For the gain on remeasurement of equity interest in 2020, income tax expense on the transaction resulted in an effective income tax rate of 11.8%.     




      3)

      In April 2021, the company entered into ASRs with several financial institutions to repurchase $1.5 billion of the company's common stock as part of its share repurchase program.  For the nine months ended September 30, 2021, the company paid $1.5 billion to the financial institutions and received an initial amount of 9.1 million shares of its common stock, for a value of $1.2 billion, which represents 80% of the total value of shares to be repurchased under the ASRs.  The specific number of shares that the company ultimately will purchase under the ASRs will be based on the average of the daily volume-weighted average price per share of the company's common stock during a repurchase period.  For the nine months ended September 30, 2021, the company repurchased 12.5 million shares of its common stock for a value of $1.6 billion, including 9.1 million shares repurchased under ASRs.  There were no shares repurchased during the three months ended September 30, 2021.  In each of February and March 2021, the company's Board of Directors increased the size of its share repurchase program by $1 billion.  As of September 30, 2021, $1.3 billion remained available under the company's share repurchase authorization. 




      4)

      For the three and nine months ended September 30, 2020, net cash provided by operating activities includes $73 million and $138 million, respectively, that the company received from the funds that were appropriated to healthcare providers under the CARES Act, which funds were returned during the fourth quarter of 2020.




      5)

      The outlook for adjusted diluted EPS represents management's estimates for the full year 2021 before the impact of special items. Further impacts to earnings related to special items may occur throughout 2021.  Additionally, the amount of ETB is dependent upon employee stock option exercises and the company's stock price, and changes in the carrying value of our strategic investments are based on fluctuations in the investee's stock price, both of which are difficult to predict.  The following table reconciles our full year 2021 outlook for adjusted diluted EPS to the corresponding amounts determined under GAAP:









      Low


      High




      Diluted EPS

      $

      14.69



      $

      15.09





      Restructuring and integration charges (a)

      0.44



      0.44





      COVID-19 impact (b)

      0.03



      0.03





      Amortization expense (c)

      0.63



      0.63





      Costs associated with Quest for Health Equity (d)

      0.10



      0.10





      Gain on sale of ownership in joint venture (e)

      (2.02)



      (2.02)





      Other (f)

      (0.23)



      (0.23)





      ETB

      (0.14)



      (0.14)





      Adjusted diluted EPS

      $

      13.50



      $

      13.90









      (a)

      Represents estimated pre-tax charges of $75 million primarily associated with systems conversions and integration incurred in connection with further restructuring and integrating our business.  Income tax benefits were calculated using a combined statutory income tax rate of 25.5%.





      (b)

      Represents estimated pre-tax charges of $4 million associated with the impact of certain items resulting from the COVID-19 pandemic.  Income tax benefits were calculated using a combined statutory income tax rate of 25.5%.





      (c)

      Represents the estimated impact of amortization expense on the calculation of adjusted diluted EPS.  Income tax benefits were calculated using a combined statutory income tax rate of 25.5%.











      Amortization of intangible assets

      $

      105






      Amortization expense included in equity in earnings of equity method investees, net of taxes

      2






      Total pre-tax amortization expense

      $

      107












      Total amortization expense, net of an estimated income tax benefit using a combined statutory
      income tax rate of 25.5%

      $

      80









      (d)

      Represents estimated pre-tax charges of $18 million associated with donations, contributions and other financial support through Quest for Health Equity.  Income tax benefits were calculated using a combined statutory income tax rate of 25.5%.





      (e)

      Represents a pre-tax gain of $314 million recorded in other income, net following the sale of the company's 40% ownership interest in Q2 Solutions®.   Income tax expense on the transaction resulted in an effective income tax rate of 17.6%.





      (f)

      Represents net pre-tax gains of $38 million associated with changes in the carrying value of our strategic investments partially offset by a non-cash impairment charge to the carrying value of an equity method investment.  Income tax expense was calculated using a combined statutory income tax rate of 25.5%.

      SOURCE Quest Diagnostics

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