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Table of Contents
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
FORM 10-Q

(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2021

Or
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to

Commission file number 001-12215

Quest Diagnostics Incorporated
Delaware 16-1387862
(State of Incorporation) (I.R.S. Employer Identification Number)
500 Plaza Drive
Secaucus, NJ 07094
(973) 520-2700
Securities registered pursuant to Section 12(b) of the Act:
Title of each class Trading Symbol(s) Name of each exchange on which registered
Common Stock, $0.01 Par Value DGX New York Stock Exchange
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large accelerated filer Accelerated filer
Non-accelerated filer Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes No
As of April 15, 2021, there were outstanding 130,638,109 shares of the registrant’s common stock, $.01 par value.


Table of Contents
PART I - FINANCIAL INFORMATION
  Page
Item 1. Financial Statements (unaudited)  
   
Index to unaudited consolidated financial statements filed as part of this report:  
   
2
   
3
4
   
5
6
7
 
 
   
21
 
 
   
31
 
 
   
31

1

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
FOR THE THREE MONTHS ENDED MARCH 31, 2021 AND 2020
(unaudited)
(in millions, except per share data)

Three Months Ended March 31,
2021 2020
Net revenues $ 2,720  $ 1,822 
Operating costs and expenses and other operating income:    
Cost of services 1,626  1,270 
Selling, general and administrative 407  347 
Amortization of intangible assets 27  25 
Other operating expense, net — 
Total operating costs and expenses, net 2,060  1,647 
Operating income 660  175 
Other income (expense):    
Interest expense, net (38) (41)
Other income (expense), net (16)
Total non-operating expense, net (34) (57)
Income before income taxes and equity in earnings of equity method investees 626  118 
Income tax expense (153) (26)
Equity in earnings of equity method investees, net of taxes 17  14 
Net income 490  106 
Less: Net income attributable to noncontrolling interests 21 
Net income attributable to Quest Diagnostics $ 469  $ 99 
Earnings per share attributable to Quest Diagnostics’ common stockholders:    
Basic $ 3.52  $ 0.74 
Diluted $ 3.46  $ 0.73 
Weighted average common shares outstanding:    
Basic 133  134 
Diluted 135  135 










The accompanying notes are an integral part of these statements.

2

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
FOR THE THREE MONTHS ENDED MARCH 31, 2021 AND 2020
(unaudited)
(in millions)
Three Months Ended March 31,
2021 2020
Net income $ 490  $ 106 
Other comprehensive loss:
Foreign currency translation adjustment (3) (19)
Net change in available-for-sale debt securities, net of taxes (7) — 
Other comprehensive loss (10) (19)
Comprehensive income 480  87 
Less: Comprehensive income attributable to noncontrolling interests
21 
Comprehensive income attributable to Quest Diagnostics $ 459  $ 80 





















The accompanying notes are an integral part of these statements.

3

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
MARCH 31, 2021 AND DECEMBER 31, 2020
(unaudited)
(in millions, except per share data)
March 31,
2021
December 31,
2020
Assets    
Current assets:    
Cash and cash equivalents $ 1,230  $ 1,158 
Accounts receivable, net of allowance for credit losses of $29 and $28 as of March 31, 2021 and December 31, 2020, respectively
1,382  1,520 
Inventories 223  223 
Prepaid expenses and other current assets 164  157 
Total current assets 2,999  3,058 
Property, plant and equipment, net 1,624  1,627 
Operating lease right-of-use assets 600  604 
Goodwill 6,870  6,873 
Intangible assets, net 1,141  1,167 
Investments in equity method investees 527  521 
Other assets 170  176 
Total assets $ 13,931  $ 14,026 
Liabilities and Stockholders’ Equity    
Current liabilities:    
Accounts payable and accrued expenses $ 1,559  $ 1,633 
Current portion of long-term debt
Current portion of long-term operating lease liabilities 146  141 
Total current liabilities 1,707  1,776 
Long-term debt 4,010  4,013 
Long-term operating lease liabilities 503  499 
Other liabilities 842  847 
Commitments and contingencies
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 March 31, 2021 and December 31, 2020; 217 shares issued as of both March 31, 2021 and December 31, 2020
Additional paid-in capital 2,824  2,841 
Retained earnings 9,690  9,303 
Accumulated other comprehensive loss (31) (21)
Treasury stock, at cost; 86 and 84 shares as of March 31, 2021 and December 31, 2020, respectively
(5,740) (5,366)
Total Quest Diagnostics stockholders’ equity 6,745  6,759 
Noncontrolling interests 45  50 
Total stockholders’ equity 6,790  6,809 
Total liabilities and stockholders’ equity $ 13,931  $ 14,026 


The accompanying notes are an integral part of these statements.

4

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE THREE MONTHS ENDED MARCH 31, 2021 AND 2020
(unaudited)
(in millions)
Three Months Ended March 31,
2021 2020
Cash flows from operating activities:    
Net income $ 490  $ 106 
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 101  85 
Provision for credit losses
Deferred income tax (benefit) provision (17) 14 
Stock-based compensation expense 18  14 
Other, net (2) (2)
Changes in operating assets and liabilities:    
Accounts receivable 138  85 
Accounts payable and accrued expenses (164) (47)
Income taxes payable 163  (3)
Other assets and liabilities, net (12)
Net cash provided by operating activities 731  247 
Cash flows from investing activities:    
Business acquisitions, net of cash acquired —  (108)
Capital expenditures (86) (83)
Increase in investments and other assets (7) (15)
Net cash used in investing activities (93) (206)
Cash flows from financing activities:    
Repayments of debt (1) (801)
Purchases of treasury stock (410) (75)
Exercise of stock options 17  80 
Employee payroll tax withholdings on stock issued under stock-based compensation plans (21) (13)
Dividends paid (75) (71)
Distributions to noncontrolling interest partners (29) (7)
Other financing activities, net (47) (4)
Net cash used in financing activities (566) (891)
Net change in cash and cash equivalents and restricted cash 72  (850)
Cash and cash equivalents and restricted cash, beginning of period 1,158  1,192 
Cash and cash equivalents and restricted cash, end of period $ 1,230  $ 342 









The accompanying notes are an integral part of these statements.

5

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
FOR THE THREE MONTHS ENDED MARCH 31, 2021 AND 2020
(unaudited)
(in millions)
For the Three Months Ended March 31, 2021 Quest Diagnostics Stockholders’ Equity
Shares of
Common Stock
Outstanding
Common
Stock
Additional
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Compre-
hensive Loss
Treasury
Stock, at
Cost
Non-
controlling
Interests
Total
Stock-
holders’
Equity
Redeemable Non-controlling Interest
Balance, December 31, 2020 133  $ $ 2,841  $ 9,303  $ (21) $ (5,366) $ 50  $ 6,809  $ 82 
Net income 469 17  486 
Other comprehensive loss, net of taxes (10) (10)
Dividends declared (82) (82)
Distributions to noncontrolling interest partners
(22) (22) (7)
Issuance of common stock under benefit plans
(29) 34 
Stock-based compensation expense
18  18 
Exercise of stock options 14  17 
Shares to cover employee payroll tax withholdings on stock issued under stock-based compensation plans
(9) (12) (21)
Purchases of treasury stock
(3) (410) (410)
Balance, March 31, 2021 131  $ $ 2,824  $ 9,690  $ (31) $ (5,740) $ 45  $ 6,790  $ 79 
For the Three Months Ended March 31, 2020 Quest Diagnostics Stockholders’ Equity
Shares of
Common Stock
Outstanding
Common
Stock
Additional
Paid-In
Capital
Retained
Earnings
Accumulated
Other
Compre-
hensive Loss
Treasury
Stock, at
Cost
Non-
controlling
Interests
Total
Stock-
holders’
Equity
Redeemable Non-controlling Interest
Balance, December 31, 2019 133  $ $ 2,722  $ 8,174  $ (39) $ (5,218) $ 46  $ 5,687  $ 76 
Net income 99 105 
Other comprehensive loss, net of taxes (19) (19)
Dividends declared (76) (76)
Distributions to noncontrolling interest partners
(6) (6) (1)
Issuance of common stock under benefit plans
Stock-based compensation expense
14  14 
Exercise of stock options 12  68  80 
Shares to cover employee payroll tax withholdings on stock issued under stock-based compensation plans
(13) (13)
Purchases of treasury stock
(1) (75) (75)
Balance, March 31, 2020 134  $ $ 2,738  $ 8,197  $ (58) $ (5,222) $ 46  $ 5,703  $ 76 

The accompanying notes are an integral part of these statements.

6

QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(unaudited)
(in millions, unless otherwise indicated)

1.    DESCRIPTION OF BUSINESS
    
    Background
    
    Quest Diagnostics Incorporated and its subsidiaries ("Quest Diagnostics" or the "Company") empower people to take action to improve health outcomes.  The Company uses its extensive database of clinical lab results to derive diagnostic insights that reveal new avenues to identify and treat disease, inspire healthy behaviors and improve healthcare management.  The Company's diagnostic information services business ("DIS") provides information and insights based on the industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services. The Company provides services to a broad range of customers, including patients, clinicians, hospitals, independent delivery networks ("IDNs"), health plans, employers, accountable care organizations ("ACOs"), and direct contract entities ("DCEs"). The Company offers the broadest access in the United States to diagnostic information services through its nationwide network of laboratories, patient service centers and phlebotomists in physician offices and the Company's connectivity resources, including call centers and mobile paramedics, nurses and other health and wellness professionals. The Company is the world's leading provider of diagnostic information services. The Company provides interpretive consultation with one of the largest medical and scientific staffs in the industry. The Company's Diagnostic Solutions businesses ("DS") are the leading provider of risk assessment services for the life insurance industry and offer healthcare organizations and clinicians robust information technology solutions.

2.    SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

    Basis of Presentation
    
    The interim unaudited consolidated financial statements reflect all adjustments which in the opinion of management are necessary for a fair statement of results of operations, comprehensive income, financial condition, cash flows and stockholders' equity for the periods presented. Except as otherwise disclosed, all such adjustments are of a normal recurring nature. Operating results for the interim periods are not necessarily indicative of the results that may be expected for the full year. These interim unaudited consolidated financial statements should be read in conjunction with the audited consolidated financial statements included in the Company’s 2020 Annual Report on Form 10-K. The year-end balance sheet data was derived from the audited consolidated financial statements as of December 31, 2020, but does not include all the disclosures required by accounting principles generally accepted in the United States (“GAAP”).

    The accounting policies of the Company are the same as those set forth in Note 2 to the audited consolidated financial statements contained in the Company’s 2020 Annual Report on Form 10-K.

    A novel strain of coronavirus (“COVID-19”) continues to spread and severely impact the economy of the United States and other countries around the world. The Company's testing volume and revenues have been materially impacted by the COVID-19 pandemic, including periods of decline in testing volume in the Company's base business (which excludes COVID-19 testing) compared to historical 2019 levels and periods of significant demand for COVID-19 testing. As a result, operating results for the three months ended March 31, 2021 may not be indicative of the results that may be expected for the full year.

    Use of Estimates
    
    The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

    Earnings Per Share

    The Company's unvested restricted stock units that contain non-forfeitable rights to dividends are participating securities and, therefore, are included in the earnings allocation in computing earnings per share using the two-class method. Basic earnings per common share is calculated by dividing net income attributable to Quest Diagnostics, adjusted for earnings

7

Table of Contents
QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


allocated to participating securities, by the weighted average number of common shares outstanding. Diluted earnings per common share is calculated by dividing net income attributable to Quest Diagnostics, adjusted for earnings allocated to participating securities, by the weighted average number of common shares outstanding after giving effect to all potentially dilutive common shares outstanding during the period. Potentially dilutive common shares include the dilutive effect of outstanding stock options and performance share units granted under the Company's Amended and Restated Employee Long-Term Incentive Plan and its Amended and Restated Non-Employee Director Long-Term Incentive Plan. Earnings allocable to participating securities include the portion of dividends declared as well as the portion of undistributed earnings during the period allocable to participating securities.

    New Accounting Standards to be Adopted

    In March 2020, the Financial Accounting Standards Board issued a new accounting standard which provides temporary optional guidance to ease the potential burden in accounting for reference rate reform due to the risk of cessation of the London Interbank Offered Rate ("LIBOR"). The amendments apply only to contracts, hedging relationships, and other transactions that reference LIBOR or another reference rate expected to be discontinued because of reference rate reform. The pronouncement is effective immediately and can be applied through December 31, 2022. The adoption of this standard is not expected to have a material impact on the Company’s consolidated results of operations, financial position or cash flows.

3.    EARNINGS PER SHARE

    The computation of basic and diluted earnings per common share was as follows (in millions, except per share data):
Three Months Ended March 31,
  2021 2020
Amounts attributable to Quest Diagnostics’ common stockholders:    
Net income attributable to Quest Diagnostics $ 469  $ 99 
Less: Earnings allocated to participating securities — 
Earnings available to Quest Diagnostics’ common stockholders – basic and diluted
$ 468  $ 99 
Weighted average common shares outstanding – basic 133  134 
Effect of dilutive securities:    
Stock options and performance share units
Weighted average common shares outstanding – diluted 135  135 
Earnings per share attributable to Quest Diagnostics’ common stockholders:    
Basic $ 3.52  $ 0.74 
Diluted $ 3.46  $ 0.73 
    
    The following securities were not included in the calculation of diluted earnings per share due to their antidilutive effect:
Three Months Ended March 31,
2021 2020
Stock options and performance share units
    

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


4.     BUSINESS ACQUISITIONS

    On March 6, 2021, the Company entered into a definitive agreement to acquire the outreach laboratory services business of Mercy Health, which serves providers and patients in Arkansas, Kansas, Missouri and Oklahoma. The transaction, which is expected to close in mid-2021, remains subject to customary closing conditions.

    For details regarding the Company's 2020 acquisitions, see Note 6 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.    

5.     FAIR VALUE MEASUREMENTS

    Assets and Liabilities Measured at Fair Value on a Recurring Basis

    The following table provides a summary of the recognized assets and liabilities that are measured at fair value on a recurring basis:
Basis of Fair Value Measurements
Quoted Prices in Active Markets for Identical Assets/Liabilities Significant Other Observable Inputs Significant Unobservable Inputs
March 31, 2021 Total Level 1 Level 2 Level 3
Assets:        
Trading securities $ 71  $ 71  $ —  $ — 
Cash surrender value of life insurance policies 52  —  52  — 
Available-for-sale debt securities —  — 
Total $ 125  $ 71  $ 52  $
Liabilities:        
Deferred compensation liabilities $ 132  $ —  $ 132  $ — 
Redeemable noncontrolling interest $ 79  $ —  $ —  $ 79 
Basis of Fair Value Measurements
December 31, 2020 Total Level 1 Level 2 Level 3
Assets:              
Trading securities $ 67  $ 67  $ —  $ — 
Cash surrender value of life insurance policies 50  —  50  — 
Available-for-sale debt securities 12  —  —  12 
Total $ 129  $ 67  $ 50  $ 12 
Liabilities:        
Deferred compensation liabilities $ 126  $ —  $ 126  $ — 
Redeemable noncontrolling interest $ 82  $ —  $ —  $ 82 
    
    A detailed description regarding the Company's fair value measurements is contained in Note 7 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.    


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    The Company offers certain employees the opportunity to participate in a non-qualified supplemental deferred compensation plan. A participant's deferrals, together with Company matching credits, are invested in a variety of participant-directed stock and bond mutual funds that are classified as trading securities. The trading securities are classified within Level 1 of the fair value hierarchy because the changes in the fair value of these securities are measured using quoted prices in active markets based on the market price per unit multiplied by the number of units held, exclusive of any transaction costs. A corresponding adjustment for changes in fair value of the trading securities is also reflected in the changes in fair value of the deferred compensation obligation. The deferred compensation liabilities are classified within Level 2 of the fair value hierarchy because their inputs are derived principally from observable market data by correlation to the trading securities.

    The Company offers certain employees the opportunity to participate in a non-qualified deferred compensation program. A participant's deferrals, together with Company matching credits, are “invested” at the direction of the employee in a hypothetical portfolio of investments which are tracked by an administrator. The Company purchases life insurance policies, with the Company named as beneficiary of the policies, for the purpose of funding the program's liability. Changes in the cash surrender value of the life insurance policies are based upon earnings and changes in the value of the underlying investments. Changes in the fair value of the deferred compensation obligation are derived using quoted prices in active markets based on the market price per unit multiplied by the number of units. The cash surrender value and the deferred compensation obligation are classified within Level 2 of the fair value hierarchy because their inputs are derived principally from observable market data by correlation to the hypothetical investments. Deferrals under the plan currently may only be made by participants who made deferrals under the plan in 2017.

    The Company's available-for-sale debt securities are measured at fair value based on estimated future cash flows. These fair value measurements are classified within Level 3 of the fair value hierarchy as the fair value is based on significant inputs that are not observable, including cash flow projections.
        
    In connection with the sale of an 18.9% noncontrolling interest in a subsidiary to UMass Memorial Medical Center ("UMass") on July 1, 2015, the Company granted UMass the right to require the Company to purchase all of its interest in the subsidiary at fair value commencing July 1, 2020. As of March 31, 2021, the redeemable noncontrolling interest was presented at its fair value. The fair value measurement of the redeemable noncontrolling interest is classified within Level 3 of the fair value hierarchy because the fair value is based on a discounted cash flow analysis that takes into account, among other items, the joint venture's expected future cash flows, long term growth rates, and a discount rate commensurate with economic risk.

    During the three months ended March 31, 2021, the Company recorded an $8 million impairment charge, which is included in equity in earnings of equity method investees, net of taxes, in order to adjust to fair value an investment that is accounted for under the equity method of accounting. Following the impairment charge, the carrying value of the investment is not material. The fair value measurement was classified within Level 3 of the fair value hierarchy as it was based on significant inputs that are not observable, including cash flow projections.
    
    The carrying amounts of cash and cash equivalents, accounts receivable, and accounts payable and accrued expenses approximate fair value based on the short maturities of these instruments. As of March 31, 2021 and December 31, 2020, the fair value of the Company’s debt was estimated at $4.4 billion and $4.6 billion, respectively. Principally all of the Company's debt is classified within Level 1 of the fair value hierarchy because the fair value of the debt is estimated based on rates currently offered to the Company with identical terms and maturities, using quoted active market prices and yields, taking into account the underlying terms of the debt instruments.

6.    GOODWILL AND INTANGIBLE ASSETS

    The changes in goodwill for the three months ended March 31, 2021 and for the year ended December 31, 2020 were as follows:
March 31, 2021 December 31, 2020
Balance, beginning of period $ 6,873  $ 6,619 
Goodwill acquired during the period —  247 
Adjustments to goodwill (3)
Balance, end of period $ 6,870  $ 6,873 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    
    Principally all of the Company’s goodwill as of March 31, 2021 and December 31, 2020 was associated with its DIS business.

    For the three months ended March 31, 2021, adjustments to goodwill primarily related to foreign currency translation. For the year ended December 31, 2020, goodwill acquired was principally associated with the acquisitions of Blueprint Genetics Oy, Memorial Hermann Diagnostic Laboratories, the outreach laboratory division of Memorial Hermann Health System; and the remaining 56% interest in Mid America Clinical Laboratories, LLC (see Note 6 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K). For the year ended December 31, 2020, adjustments to goodwill primarily related to foreign currency translation.     

    Intangible assets as of March 31, 2021 and December 31, 2020 consisted of the following:
Weighted
Average
Amortization
Period
(in years)
March 31, 2021 December 31, 2020
Cost Accumulated
Amortization
Net Cost Accumulated
Amortization
Net
Amortizing intangible assets:            
Customer-related 17 $ 1,481  $ (659) $ 822  $ 1,479  $ (638) $ 841 
Non-compete agreements 9 (2) (2)
Technology 15 140  (68) 72  141  (65) 76 
Other 5 108  (98) 10  108  (95) 13 
Total 17 1,732  (827) 905  1,731  (800) 931 
Intangible assets not subject to amortization:          
Trade names   235  —  235  235  —  235 
Other   —  — 
Total intangible assets $ 1,968  $ (827) $ 1,141  $ 1,967  $ (800) $ 1,167 
    
    The estimated amortization expense related to amortizable intangible assets for each of the five succeeding fiscal years and thereafter as of March 31, 2021 is as follows:
Year Ending December 31,  
Remainder of 2021 $ 74 
2022 98 
2023 96 
2024 93 
2025 92 
2026 86 
Thereafter 366 
Total $ 905 

7.    FINANCIAL INSTRUMENTS

    The Company uses derivative financial instruments to manage its exposure to market risks for changes in interest rates and, from time to time, foreign currencies. This strategy includes the use of interest rate swap agreements, forward-starting interest rate swap agreements, interest rate lock agreements and foreign currency forward contracts to manage its exposure to movements in interest and currency rates. The Company has established policies and procedures for risk assessment and the approval, reporting and monitoring of derivative financial instrument activities. These policies prohibit holding or issuing derivative financial instruments for speculative purposes. The Company does not enter into derivative financial instruments that contain credit-risk-related contingent features or requirements to post collateral.

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)



    Interest Rate Risk
    
    The Company is exposed to interest rate risk on its cash and cash equivalents and its debt obligations. Interest income earned on cash and cash equivalents may fluctuate as interest rates change; however, due to their relatively short maturities, the Company does not hedge these assets or their investment cash flows and the impact of interest rate risk is not material. The Company's debt obligations consist of fixed-rate and variable-rate debt instruments. The Company's primary objective is to achieve the lowest overall cost of funding while managing the variability in cash outflows within an acceptable range. In order to achieve this objective, the Company has historically entered into interest rate swap agreements.

    Interest rate swaps involve the periodic exchange of payments without the exchange of underlying principal or notional amounts. Net settlements between the counterparties are recognized as an adjustment to interest expense, net.

    Interest Rate Derivatives – Cash Flow Hedges

    From time to time, the Company has entered into various interest rate lock agreements and forward-starting interest rate swap agreements to hedge part of the Company's interest rate exposure associated with the variability in future cash flows attributable to changes in interest rates.

    The total net loss, net of taxes, recognized in accumulated other comprehensive loss, related to the Company's cash flow hedges was $1 million as of both March 31, 2021 and December 31, 2020. The net amount of deferred losses on cash flow hedges that is expected to be reclassified from accumulated other comprehensive loss into interest expense, net within the next twelve months is $1 million.

    Interest Rate Derivatives – Fair Value Hedges

    Historically, the Company has entered into various fixed-to-variable interest rate swap agreements in order to convert a portion of the Company's long-term debt into variable interest rate debt. All such fixed-to-variable interest rate swap agreements have been terminated and proceeds from the terminations have been reflected as basis adjustments to the hedged debt instruments and are being amortized as a reduction of interest expense, net over the remaining terms of such debt instruments.

    As of March 31, 2021 and December 31, 2020, the following amounts were recorded on the consolidated balance sheets related to cumulative basis adjustments for fair value hedges included in the carrying amount of long-term debt:
Hedge Accounting Basis Adjustment (a)
Balance Sheet Classification March 31, 2021 December 31, 2020
Long-term debt $ 48  $ 51 

(a) As of both March 31, 2021 and December 31, 2020, the entire balance is associated with remaining unamortized hedging adjustments on discontinued relationships.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    The following table presents the effect of fair value hedge accounting on the consolidated statements of operations for the three months ended March 31, 2021 and 2020:
Three Months Ended March 31,
2021 2020
Other income (expense), net Other income (expense), net
Total for line item in which the effects of fair value hedges are recorded $ $ (16)
Gain (loss) on fair value hedging relationships:
Hedged items (Long-term debt) $ —  $ (69)
Derivatives designated as hedging instruments $ —  $ 69 
    
    A detailed description regarding the Company's use of derivative financial instruments is contained in Note 15 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.        

8.    STOCKHOLDERS’ EQUITY AND REDEEMABLE NONCONTROLLING INTEREST
    
    Stockholders' Equity    

    Changes in Accumulated Other Comprehensive Loss by Component

    Comprehensive income (loss) includes:

Foreign currency translation adjustments;
Net deferred gains (losses) on cash flow hedges, which represent deferred gains (losses), net of tax, on interest rate-related derivative financial instruments designated as cash flow hedges, net of amounts reclassified to interest expense (see Note 7); and
Net changes in available-for-sale debt securities, which represent unrealized holding gains (losses), net of tax on available-for-sale debt securities.

    For the three months ended March 31, 2021 and 2020, the tax effects related to the deferred gains (losses) on cash flow hedges and net changes in available-for-sale debt securities were not material. Foreign currency translation adjustments related to indefinite investments in non-U.S. subsidiaries are not adjusted for income taxes.

    Dividend Program
    
    During the first quarter of 2021, the Company's Board of Directors declared a quarterly cash dividend of $0.62 per common share. During each of the four quarters of 2020, the Company's Board of Directors declared a quarterly cash dividend of $0.56 per common share.
    
    Share Repurchase Program
    
    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 March 31, 2021, $2.5 billion remained available under the Company’s share repurchase authorization. The share repurchase authorization has no set expiration or termination date.
        
    Share Repurchases

    For the three months ended March 31, 2021, the Company repurchased 3.4 million shares of its common stock for $410 million.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    For the three months ended March 31, 2020, the Company repurchased 0.7 million shares of its common stock for $75 million.

    Shares Reissued from Treasury Stock

    The Company's practice has been to issue shares related to its Employee Stock Purchase Plan ("ESPP") and its stock-based compensation program from shares of its common stock held in treasury or by issuing new shares of its common stock. In January 2021, the Company began to issue shares related to its ESPP and stock-based compensation program solely from common stock held in treasury. For the three months ended March 31, 2021 and 2020, the Company reissued 0.6 million shares and 1.1 million shares, respectively from treasury stock. For details regarding the Company's stock ownership and compensation plans, see Note 17 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.    

    Redeemable Noncontrolling Interest

    In connection with the sale of an 18.9% noncontrolling interest in a subsidiary to UMass on July 1, 2015, the Company granted UMass the right to require the Company to purchase all of its interest in the subsidiary at fair value commencing July 1, 2020. The subsidiary performs diagnostic information services in a defined territory within the state of Massachusetts. Since the redemption of the noncontrolling interest is outside of the Company's control, it has been presented outside of stockholders' equity at the greater of its carrying amount or its fair value. As of March 31, 2021 and December 31, 2020, the redeemable noncontrolling interest was presented at its fair value. For further information regarding the fair value of the redeemable noncontrolling interest, see Note 5.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)



9.    SUPPLEMENTAL CASH FLOW AND OTHER DATA

    Supplemental cash flow and other data for the three months ended March 31, 2021 and 2020 was as follows:
Three Months Ended March 31,
2021 2020
Depreciation expense $ 74  $ 60 
Amortization expense 27  25 
Depreciation and amortization expense $ 101  $ 85 
Interest expense $ (38) $ (42)
Interest income — 
Interest expense, net $ (38) $ (41)
Interest paid $ 32  $ 48 
Income taxes paid $ $ 18 
Accounts payable associated with capital expenditures $ 30  $ 11 
Dividends payable $ 82  $ 75 
Businesses acquired:    
Fair value of assets acquired $ —  $ 131 
Fair value of liabilities assumed —  (20)
Fair value of net assets acquired —  111 
Less: Cash acquired — 
Business acquisitions, net of cash acquired $ —  $ 108 
Leases:
Leased assets obtained in exchange for new operating lease liabilities $ 36  $ 32 

    


10.     COMMITMENTS AND CONTINGENCIES

    Letters of Credit

    The Company can issue letters of credit totaling $100 million under its $600 million secured receivables credit facility and $150 million under its $750 million senior unsecured revolving credit facility. For further discussion regarding the Company's secured receivables credit facility and senior unsecured revolving credit facility, see Note 13 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.
    

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    In support of its risk management program, to ensure the Company’s performance or payment to third parties, $70 million in letters of credit under the secured receivables credit facility were outstanding as of March 31, 2021. The letters of credit primarily represent collateral for current and future automobile liability and workers’ compensation loss payments.

    Contingent Lease Obligations
    
    The Company remains subject to contingent obligations under certain real estate leases, including leases that were entered into by certain predecessor companies of a subsidiary prior to the Company's acquisition of the subsidiary. No liability has been recorded for any of these potential contingent obligations. For further details, see Note 18 to the audited consolidated financial statements in the Company’s 2020 Annual Report on Form 10-K.

    Certain Legal Matters

    The Company may incur losses associated with these proceedings and investigations, but it is not possible to estimate the amount of loss or range of loss, if any, that might result from adverse judgments, settlements, fines, penalties, or other resolution of these proceedings and investigations based on the stage of these proceedings and investigations, the absence of specific allegations as to alleged damages, the uncertainty as to the certification of a class or classes and the size of any certified class, if applicable, and/or the lack of resolution of significant factual and legal issues. The Company has insurance coverage rights in place (limited in amount; subject to deductible) for certain potential costs and liabilities related to these proceedings and investigations.

401(k) Plan Lawsuit
    
    In 2020, two putative class action lawsuits were filed in the U.S. District Court for New Jersey against the Company and other defendants with respect to the Company’s 401(k) plan. The complaint alleges, among other things, that the fiduciaries of the 401(k) plan breached their duties by failing to disclose the expenses and risks of plan investment options, allowing unreasonable administration expenses to be charged to plan participants, and selecting and retaining high cost and poor performing investments. In October 2020, the court consolidated the two lawsuits under the caption In re: Quest Diagnostics ERISA Litigation and plaintiffs filed a consolidated amended complaint. The Company plans to vigorously defend this matter and has filed a motion to dismiss the complaint.

AMCA Data Security Incident

    On June 3, 2019, the Company reported that Retrieval-Masters Creditors Bureau, Inc./American Medical Collection Agency (“AMCA”) had informed the Company and Optum360 LLC that an unauthorized user had access to AMCA’s system between August 1, 2018 and March 30, 2019 (the “AMCA Data Security Incident”). Optum360 provides revenue management services to the Company, and AMCA provided debt collection services to Optum360. AMCA first informed the Company of the AMCA Data Security Incident on May 14, 2019. AMCA’s affected system included financial information (e.g., credit card numbers and bank account information), medical information and other personal information (e.g., social security numbers). Test results were not included. Neither Optum360’s nor the Company’s systems or databases were involved in the incident. AMCA also informed the Company that information pertaining to other laboratories’ customers was also affected. Following announcement of the AMCA Data Security Incident, AMCA sought protection under the U.S. bankruptcy laws. The bankruptcy proceeding has been dismissed.

    Numerous putative class action lawsuits were filed against the Company related to the AMCA Data Security Incident. The U.S. Judicial Panel on Multidistrict Litigation transferred the cases still pending to, and consolidated them for pre-trial proceedings in, the U.S. District Court for New Jersey. In November 2019, the plaintiffs in the multidistrict proceeding filed a consolidated putative class action complaint against the Company and Optum360 that named additional individuals as plaintiffs and that asserted a variety of common law and statutory claims in connection with the AMCA Data Security Incident. In January 2020, the Company moved to dismiss the consolidated complaint; the motion to dismiss is pending.

    In addition, certain federal and state governmental authorities are investigating, or otherwise seeking information and/or documents from the Company related to the AMCA Data Security Incident and related matters, including the Office for Civil Rights of the U.S. Department of Health and Human Services, Attorneys General offices from numerous states and the District of Columbia, and certain U.S. senators.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    Other Legal Matters

    In the normal course of business, the Company has been named, from time to time, as a defendant in various legal actions, including arbitrations, class actions and other litigation, arising in connection with the Company's activities as a provider of diagnostic testing, information and services. These actions could involve claims for substantial compensatory and/or punitive damages or claims for indeterminate amounts of damages, and could have an adverse impact on the Company's client base and reputation.

    The Company is also involved, from time to time, in other reviews, investigations and proceedings by governmental agencies regarding the Company's business which may result in adverse judgments, settlements, fines, penalties, injunctions or other relief.

    The federal or state governments may bring claims based on the Company's current practices, which it believes are lawful. In addition, certain federal and state statutes, including the qui tam provisions of the federal False Claims Act, allow private individuals to bring lawsuits against healthcare companies on behalf of government or private payers. The Company is aware of lawsuits, and from time to time has received subpoenas, related to billing practices based on the qui tam provisions of the Civil False Claims Act or other federal and state statutes, regulations or other laws. The Company understands that there may be other pending qui tam claims brought by former employees or other "whistle blowers" as to which the Company cannot determine the extent of any potential liability.

    Management cannot predict the outcome of such matters. Although management does not anticipate that the ultimate outcome of such matters will have a material adverse effect on the Company's financial condition, given the high degree of judgment involved in establishing loss estimates related to these types of matters, the outcome of such matters may be material to the Company's consolidated results of operations or cash flows in the period in which the impact of such matters is determined or paid.

    These matters are in different stages. Some of these matters are in their early stages. Matters may involve responding to and cooperating with various government investigations and related subpoenas. As of March 31, 2021, the Company does not believe that material losses related to legal matters are probable.

    Reserves for legal matters totaled $2 million and $1 million as of March 31, 2021 and December 31, 2020, respectively.

    Reserves for General and Professional Liability Claims

    As a general matter, providers of clinical testing services may be subject to lawsuits alleging negligence or other similar legal claims. These suits could involve claims for substantial damages. Any professional liability litigation could also have an adverse impact on the Company's client base and reputation. The Company maintains various liability insurance coverages for, among other things, claims that could result from providing, or failing to provide, clinical testing services, including inaccurate testing results, and other exposures. The Company's insurance coverage limits its maximum exposure on individual claims; however, the Company is essentially self-insured for a significant portion of these claims. Reserves for such matters, including those associated with both asserted and incurred but not reported claims, are established on an undiscounted basis by considering actuarially determined losses based upon the Company's historical and projected loss experience. Such reserves totaled $142 million and $138 million as of March 31, 2021 and December 31, 2020, respectively. Management believes that established reserves and present insurance coverage are sufficient to cover currently estimated exposures.


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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


11.    BUSINESS SEGMENT INFORMATION

    The Company's DIS business is the only reportable segment based on the manner in which the Chief Executive Officer, who is the Company's chief operating decision maker ("CODM"), assesses performance and allocates resources across the organization. The DIS business provides diagnostic information services to a broad range of customers, including patients, clinicians, hospitals, IDNs, health plans, employers, ACOs and DCEs. The Company is the world's leading provider of diagnostic information services, which includes providing information and insights based on the industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services. The DIS business accounted for greater than 95% of net revenues in 2021 and 2020.

    All other operating segments include the Company's DS businesses, which consist of its risk assessment services and healthcare information technology businesses. The Company's DS businesses are the leading provider of risk assessment services for the life insurance industry and offer healthcare organizations and clinicians robust information technology solutions.
        
    As of March 31, 2021, substantially all of the Company’s services were provided within the United States, and substantially all of the Company’s assets were located within the United States.

    The following table is a summary of segment information for the three months ended March 31, 2021 and 2020. Segment asset information is not presented since it is not used by the CODM at the operating segment level. Operating earnings (loss) of each segment represents net revenues less directly identifiable expenses to arrive at operating income (loss) for the segment. General corporate activities included in the table below are comprised of general management and administrative corporate expenses, amortization and impairment of intangible assets and other operating income and expenses, net of certain general corporate activity costs that are allocated to the DIS and DS businesses. The accounting policies of the segments are the same as those of the Company as set forth in Note 2 to the audited consolidated financial statements contained in the Company’s 2020 Annual Report on Form 10-K and Note 2 to the interim unaudited consolidated financial statements.
Three Months Ended March 31,
2021 2020
Net revenues:    
DIS business $ 2,643  $ 1,744 
All other operating segments 77  78 
Total net revenues $ 2,720  $ 1,822 
Operating earnings (loss):    
DIS business $ 712  $ 205 
All other operating segments
General corporate activities (61) (39)
Total operating income 660  175 
Non-operating expense, net (34) (57)
Income before income taxes and equity in earnings of equity method investees 626  118 
Income tax expense (153) (26)
Equity in earnings of equity method investees, net of taxes 17  14 
Net income 490  106 
Less: Net income attributable to noncontrolling interests 21 
Net income attributable to Quest Diagnostics $ 469  $ 99 

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NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)



    Net revenues by major service were as follows:

Three Months Ended March 31,
2021 2020
Routine clinical testing services $ 1,032  $ 945 
COVID-19 testing services 828  24 
Gene-based and esoteric (including advanced diagnostics) testing services 653  641 
Anatomic pathology testing services 130  134 
All other 77  78 
Total net revenues $ 2,720  $ 1,822 

12.    RELATED PARTIES

    The Company's equity method investees primarily consist of its clinical trials central laboratory services joint venture (see Note 14), a diagnostic information services joint venture, and an investment in a fund that purchases strategic holdings in private companies in the healthcare industry. During the three months ended March 31, 2021 and 2020, the Company recognized net revenues of $5 million and $9 million, respectively, associated with diagnostic information services provided to its equity method investees. As of March 31, 2021 and December 31, 2020, there was $5 million and $3 million, respectively, of accounts receivable from equity method investees related to such services.

    During the three months ended March 31, 2021 and 2020, the Company recognized income of $3 million and $4 million, respectively, associated with the performance of certain corporate services, including transition services, for its equity method investees, classified within selling, general and administrative expenses. As of March 31, 2021 and December 31, 2020, there was $1 million and $3 million, respectively, of other receivables from equity method investees included in prepaid expenses and other current assets related to these service agreements and other transition related items. In addition, accounts payable and accrued expenses as of both March 31, 2021 and December 31, 2020 included $1 million due to equity method investees.

    During the three months ended March 31, 2021 and 2020, the Company received dividends from its equity method investees of $16 million and $5 million, respectively.

13.    REVENUE RECOGNITION

    DIS

    Net revenues in the Company’s DIS business accounted for over 95% of the Company’s total net revenues for the three months ended March 31, 2021 and 2020 and are primarily comprised of a high volume of relatively low-dollar transactions. The DIS business, which provides clinical testing services and other services, satisfies its performance obligations and recognizes revenues primarily upon completion of the testing process (when results are reported) or when services have been rendered. The Company estimates the amount of consideration it expects to be entitled to receive from customer groups in exchange for providing services using the portfolio approach. These estimates include the impact of contractual allowances (including payer denials), and patient price concessions. The portfolios determined using the portfolio approach consist of the following groups of customers: healthcare insurers, government payers (Medicare and Medicaid programs), client payers and patients.

    For further details regarding revenue recognition in the Company's DIS business, see Note 3 to the audited consolidated financial statements in the Company's 2020 Annual Report on Form 10-K.

    DS


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QUEST DIAGNOSTICS INCORPORATED AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS – CONTINUED
(unaudited)
(in millions, unless otherwise indicated)


    The Company’s DS businesses primarily satisfy their performance obligations and recognize revenues when delivery has occurred or services have been rendered.

    The approximate percentage of net revenue by type of customer was as follows:
    
Three Months Ended March 31,
2021 2020
Healthcare insurers:
Fee-for-service 38  % 34  %
Capitated
Total healthcare insurers 40  37 
Government payers 10  14 
Client payers 35  33 
Patients 12  12 
Total DIS 97  96 
DS
Net revenues 100  % 100  %
    
    The approximate percentage of net accounts receivable by type of customer was as follows:
March 31, 2021 December 31, 2020
Healthcare Insurers 33  % 34  %
Government Payers
Client Payers 43  46 
Patients (including coinsurance and deductible responsibilities) 13  11 
Total DIS 96  97 
DS
Net accounts receivable 100  % 100  %

    

14.    SUBSEQUENT EVENTS

    On April 1, 2021, the Company sold its 40% ownership interest in Q2 Solutions® ("Q2 Solutions"), its clinical trials central laboratory services joint venture, to IQVIA Holdings, Inc. ("IQVIA"), its joint venture partner for $760 million in an all-cash transaction. Prior to the transaction, the Company accounted for its minority interest as an equity method investment. As a result of the transaction, the Company expects to record a pre-tax gain during the second quarter of 2021 of approximately $310 million.

    Under a multi-year agreement, the Company will remain the strategic preferred laboratory provider for Q2 Solutions' clients, providing a range of complementary lab testing capabilities to augment Q2 Solutions' core offerings and extend its industry leading suite of services.




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Item 2.Management’s Discussion and Analysis of Financial Condition and Results of Operations

Our Company

    Diagnostic Information Services

    Quest Diagnostics empowers people to take action to improve health outcomes. We use our extensive database of clinical lab results to derive diagnostic insights that reveal new avenues to identify and treat disease, inspire healthy behaviors and improve healthcare management. Our diagnostic information services business ("DIS") provides information and insights based on the industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services. We provide services to a broad range of customers, including patients, clinicians, hospitals, independent delivery networks ("IDNs"), health plans, employers, accountable care organizations ("ACOs"), and direct contract entities ("DCEs"). We offer the broadest access in the United States to diagnostic information services through our nationwide network of laboratories, patient service centers and phlebotomists in physician offices and our connectivity resources, including call centers and mobile paramedics, nurses and other health and wellness professionals. We are the world's leading provider of diagnostic information services. We provide interpretive consultation with one of the largest medical and scientific staffs in the industry. Our DIS business makes up greater than 95% of our consolidated net revenues.

    We assess our revenue performance for the DIS business based upon, among other factors, volume (measured by test requisitions) and revenue per requisition.

    Each requisition accompanies patient specimens, indicating the test(s) to be performed and the party to be billed for the test(s).

    Revenue per requisition is impacted by various factors, including, among other items, the impact of fee schedule changes (i.e., unit price), test mix, payer mix, and the number of tests per requisition. Management uses number of requisitions and revenue per requisition data to assist with assessing the growth and performance of the business, including understanding trends affecting number of requisitions, pricing and test mix. Therefore, we believe that information related to changes in these metrics from period to period are useful information for investors as it allows them to assess the performance of the business.

    Diagnostic Solutions

    In our Diagnostic Solutions ("DS") businesses, which represent the balance of our consolidated net revenues, we offer a variety of solutions for life insurers and healthcare organizations and clinicians. We are the leading provider of risk assessment services for the life insurance industry. In addition, we offer healthcare organizations and clinicians robust information technology solutions.

First Quarter Highlights
    
Three Months Ended March 31,
2021 2020
(dollars in millions, except per share data)
Net revenues $2,720 $1,822
DIS revenues $2,643 $1,744
Revenue per requisition change 20.5% (1.2)%
Requisition volume change 25.6% (2.4)%
Organic requisition volume change 21.6% (2.7)%
DS revenues $77 $78
Net income attributable to Quest Diagnostics $469 $99
Diluted earnings per share $3.46 $0.73
Net cash provided by operating activities $731 $247

    For further discussion of the year-over-year changes for the three months ended March 31, 2021 compared to the three months ended March 31, 2020, see Results of Operations below.


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Impact of COVID - 19

    As a novel strain of coronavirus (COVID-19) continues to spread and severely impact the economy of the United States and other countries around the world, we are committed to being a part of the coordinated public and private sector response to this unprecedented challenge. We have made substantial investments to expand the amount of COVID-19 testing available to the country and are currently capable of performing approximately 300,000 COVID-19 molecular diagnostic tests per day to aid in the diagnosis of COVID-19 and approximately 350,000 COVID-19 antibody tests per day to aid in the detection of immune response. We have been effectively managing challenges in the global supply chain; and, at this point, we have sufficient supplies to conduct our business.

    During 2020 and the first quarter of 2021, our testing volume and revenues were materially impacted by the COVID-19 pandemic.

    During January and February 2020, we experienced growth in DIS revenues and volume compared to the prior year period. However, in March 2020, we experienced a material decline in testing volume due to the COVID-19 pandemic. During May and June 2020, we began to experience a recovery in base testing volume (which excludes COVID-19 testing), which continued in the second half of 2020 and the first quarter of 2021. For the first quarter of 2021, our base testing volume, excluding volume associated with recent acquisitions and recent agreements associated with our Professional Laboratory Services offerings, was 7.9% below our historical first quarter of 2019 levels. We estimate that the impact of weather negatively impacted the comparison by 1%.

    The decrease in base testing volume was driven by federal, state and local governmental policies and initiatives designed to reduce the transmission of COVID-19, a significant reduction in physician office visits, the cancellation of elective medical procedures, customers closing or severely curtailing their operations (voluntarily or in response to government orders), and the adoption of work-from-home policies, all of which have had, and may continue to have, an impact on our operating results, financial position and cash flows, including base testing volume.

    Beginning during the second quarter of 2020, we experienced growing demand for COVID-19 testing services and we expanded our capacity throughout 2020 in order to satisfy the demand, which has had a significant impact on our testing volumes. Since the fourth quarter of 2020, demand for COVID-19 testing has decreased reflecting an industry-wide trend. Compared to the fourth quarter of 2020, our net revenues associated with COVID-19 testing in the first quarter of 2021 declined by 27.9%. We expect demand for COVID-19 testing to continue to decline throughout 2021 as more people become vaccinated.

    Additionally, our revenue per requisition has been positively impacted by favorable mix, driven in large part by COVID-19 molecular testing. In April 2020 the Centers for Medicare and Medicaid Services ("CMS") announced that it would increase the reimbursement for certain COVID-19 molecular tests making use of high-throughput technologies developed by the private sector that allow for increased testing capacity, faster results, and more effective means of combating the spread of the virus to $100 per test, effective April 14, 2020. Beginning January 1, 2021, Medicare changed the base reimbursement rate for COVID-19 diagnostic tests run on high-throughput technologies to $75 per test with an additional payment of $25 per test if the laboratory (1) completes the test in two calendar days or less and (2) completes the majority of its COVID-19 tests that use high throughput technology in two calendar days or less for all of its patients in the previous month. Certain healthcare insurers have now moved to a similar reimbursement model for COVID-19 molecular tests.

    We believe the COVID-19 pandemic’s impact on our consolidated results of operations, financial position and cash flows will be primarily driven by: the severity and duration of the COVID-19 pandemic; healthcare insurer, government, and client payer reimbursement rates for COVID-19 molecular testing; the COVID-19 pandemic’s impact on the U.S. healthcare system and the U.S. economy; and the timing, scope and effectiveness of federal, state and local governmental responses to the COVID-19 pandemic. We may also be impacted by changes in the severity of the COVID-19 pandemic at different times in the various cities and regions where we operate and offer services. Even after the COVID-19 pandemic has moderated and the business and social distancing restrictions have eased, we may continue to experience similar effects to our businesses, consolidated results of operations, financial position and cash flows. In the longer term, given the many challenges that hospitals will face, we may have more opportunities to partner with hospitals to help achieve their laboratory strategies, and the COVID-19 pandemic may also be a further catalyst for consolidation in the laboratory testing industry.


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Agreement to Acquire the Outreach Laboratory Services Business of Mercy Health

    On March 6, 2021, we entered into a definitive agreement to acquire the outreach laboratory services business of Mercy Health, which serves providers and patients in Arkansas, Kansas, Missouri and Oklahoma. The transaction, which is expected to close in mid-2021, remains subject to customary closing conditions.

Sale of Ownership Interest in Q2 Solutions® ("Q2 Solutions") to IQVIA Holdings, Inc. ("IQVIA")

    On April 1, 2021, we sold our 40% ownership interest in Q2 Solutions, our clinical trials central laboratory services joint venture, to IQVIA, our joint venture partner for $760 million in an all-cash transaction. Prior to the transaction, we accounted for our minority interest as an equity method investment. As a result of the transaction, we expect to record a pre-tax gain during the second quarter of 2021 of approximately $310 million.

    Under a multi-year agreement, we will remain the strategic preferred laboratory provider for Q2 Solutions' clients, providing a range of complementary lab testing capabilities to augment Q2 Solutions' core offerings and extend its industry leading suite of services.

Medicare Sequestration

    In April 2021, the suspension of Medicare sequestration, which has resulted in a small benefit to us in the form of higher reimbursement rates for diagnostic testing services performed on behalf of Medicare beneficiaries, was extended through the end of 2021.

Invigorate Program
        
    We are engaged in a multi-year program called Invigorate, which is designed to reduce our cost structure and improve our performance. We currently aim annually to deliver savings of approximately 3% of our costs.

    Invigorate has consisted of several flagship programs, with structured plans in each, to drive savings and improve performance across the customer value chain. These flagship programs include: organization excellence; information technology excellence; procurement excellence; field and customer service excellence; lab excellence; and revenue services excellence. In addition to these programs, we have identified key themes to change how we operate including reducing denials and patient price concessions; further digitizing our business; standardization and automation; and optimization initiatives in our lab network and patient service center network. We believe that our efforts to standardize our information technology systems, equipment and data also foster our efforts to strengthen our foundation for growth and support the value creation initiatives of our clinical franchises by enhancing our operational flexibility, empowering and enhancing the customer experience, facilitating the delivery of actionable insights and bolstering our large data platform.

    For the three months ended March 31, 2021, we incurred $15 million of pre-tax charges under our Invigorate program primarily consisting of systems conversion and integration costs, all of which result in cash expenditures. Additional restructuring charges may be incurred in future periods as we identify additional opportunities to achieve further cost savings.
    
Critical Accounting Policies
    
    There have been no significant changes to our critical accounting policies from those disclosed in our 2020 Annual Report on Form 10-K.
    
Impact of New Accounting Standards

    The adoption of new accounting standards, if any, is discussed in Note 2 to the interim unaudited consolidated financial statements.

    The impact of recent accounting pronouncements not yet effective on our consolidated financial statements is also discussed in Note 2 to the interim unaudited consolidated financial statements.

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Results of Operations    

    The following tables set forth certain results of operations data for the periods presented:
Three Months Ended March 31,
2021 2020 $ Change % Change
(dollars in millions, except per share amounts)
Net revenues:
DIS business $ 2,643  $ 1,744  $ 899  51.5  %
DS businesses 77  78  (1) (1.0)
Total net revenues $ 2,720  $ 1,822  $ 898  49.3  %
Operating costs and expenses and other operating income:    
Cost of services $ 1,626  $ 1,270  $ 356  28.0  %
Selling, general and administrative 407  347  60  17.1 
Amortization of intangible assets 27  25  8.2 
Other operating expense, net —  (5) NM
Total operating costs and expenses, net $ 2,060  $ 1,647  $ 413  25.1  %
Operating income $ 660  $ 175  $ 485  277.2  %
Other income (expense):
Interest expense, net $ (38) $ (41) $ (8.1) %
Other income (expense), net (16) 20  NM
Total non-operating expense, net $ (34) $ (57) $ 23  NM
Income tax expense $ (153) $ (26) $ (127) 493.3  %
Effective income tax rate
24.6  % 22.0  %
Equity in earnings of equity method investees, net of taxes $ 17  $ 14  $ 22.3  %
Net income attributable to Quest Diagnostics $ 469  $ 99  $ 370  374.3  %
Diluted earnings per common share attributable to Quest Diagnostics' common stockholders $ 3.46  $ 0.73  $ 2.73  375.8  %
NM - Not Meaningful

















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    The following table sets forth certain results of operations data as a percentage of net revenues for the periods presented:
Three Months Ended March 31,
2021 2020
Net revenues:
DIS business 97.2  % 95.7  %
DS businesses 2.8  4.3 
Total net revenues 100.0  % 100.0  %
Operating costs and expenses and other operating income:
   
Cost of services 59.8  % 69.7  %
Selling, general and administrative 14.9  19.0 
Amortization of intangible assets 1.0  1.4 
Other operating expense, net —  0.3 
Total operating costs and expenses, net 75.7  % 90.4  %
Operating income 24.3  % 9.6  %
    
    Operating Results
    
    Results for the three months ended March 31, 2021 were affected by certain items that on a net basis reduced diluted earnings per share by $0.30 as follows:

pre-tax amortization expense of $29 million ($27 million in amortization of intangible assets and $2 million in equity in earnings of equity method investees, net of taxes) or $0.16 per diluted share;
pre-tax charges of $17 million ($7 million in cost of services and $10 million in selling, general and administrative expenses), or $0.10 per diluted share, primarily associated with systems conversions and integration incurred in connection with further restructuring and integrating our business;
pre-tax charges of $4 million in cost of services, or $0.03 per diluted share, representing the impact of certain items resulting from the COVID-19 pandemic including incremental costs incurred primarily to protect the health and safety of our employees and customers; and
a pre-tax non-cash impairment to the carrying value of an equity method investment of $8 million, or $0.04 per diluted share, recorded in equity in earnings of equity method investees, net of taxes; partially offset by
excess tax benefits associated with stock-based compensation arrangements of $4 million, or $0.03 per diluted share, recorded in income tax expense.
        
    Results for the three months ended March 31, 2020 were affected by certain items that on a net basis reduced diluted earnings per share by $0.21 as follows:

pre-tax amortization expense of $28 million ($25 million in amortization of intangible assets and $3 million in equity in earnings of equity method investees, net of taxes) or $0.15 per diluted share;
pre-tax charges of $16 million ($7 million in cost of services and $9 million in selling, general and administrative expenses), or $0.09 per diluted share, primarily associated with systems conversions and integration incurred in connection with further restructuring and integrating our business; and
pre-tax charges of $9 million ($1 million in cost of services, $3 million in selling, general and administrative expenses and $5 million in other operating expense, net), or $0.03 per diluted share, representing the impact of certain items resulting from the COVID-19 pandemic including certain asset impairment charges, and incremental costs incurred primarily to protect the health and safety of our employees and customers and to transition certain employees to a remote work environment; partially offset by
excess tax benefits associated with stock-based compensation arrangements of $8 million, or $0.06 per diluted share, recorded in income tax expense.

    Net Revenues

    Net revenues for the three months ended March 31, 2021 increased by 49.3% compared to the prior year period.

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    DIS revenues for the three months ended March 31, 2021 increased by 51.5% compared to the prior year period. For the three months ended March 31, 2021:

Organic revenue and acquisitions contributed approximately 48.5% and 3.0%, respectively, to DIS revenue growth compared to the prior year period. Organic revenue growth was driven by demand for COVID-19 molecular testing and, to a lesser extent, growth in the base business.
Revenues in the base business (including the impact of recent acquisitions) increased by 5.1% compared to the prior year period, which was negatively impacted in March 2020 as a result of the COVID-19 pandemic. Compared to historical levels in the first quarter of 2019, revenues in the base business, excluding revenue associated with recent acquisitions and recent agreements associated with our Professional Laboratory Services offerings, decreased by 5.5%. We estimate that the impact of weather negatively impacted the comparison by 0.8%.
DIS volume increased by 25.6% with organic volume and acquisitions contributing approximately 21.6% and 4.0%, respectively. Organic volume growth was driven by demand for COVID-19 molecular testing and, to a lesser extent, growth in the base business.
Testing volume in the base business (including the impact of recent acquisitions) continued to recover and was up 5.0% compared to the prior year period, which was negatively impacted in March 2020 as a result of the COVID-19 pandemic. Compared to historical levels in the first quarter of 2019, testing volume in the base business, excluding volume associated with recent acquisitions and recent agreements associated with our Professional Laboratory Services offerings, decreased by 7.9%. We estimate that the impact of weather negatively impacted the comparison by 1%.
Revenue per requisition increased by 20.5% compared to the prior year period primarily due to favorable mix, driven in large part by COVID-19 molecular testing.
    
    Cost of Services

    Cost of services consists principally of costs for obtaining, transporting and testing specimens as well as facility costs used for the delivery of our services.

    For the three months ended March 31, 2021, cost of services increased by $356 million compared to the prior year period. The increase was primarily driven by higher variable expenses related to increased testing volumes as well as test mix and a higher supply cost associated with COVID-19 testing, and, to a lesser extent, additional operating costs associated with our acquisitions.
    
    Selling, General and Administrative Expenses ("SG&A")
    
    SG&A consist principally of the costs associated with our sales and marketing efforts, billing operations, credit loss expense and general management and administrative support as well as administrative facility costs.
    
    SG&A increased by $60 million for the three months ended March 31, 2021, compared to the prior year period, primarily driven by higher variable expenses to support our increase in testing volumes as well as higher costs associated with changes in the value of our deferred compensation obligations.
    
    The change in the value of our deferred compensation obligations is largely offset by gains or losses due to the changes in the value of the associated investments, which are recorded in other income (expense), net. For further details regarding our deferred compensation plans, see Note 17 to the audited consolidated financial statements in our 2020 Annual Report on Form 10-K.
    
    Amortization Expense

    For the three months ended March 31, 2021, amortization expense increased by $2 million compared to the prior year period as a result of recent acquisitions.

    Other operating expense, net
    
    Other operating expense, net includes miscellaneous income and expense items and other charges related to operating activities.    


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    For the three months ended March 31, 2020, other operating expense, net primarily represents certain costs incurred as a result of the COVID-19 pandemic and resulting impact on the economy including certain asset impairment charges.

    Interest Expense, Net

    Interest expense, net decreased for the three months ended March 31, 2021 compared to the prior year period, primarily driven by lower interest rates due to recent refinancing transactions, including the termination of our interest rate swap agreements in April 2020, which resulted in a deferred gain that is being amortized as a reduction of interest expense, net over the remaining term of the associated debt.

    Other Income (Expense), Net

    Other income (expense), net represents miscellaneous income and expense items related to non-operating activities, such as gains and losses associated with investments and other non-operating assets.

    For the three months ended March 31, 2021, other income (expense), net increased by $20 million compared to the prior year period primarily due to changes in the value of investments in our deferred compensation plans.

    Income Tax Expense

    Income tax expense for the three months ended March 31, 2021 and 2020 was $153 million and $26 million, respectively. The increase in income tax expense for the three months ended March 31, 2021 compared to the prior year period was primarily driven by an increase in income before income taxes and equity in earnings of equity method investees.

    For the three months ended March 31, 2021 and 2020, the effective income tax rate was 24.6% and 22.0%, respectively. The effective income tax rate benefited from $4 million and $8 million of excess tax benefits associated with stock-based compensation arrangements for the three months ended March 31, 2021 and 2020, respectively.

    Equity in Earnings of Equity Method Investees, Net of Taxes

    Equity in earnings of equity method investees, net of taxes increased for the three months ended March 31, 2021 by $3 million compared to the prior year period primarily due to the demand for COVID-19 testing services, partially offset by an $8 million non-cash impairment to the carrying value of an equity method investment.
    

Quantitative and Qualitative Disclosures About Market Risk

    We address our exposure to market risks, principally the risk of changes in interest rates, through a controlled program of risk management that includes the use of derivative financial instruments. We do not hold or issue derivative financial instruments for speculative purposes. We seek to mitigate the variability in cash outflows that result from changes in interest rates by maintaining a balanced mix of fixed-rate and variable-rate debt obligations. In order to achieve this objective, we have historically entered into interest rate swap agreements. Interest rate swap agreements involve the periodic exchange of payments without the exchange of underlying principal or notional amounts. Net settlements are recognized as an adjustment to interest expense, net. We believe that our exposures to foreign exchange impacts and changes in commodity prices are not material to our consolidated results of operations, financial position or cash flows.
    
    As of March 31, 2021 and December 31, 2020, the fair value of our debt was estimated at approximately $4.4 billion and $4.6 billion, respectively, principally using quoted prices in active markets and yields for the same or similar types of borrowings, taking into account the underlying terms of the debt instruments. As of March 31, 2021 and December 31, 2020, the estimated fair value exceeded the carrying value of the debt by $378 million and $597 million, respectively. A hypothetical 10% increase in interest rates (representing 23 basis points as of March 31, 2021 and 17 basis points as of December 31, 2020) would potentially reduce the estimated fair value of our debt by approximately $94 million and $82 million as of March 31, 2021 and December 31, 2020, respectively.

    Borrowings under our secured receivables credit facility and our senior unsecured revolving credit facility are subject to variable interest rates. Interest on our secured receivables credit facility is based on either commercial paper rates for highly rated issuers, or LIBOR, plus a spread. As of March 31, 2021, interest on our senior unsecured revolving credit facility is based on certain published rates plus an applicable margin based on changes in our public debt ratings and our leverage ratio. As such, our borrowing cost under this credit arrangement is subject to fluctuations in interest rates, our leverage ratio and changes in our

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public debt ratings. As of March 31, 2021, the borrowing rates under these debt instruments were: for our secured receivables credit facility, commercial paper rates for highly-rated issuers or LIBOR, plus a spread of 0.825% to 0.950%; and for our senior unsecured revolving credit facility, LIBOR plus 1.125%. As of March 31, 2021, there were no borrowings outstanding under either our $600 million secured receivables credit facility or our $750 million senior unsecured revolving credit facility.

    A hypothetical 10% change to the variable rate component of our variable rate indebtedness would not materially change our annual interest expense.     

    For further details regarding our outstanding debt, see Note 13 to the audited consolidated financial statements included in our 2020 Annual Report on Form 10-K. For details regarding our financial instruments and hedging activities, see Note 7 to the interim unaudited consolidated financial statements and Note 15 to the audited consolidated financial statements included in our 2020 Annual Report on Form 10-K.

    Risk Associated with Investment Portfolio

    Our investment portfolio primarily includes equity investments comprised mostly of strategic holdings in privately and publicly held companies. These securities are exposed to price fluctuations and are generally concentrated in the life sciences and healthcare industries. Equity investments (except those accounted for under the equity method of accounting or those that result in consolidation of the investee) with readily determinable fair values are measured at fair value with changes in fair value recognized in net income. Equity investments that do not have readily determinable fair values are measured at cost minus impairment, if any, plus or minus changes resulting from observable price changes. We regularly evaluate these equity investments to determine if there are any indicators that the investment is impaired. The carrying value of our equity investments that do not have readily determinable fair values was $25 million as of March 31, 2021.
    
    We do not hedge our equity price risk. The impact of an adverse movement in equity prices on our holdings in privately held companies cannot be easily quantified, as our ability to realize returns on investments depends on, among other things, the enterprises’ ability to raise additional capital or derive cash inflows from continuing operations or through liquidity events such as initial public offerings, mergers or private sales.

    In conjunction with the preparation of our March 31, 2021 financial statements, we considered whether the carrying values of our investments were impaired and concluded that no such impairment existed. However, should the impact of the COVID-19 pandemic be worse than currently expected, it is possible that we could incur impairment charges in the future.

Liquidity and Capital Resources
Three Months Ended March 31, Change
2021 2020
(dollars in millions)
Net cash provided by operating activities $ 731  $ 247  $ 484 
Net cash used in investing activities (93) (206) 113 
Net cash used in financing activities (566) (891) 325 
Net change in cash and cash equivalents and restricted cash $ 72  $ (850) $ 922 
    
    Cash and Cash Equivalents

    Cash and cash equivalents consist of cash and highly-liquid short-term investments. Cash and cash equivalents as of March 31, 2021 totaled $1,230 million, compared to $1,158 million as of December 31, 2020.

    As of March 31, 2021, approximately 3% of our $1,230 million of consolidated cash and cash equivalents were held outside of the United States.

    Cash Flows from Operating Activities

    Net cash provided by operating activities for the three months ended March 31, 2021 and 2020 was $731 million and $247 million, respectively. The $484 million increase in net cash provided by operating activities for the three months ended March 31, 2021, compared to the prior year period was primarily a result of:


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higher operating income in 2021 as compared to 2020; and, to a lesser extent,
the timing of movements in our working capital accounts; partially offset by
higher performance-based compensation payments in 2021 compared to 2020.
    
    Days sales outstanding ("DSO"), a measure of billing and collection efficiency, was 46 days as of both March 31, 2021 and December 31, 2020 and 51 days as of March 31, 2020. The changes in our DSO is partially due to recent fluctuations in our monthly revenue due to the impact of the COVID-19 pandemic.

    Cash Flows from Investing Activities

    Net cash used in investing activities for the three months ended March 31, 2021 and 2020 was $93 million and $206 million, respectively. This $113 million decrease in cash used in investing activities for the three months ended March 31, 2021, compared to the prior year period was primarily a result of a $108 million decrease in net cash paid for business acquisitions.

    Cash Flows from Financing Activities

    Net cash used in financing activities for the three months ended March 31, 2021 and 2020 was $566 million and $891 million, respectively. This $325 million decrease in cash used in financing activities for the three months ended March 31, 2021, compared to the prior year period was primarily a result of:

an $800 million decrease in repayments of debt; partially offset by
a $335 million increase in repurchases of our common stock (see "Share Repurchase Program" for further details);
a $63 million decrease in proceeds from the exercise of stock options, which was a result of a decrease in the volume of stock options exercised compared to the prior year; and
a $46 million change in bank overdrafts, which are generally settled in cash the following day.

    During the three months ended March 31, 2020, we redeemed in full the outstanding indebtedness under our senior notes due January 2020 and senior notes due March 2020 using proceeds from the issuance, in December 2019, of the 2.95% senior notes due June 2030, along with cash on hand. During both the three months ended March 31, 2021 and 2020, there were no borrowings or repayments under our secured receivables credit facility or senior unsecured revolving credit facility.

    Dividend Program
    
    During the first quarter of 2021, our Board of Directors declared a quarterly cash dividend of $0.62 per common share. During each of the four quarters of 2020, our Board of Directors declared a quarterly cash dividend of $0.56 per common share.
    
    Share Repurchase Program

    In each of February and March 2021, our Board of Directors increased the size of our share repurchase program by $1 billion. As of March 31, 2021, $2.5 billion remained available under our share repurchase authorization. The share repurchase authorization has no set expiration or termination date.

    Share Repurchases

    For the three months ended March 31, 2021, we repurchased 3.4 million shares of our common stock for $410 million.

    For the three months ended March 31, 2020, we repurchased 0.7 million shares of our common stock for $75 million.

    Equity Method Investees

    Our equity method investees primarily consist of our clinical trials central laboratory services joint venture (which we sold our ownership interest in during April 2021), a diagnostic information services joint venture, and an investment in a fund that purchases strategic holdings in private companies in the healthcare industry. Such investees are accounted for under the equity method of accounting. Our investment in equity method investees is less than 5% of our consolidated total assets. Our proportionate share of income before income taxes associated with our equity method investees is less than 5% of our consolidated income before income taxes and equity in earnings of equity method investees. We have no material unconditional obligations or guarantees to, or in support of, our equity method investees and their operations.

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    In conjunction with the preparation of our March 31, 2021 financial statements, we considered whether the carrying values of our equity method investments were impaired and, during the three months ended March 31, 2021, we recorded an $8 million impairment charge for one of the investments. Should the impact of the COVID-19 pandemic be worse than currently expected, it is possible that we could incur additional impairment charges in the future.

    For further details regarding related party transactions with our equity method investees, see Note 12 to the interim unaudited consolidated financial statements and Note 20 to the audited consolidated financial statements in our 2020 Annual Report on Form 10-K.
    
    Requirements and Capital Resources

    We estimate that we will invest approximately $350 million to $400 million during 2021 for capital expenditures, to support and grow our existing operations, principally related to investments in information technology, laboratory equipment and facilities, including COVID-19 testing equipment and completion of our new multi-year laboratory construction in New Jersey, and investments in our advanced diagnostics and consumer growth strategies.

    During the second quarter of 2021, we expect to launch an accelerated share repurchase in the amount of approximately $1.5 billion.

    Together with the Quest Diagnostics Foundation, during 2020 we launched a multi-year initiative to reduce health disparities in underserved communities, including those impacted by the COVID-19 pandemic. As part of this initiative, we plan to offer testing services and fund a range of initiatives estimated to total more than $100 million aimed at improving access to testing and awareness of the value of diagnostic insights in managing overall health, a significant portion of which will occur in 2021.

    As of March 31, 2021, we had $1.3 billion of borrowing capacity available under our existing credit facilities, including $530 million available under our secured receivables credit facility and $750 million available under our senior unsecured revolving credit facility. There were no borrowings under these credit facilities as of March 31, 2021. In support of our risk management program, to ensure our performance or payment to third parties, $70 million in letters of credit under the secured receivables credit facility were outstanding as of March 31, 2021. The secured receivables credit facility includes a $250 million loan commitment which matures in October 2021, and a $250 million loan commitment and a $100 million letter of credit facility which mature in October 2022. The senior unsecured revolving credit facility matures in March 2023. For further details regarding the credit facilities, see Note 13 to the audited consolidated financial statements in our 2020 Annual Report on Form 10-K.

    Our secured receivables credit facility is subject to customary affirmative and negative covenants, and certain financial covenants with respect to the receivables that comprise the borrowing base and secure the borrowings under the facility. Our senior unsecured revolving credit facility is also subject to certain financial covenants and limitations on indebtedness. As of March 31, 2021, we were in compliance with all such applicable financial covenants.

    We believe that our cash and cash equivalents and cash from operations, together with our borrowing capacity under our credit facilities, will provide sufficient financial flexibility to fund seasonal and other working capital requirements, capital expenditures, debt service requirements and other obligations, cash dividends on common shares, share repurchases and additional growth opportunities for the foreseeable future. However, should it become necessary, we believe that our credit profile should provide us with access to additional financing in order to fund normal business operations, make interest payments, fund growth opportunities and satisfy upcoming debt maturities.


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Table of Contents
Forward-Looking Statements
    
    Some statements and disclosures in this document are forward-looking statements. Forward-looking statements include all statements that do not relate solely to historical or current facts and can be identified by the use of words such as “may,” “believe,” “will,” “expect,” “project,” “estimate,” “anticipate,” “plan” or “continue.” These forward-looking statements are based on our current plans and expectations and are subject to a number of risks and uncertainties that could cause our plans and expectations, including actual results, to differ materially from the forward-looking statements. Risks and uncertainties that may affect our future results 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 and strategic partners and other factors discussed in our most recently filed Annual Report on Form 10-K and 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.

Item 3.    Quantitative and Qualitative Disclosures About Market Risk
      
    See Item 2. "Management's Discussion and Analysis of Financial Condition and Results of Operations."

Item 4.    Controls and Procedures

    Management, including our Chief Executive Officer and our Chief Financial Officer, has evaluated the effectiveness of our disclosure controls and procedures (as defined under Rules 13a-15(e) and 15d-15(e) of the Securities Exchange Act of 1934, as amended). Based upon that evaluation, our Chief Executive Officer and our Chief Financial Officer concluded that our disclosure controls and procedures were effective as of the end of the period covered by this quarterly report.

    During the first quarter of 2021, there were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) under the Securities Exchange Act of 1934, as amended) that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.




PART II - OTHER INFORMATION

Item 1.    Legal Proceedings
    
    See Note 10 to the interim unaudited consolidated financial statements for information regarding the status of legal proceedings involving the Company.

Item 1A. Risk Factors

    Item 1A. of our Annual Report on Form 10-K for the year ended December 31, 2020 includes a discussion of our risk factors. There have been no material changes in the risk factors described in such report.


31

Table of Contents
Item 2.    Unregistered Sales of Equity Securities and Use of Proceeds

    The table below sets forth the information with respect to purchases made by or on behalf of the Company of its common stock during the first quarter of 2021.
ISSUER PURCHASES OF EQUITY SECURITIES
Period Total Number of
Shares
Purchased
Average Price
Paid per Share
Total Number of
Shares Purchased
as Part of Publicly
Announced Plans
or Programs
Approximate
Dollar Value of
Shares that May
Yet Be Purchased
Under the Plans
or Programs
 (in thousands)
January 1, 2021 – January 31, 2021        
Share Repurchase Program (A) —  $ —  —  $ 917,139 
Employee Transactions (B) 2,815  $ 119.45  N/A N/A
February 1, 2021 – February 28, 2021      
Share Repurchase Program (A) 1,383,227  $ 120.11  1,383,227  $ 1,751,000 
Employee Transactions (B) 78,541  $ 121.25  N/A N/A
March 1, 2021 – March 31, 2021    
Share Repurchase Program (A) 1,994,788  $ 122.57  1,994,788  $ 2,506,502 
Employee Transactions (B) 102,538  $ 115.42  N/A N/A
Total        
Share Repurchase Program (A) 3,378,015  $ 121.56  3,378,015  $ 2,506,502 
Employee Transactions (B) 183,894  $ 117.97  N/A N/A

(A)Since the share repurchase program’s inception in May 2003, our Board of Directors has authorized $11 billion of share repurchases of our common stock through March 31, 2021. The share repurchase authorization has no set expiration or termination date. In each of February and March 2021, the Company's Board of Directors increased the size of its share repurchase program by $1 billion.

(B)Includes: (1) shares delivered or attested to in satisfaction of the exercise price and/or tax withholding obligations by holders of stock options (granted under the Company’s Amended and Restated Employee Long-Term Incentive Plan) who exercised options; and (2) shares withheld (under the terms of grants under the Amended and Restated Employee Long-Term Incentive Plan) to offset tax withholding obligations that occur upon the delivery of outstanding common shares underlying restricted stock units and performance share units.




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Table of Contents
Item 6.Exhibits

    Exhibits:
31.1
   
31.2
   
32.1
   
32.2
   
10.1
101.INS Inline XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document
   
101.SCH Inline XBRL Taxonomy Extension Schema Document - dgx-20210331.xsd
   
101.CAL Inline XBRL Taxonomy Extension Calculation Linkbase Document - dgx-20210331_cal.xml
   
101.DEF Inline XBRL Taxonomy Extension Definition Linkbase Document - dgx-20210331_def.xml
   
101.LAB Inline XBRL Taxonomy Extension Label Linkbase Document - dgx-20210331_lab.xml
   
101.PRE Inline XBRL Taxonomy Extension Presentation Linkbase Document - dgx-20210331_pre.xml
104 Cover Page Interactive Data File (formatted in Inline XBRL and contained in Exhibit 101)

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Signatures
    Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
April 23, 2021
Quest Diagnostics Incorporated
By  /s/ Stephen H. Rusckowski
  Stephen H. Rusckowski
  Chairman, Chief Executive Officer
and President
 
   
By /s/ Mark J. Guinan
  Mark J. Guinan
  Executive Vice President and
Chief Financial Officer


34
Exhibit 10.1
Quest Diagnostics Incorporated
2021 Equity Award Agreement
This Equity Award Agreement (the “Agreement”) dated as of [Grant Date] (the “Grant Date”) between Quest Diagnostics Incorporated, 500 Plaza Drive, Secaucus, NJ 07094 (the “Company”) and the employee to whom the awards described herein are made (the “Employee”) is subject in all respects to the Company’s Amended and Restated Employee Long-Term Incentive Plan (the “Plan”). All references to “Shares” mean shares of the Company’s Common Stock.
This Agreement and the awards described herein are effective as of the grant date but shall be canceled if the Employee fails to complete, not later than thirty (30) days after such awards are communicated electronically to the Employee, all the steps to accept the Options (as hereinafter defined) electronically at the Fidelity Net Benefits website (https://nb.fidelity.com) (the “Site”), including without limitation acknowledging that the Employee has read all of the documentation provided at the Site and confirming acceptance of the Options.
If the Site does not reflect confirmation of acceptance of the Options by Midnight on the thirtieth (30th) day after the awards described herein are communicated electronically to the Employee, this Agreement, and the awards described herein, shall be cancelled.
The Employee’s taking the necessary steps so that the Site reflects confirmation of acceptance for the Options will suffice to reflect the Employee’s acceptance of the RSUs (as hereinafter defined) and the Performance Shares (as hereinafter defined) as well as the Options. Thus, it is not necessary for the Employee to make a separate electronic acceptance of the RSUs or the Performance Shares.
If you are not a United States citizen or resident as such term is defined by the Internal Revenue Code and you are employed outside the United States, please consult the “International Supplement” attached as Appendix B to this Agreement. The International Supplement amends certain terms and conditions of this Agreement as they apply to individuals employed outside the United States.
AWARDS COVERED BY THIS AGREEMENT
SECTION 1.    Award of Stock Options. The Company hereby awards stock options (each, an “Option”) to the Employee under the Plan. The number of Options awarded to the Employee is indicated at the Site. Each Option entitles the Employee, subject to the terms and conditions of this Agreement and the Plan, to purchase from the Company at the exercise price set forth for the Options at the Site (the “Exercise Price”) one Share (an “Option Share”). The Options shall vest and become exercisable on the terms set forth in Section 4. The Options shall expire on, and no Option Shares may be purchased pursuant to this Agreement after, the
1

Exhibit 10.1
tenth anniversary of the Grant Date (such tenth anniversary is referred to as the “Option Expiration Date”). The Compensation Committee of the Board of Directors of the Company (the “Compensation Committee”) may, in its sole discretion, convert any or all of the Options at any time to a stock-settled stock appreciation grant. The Options are not intended to be “incentive stock options” within the meaning of Section 422 of the Internal Revenue Code of 1986, as amended (the “Code”), and this Agreement shall be construed and interpreted in accordance with such intention.
SECTION 2.    Restricted Share Units. The Company hereby awards restricted share units (each, an “RSU”) to the Employee under the Plan. The number of RSUs awarded to the Employee is indicated at the Site. Each RSU corresponds to one Share and constitutes a contingent and unsecured promise of the Company to pay the Employee one Share for each vested RSU, subject to the terms and conditions set forth in the Plan and this Agreement. The RSUs shall vest and convert to Shares on the terms set forth in Section 4. For purposes of this Agreement, an “RSU Share” means a Share delivered upon conversion of an RSU.
SECTION 3.    Performance Shares. Capitalized terms used in this Section 3 without definition have the meanings set forth in Appendix A. The Employee shall be eligible to receive and vest in Shares as provided in this Section 3 and Section 7 based on (a) the number of target performance shares indicated for the Employee at the Site (“Target Performance Shares”) and (b) the Company’s performance during the Performance Period. Performance will be measured as of the end of the performance period that began on January 1, 2021 and will continue through December 31, 2023 (the “Performance Period”). 35% of the Target Performance Shares will be earned based on the annual compounded growth of Base Business Net Revenues (“Base Business Revenue Growth”) during the Performance Period, determined by comparing the Company’s Base Business Net Revenues for the Final Year of the Performance Period (as reported by the Company for the relevant year) with the Company’s Base Business Net Revenues for the Baseline Year (as reported by Company for the year). After the Performance Period, Base Business Revenue Growth will be calculated and the number of Shares to be issued (subject to vesting under Section 7 and withholding of taxes under Section 14) in respect of the Base Business Revenue Growth performance measure shall be based upon the following formula (such Shares, and the Shares determined using the COVID-19 Net Revenue, Average ROIC, and Relative TSR performance measures described below in this Section 3 being “Earned Performance Shares”):
Annual Compounded Base Business Revenue Growth* “Earnings Multiple”* multiplied by 35% of Target Performance Shares = Earned Performance Shares
Greater Than or Equal to %    
Greater Than or Equal to % but Less Than or Equal to %…………………………………...
2 x 35% x Target Performance Shares
1 x 35% x Target Performance Shares
Equal to % 0.25 x 35% x Target Performance Shares
Less Than % 0 x 35% x Target Performance Shares
*The Earnings Multiple for Base Business Revenue Growth between the percentages designated in the above table will be interpolated.
2

Exhibit 10.1
15% of the Target Performance Shares will be earned based on the Company’s cumulative COVID-19 Net Revenue (as defined in Appendix A) during the Performance Period. After the Performance Period, the COVID-19 Net Revenue will be calculated and the number of Earned Performance Shares to be issued (subject to vesting under Section 7 and withholding of taxes under Section 14) in respect of the COVID-19 Net Revenue performance measure shall be based upon the following formula:
COVID-19 Net Revenue (mm)* “Earnings Multiple”* multiplied by 15% of Target Performance Shares = Earned Performance Shares
Greater Than or Equal to $    
Equal to $…………………………………
2 x 15% x Target Performance Shares
1 x 15% x Target Performance Shares
Equal to $ 0.25 x 15% x Target Performance Shares
Less Than $ 0 x 15% x Target Performance Shares
*The Earnings Multiple for COVID-19 Net Revenue between the percentages designated in the above table will be interpolated.
30% of the Target Performance Shares will be earned based on the Company’s Average ROIC (as defined in Appendix A) during the Performance Period. After the Performance Period, the Average ROIC will be calculated and the number of Earned Performance Shares to be issued (subject to vesting under Section 7 and withholding of taxes under Section 14) in respect of the Average ROIC performance measure shall be based upon the following formula:
Average ROIC* “Earnings Multiple”* multiplied by 30% of Target Performance Shares = Earned Performance Shares
Greater Than or Equal to %    
Greater Than or Equal to % but Less Than or Equal to %…………………………...
2 x 30% x Target Performance Shares
1 x 30% x Target Performance Shares
Equal to % 0.25 x 30% x Target Performance Shares
Less Than % 0 x 30% x Target Performance Shares

*The Earnings Multiple for Average ROIC between the percentages designated in the above table will be interpolated.
The remaining 20% of the Target Performance Shares will be earned based on the Company’s Relative TSR (as defined in Appendix A) during the Performance Period. After the Performance Period, the Relative TSR will be calculated and the number of Earned Performance Shares to be issued (subject to vesting under Section 7 and withholding of taxes under Section 14) in respect of the Relative TSR performance measure shall be based upon the following formula:
Relative TSR* “Earnings Multiple”* multiplied by 20% of Target Performance Shares = Earned Performance Shares
Greater Than or Equal to Percentile 2 x 20% x Target Performance Shares
Equal to Percentile 1 x 20% x Target Performance Shares
Equal to Percentile 0.5 x 20% x Target Performance Shares
Less Than Percentile 0 x 20% x Target Performance Shares

3

Exhibit 10.1
*The Earnings Multiple for Relative TSR between the percentiles designated in the above table will be interpolated.
The aggregate number of Earned Performance Shares will equal the sum of the number of Performance Shares earned in respect of the Base Business Revenue Growth performance measure, the number of Performance Shares earned in respect of the COVID-19 Net Revenue performance measure, the number of Earned Performance Shares earned in respect of the Average ROIC performance measure and the number of Earned Performance Shares earned in respect of the Relative TSR performance measure. The maximum number of Earned Performance Shares is 2x the number of Target Performance Shares.
STOCK OPTIONS AND RESTRICTED SHARE UNITS
SECTION 4.    Vesting of Options and RSUs.
(a)    General Vesting Requirements for Options. Except as otherwise provided below, the Options shall vest and become exercisable on the vesting dates set forth below (the “Option Vesting Dates”), provided that the Employee remains in continuous employment with the Company Group (as defined in Section 23) through the applicable Option Vesting Date. Options shall be exercisable only to the extent vested.
Option Vesting Dates            Vesting Percent        Cumulative
First anniversary of Grant Date        33.3%            33.3%
Second anniversary of Grant Date        33.3%            66.6%
Third anniversary of Grant Date        33.4%            100%

4

Exhibit 10.1
(b)    General Vesting Requirements and Conversion Rules for RSUs. Except as otherwise provided in this Agreement, the RSUs shall vest on the vesting dates set forth below (the “RSU Vesting Dates”), provided that the Employee remains in continuous employment with the Company Group through the applicable RSU Vesting Date.
RSU Vesting Dates            Vesting Percent        Cumulative
First anniversary of Grant Date        33.3%            33.3%
Second anniversary of Grant Date        33.3%            66.6%
Third anniversary of Grant Date        33.4%            100%
In the case of an Employee who continues in employment through an RSU Vesting Date, the RSUs that vest on that RSU Vesting Date will convert to Shares as soon as practicable, and in all cases within fourteen (14) days, after the RSU Vesting Date. In the case of RSUs that vest as provided in Sections 4(d) through 4(f), the RSUs, although vested, will not convert to shares by virtue of having vested and instead will convert to Shares as soon as practical, and in all cases within fourteen (14) days, after each remaining RSU Vesting Date following the relevant vesting event specified in Sections 4(d) through 4(f); in other words, the RSUs will convert to Shares as though the Employee’s employment had continued through the applicable RSU Vesting Date. In all cases, upon conversion, the RSU Shares, net of required tax withholding as described in Section 14 below, shall be transferred into the Employee’s account at the Company’s dedicated broker.
(c)    Termination of Employment Generally. If the Employee’s employment terminates for any reason other than those described in Section 4(d) through 4(f) prior to the third anniversary of the Grant Date, any Options and any RSUs that have not vested as of the date of termination of employment (the Employee’s “Termination Date”) will be canceled.
(d)    Death and Disability. If the Employee’s employment terminates due to death or Disability (as defined in Section 23), all Options and all RSUs shall immediately vest.
(e)    Change in Control. If within two years following the date of a Change in Control (as defined in the Plan), the Employee’s employment is terminated by the Company Group (or its successor) without Cause (as defined in Section 23) or the Employee resigns from his or her employment for Good Reason (as defined in Section 23), then all Options and all RSUs shall immediately vest on the Employee’s Termination Date. Notwithstanding the preceding sentence, in the event of a Change in Control in which the Company is not the surviving entity, and the surviving entity or successor to the Company does not agree to assume the Company’s obligations with respect to the Options under this Equity Award Agreement or to grant the Employee a Replacement Award (as defined in Section 23), then all Options and all RSUs shall vest immediately prior to the Change in Control in such a manner that will enable the Employee to participate in the Change in Control with respect to the Shares issuable upon exercise of the Options and conversion of the RSUs on the same basis as other holders of the Company’s outstanding Common Stock.
(f)    Retirement. If on or after the first anniversary of the Grant Date, the Employee’s employment with the Company Group terminates due to Retirement (as defined in
5

Exhibit 10.1
Section 23), the Employee will immediately vest in any Options and any RSUs that have not vested as of the Termination Date.
SECTION 5.    Exercise of Options.     The Employee may exercise Options in accordance with the procedures specified by the Company from time to time. The Exercise Price of Options shall be paid in full with, or in a combination of: (a) cash; (b) Shares that are owned by the Employee and are fully vested and freely transferable by the Employee, duly endorsed or accompanied by stock powers executed in blank; (c) a net share settlement procedure; or (d) through the withholding of Shares subject to the Options. The Company in its discretion may permit the Employee (if the Employee owns Shares that are fully vested and fully transferable by the Employee) to “attest” to his/her ownership of the number of Shares required to pay all or part of the purchase price (and not require delivery of the Shares), in which case the Company will deliver to the Employee the number of Shares to which the Employee is entitled, net of the “attested” Shares. If payment is made in whole or in part with Shares (including through the withholding of Shares subject to Options), the value of such Shares shall be the mean of its high and low prices on the New York Stock Exchange Composite list (or such other stock exchange as shall be the principal public trading market for the Shares) on the day of exercise. No “reload” or other option will be granted by reason of any such exercise.
SECTION 6.    Exercise of Option After Termination of Employment, Death, Disability or Retirement. The provisions covering the exercise of the Options following termination of employment are as follows, provided that in no event may any Options be exercised after the Option Expiration Date:
(a)    Termination in General. If the Employee’s employment terminates for any reason other than those described in Section 6(b) through 6(d), the Options that have vested simultaneously with or before the Employee’s termination of employment may be exercised for ninety (90) days following such termination (but not beyond the Option Expiration Date) and such vested Options shall thereafter expire and cease to be exercisable.
(b)    Death. If the Employee shall die while employed, then any Options that are vested and exercisable (including any Options that become vested and exercisable under Section 4(d)) may be exercised through the fifth anniversary of the date of termination (but not beyond the Option Expiration Date) and shall thereafter expire. If the Employee shall die after termination of employment but while all or any portion of the Options are still exercisable, they shall remain exercisable through the first anniversary of the date of death but not beyond the Option Expiration Date.
(c)    Disability. If the Employee’s employment shall terminate due to Disability, then any Options that are vested and exercisable (including any Options that become vested and exercisable under Section 4(d)), may be exercised through the fifth anniversary of the date of termination (but not beyond the Option Expiration Date) and shall thereafter expire.
(d)    Retirement. If the Employee’s employment with the Company Group terminates due to Retirement, then any Options that are vested and exercisable (including any Options that become vested and exercisable under Section 4(f)) may be exercised through the
6

Exhibit 10.1
fifth anniversary of the date of termination (but not beyond the Option Expiration Date) and shall thereafter expire.
PERFORMANCE SHARES
SECTION 7.    Vesting of Performance Shares.
(a)    Performance Share Vesting Period. Except as otherwise provided in this Agreement, Earned Performance Shares will vest at the end of the vesting period beginning on the Grant Date and continuing through February 18, 2024 (the “Performance Share Vesting Period”), provided that the Employee remains in continuous employment with the Company Group through the end of the Performance Share Vesting Period. Earned Performance Shares, net of required tax withholding as described in Section 14 below, will be transferred into the Employee’s account at the Company’s dedicated broker as soon as practicable after the final calculation of the number of Earned Performance Shares but in any event on or prior to March 15, 2024.
(b)    Change in Control. If a Change in Control occurs prior to the end of the Performance Share Vesting Period then a number of Earned Performance Shares shall be calculated as of the Change in Control and shall be equal to the greater of:
(i)    the number of Earned Performance Shares that would be awarded if the calculation under Section 3 were based on the most recent fiscal year end results of the Company (rather than the Final Year of the Performance Period); and
(ii)    the number of Target Performance Shares.
Such Earned Performance Shares shall not vest solely by virtue of the occurrence of the Change in Control but shall instead remain subject to vesting, and shall be transferred into the Employee’s account at the Company’s dedicated broker, as provided in Section 7(a); provided, however, that in the event of a Change in Control in which the Company is not the surviving entity, and the surviving entity or successor to the Company does not agree to assume the Company’s obligations with respect to the Performance Shares under this Equity Award Agreement or to grant the Employee a Replacement Award, such Earned Performance Shares, net of required tax withholding as described in Section 14 below, will be transferred to the Employee’s account at the Company’s dedicated broker within five business days after the consummation of the Change in Control. If within two years following the date of a Change in Control, the Employee’s employment is terminated by the Company Group (or successor to the Employee’s employer within the Company Group) without Cause or the Employee resigns from his or her employment for Good Reason, the Employee shall immediately vest in the number of Earned Performance Shares calculated in accordance with the first sentence of this Section 7(b), and (to the extent not previously transferred pursuant to the preceding sentence) such Earned Performance Shares, net of required tax withholding as described in Section 14 below, will be transferred to the Employee’s account at the Company’s dedicated broker within five business days after the Employee’s Termination Date. If (and only if) the Company continues to file annual reports pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934, as
7

Exhibit 10.1
amended, following the Change in Control, including for the Final Year of the Performance Period, then following the end of the Performance Period, to the extent that the number of Earned Performance Shares calculated pursuant to Section 3 exceeds the number of Earned Performance Shares calculated pursuant to the first sentence of this Section 7(b), the full amount of Earned Performance Shares resulting from the calculation in accordance with Section 3 (net of the number of Earned Performance Shares, if any, previously delivered or withheld for taxes under the preceding two sentences) will be so transferred as provided in Section 7(a). If the Employee terminates employment prior to the Change in Control, the Earned Performance Shares will vest, be pro-rated or be canceled, as applicable, in accordance with Section 7(c).
(c)    Adjustments to Earned Performance Shares and Vesting of Earned Performance Shares on Termination of Employment. The Employee (or, in the case of death, the Employee’s beneficiary or estate) shall be entitled to receive 100% of the Earned Performance Shares calculated pursuant to Section 3, and such Earned Performance Shares shall not be subject to a service-based vesting requirement, if prior to the end of the Performance Share Vesting Period (x) the Employee’s employment terminates by reason of death or Disability or (y) the Employee’s employment terminates by reason of Retirement on or after the first anniversary of the Grant Date. Such Earned Performance Shares (if any) will be delivered as provided in Section 7(a) or Section 7(b), if applicable. The number of Earned Performance Shares calculated pursuant to Section 3 to which the Employee is entitled will be adjusted in the following circumstances:
(i)    Termination of Employment Generally. If the Employee’s employment terminates prior to the end of the Performance Share Vesting Period for any reason other than death, Disability, Retirement on or after the first anniversary of the Grant Date or the circumstances described in Section 7(b) or 7(c)(ii), all of the Target Performance Shares will be canceled and none of the Earned Performance Shares will vest.
(ii)    Involuntary Termination without Cause or Divestiture. If prior to the end of the Performance Share Vesting Period the Employee’s employment is terminated by the Company Group without Cause or as a result of a divestiture and the Employee is employed by the divested or purchasing entity, then, notwithstanding the provision of Section 7(c)(i), the Employee shall vest in the number of Earned Performance Shares determined by multiplying the Earned Performance Shares by a fraction (A) the numerator of which is the number of full months that the Employee was employed by the Company Group during the Performance Share Vesting Period and (B) the denominator of which is the number of months in the Performance Share Vesting Period; and the balance of the Earned Performance Shares will be canceled.
TERMS AND CONDITIONS APPLICABLE TO ALL AWARDS
SECTION 8.    Cancellation. The Employee acknowledges and agrees that, in consideration for the Employee’s being granted the award covered by this Agreement, the Employee shall abide by the terms and conditions of the restrictive covenant agreement attached hereto as Appendix C (the “Restrictive Covenant Agreement”), which terms and conditions are
8

Exhibit 10.1
incorporated herein by reference. Notwithstanding anything to the contrary contained herein, this Agreement shall expire and be canceled, the Employee will not vest in any additional Options, the Employee may not exercise any Options, whether or not vested, and all RSUs, RSU Shares, Target Performance Shares (whether or not vested or earned) and Earned Performance Shares shall be canceled if:
(a)    the Employee shall cause the Company or any other member of the Company Group to suffer financial harm or damage to its reputation (either before or after termination of employment) through (x) dishonesty, (y) violation of law in the course of the Employee’s employment or violation of the Company’s Corporate Compliance Manual and compliance bulletins or other written policies or (z) material deviation from the duties owed the Company Group by the Employee; or
(b)    the Employee is subject to the Executive Share Ownership Policy, as such policy may be amended from time to time (the “Ownership Policy”), and the Employee makes any false attestation under the Ownership Policy; or
(c)    the Employee violates the terms of the Restrictive Covenant Agreement or any other confidentiality, non-solicit or non-compete obligation, or any other restrictive covenant set forth in any agreement between the Employee and the Company or any other member of the Company Group, or otherwise pursuant to any written policy of the Company or any other member of the Company Group (each, a “Restrictive Covenant”).
The Company may require the Employee to provide a written certification or other evidence, from time to time in the Company’s sole discretion, to confirm that no cancellation event identified in clauses (a), (b) or (c) above has occurred, including upon or following a termination of employment for any reason and/or during a specified period of time prior to the exercise of any Options or the scheduled delivery of any Option Shares, RSU Shares or Earned Performance Shares. If the Employee fails to provide any required certification or other evidence by the specified deadline, the Company shall have the right to cancel the Employee’s awards and/or, as discussed in the next paragraph, to cause the exercise of any Option and the delivery of any Option Shares, RSU Shares or Earned Performance Shares under this Agreement to be rescinded (and if the Employee has previously sold the Shares issued pursuant to this Agreement, the Employee would be required to pay back to the Company the pre-tax proceeds received from the sale of such Shares).
The Employee understands that the cancellation of any awards or rights under this Agreement is only one of the remedies that potentially may be asserted against the Employee for injuries or damages sustained by the Company or any other member of the Company Group as a result of any action described in this Section 8 or a violation of any Restrictive Covenant. Such cancellation shall be in addition to any equitable and legal rights the Company or any other member of the Company Group has or may have and shall not constitute a release of any claim that the Company or any other member of the Company Group may have for damages, past, present, or future. In addition, a breach by the Employee of any provisions of any Restrictive Covenant that occurs after any exercise of any Option or delivery of Shares pursuant to this Agreement (including any breach occurring after termination of employment) shall cause the
9

Exhibit 10.1
exercise of the Option and the delivery of any Option Shares, RSU Shares or Earned Performance Shares under this Agreement to be rescinded (and if the Employee has previously sold the Shares issued pursuant to this Agreement, the Employee would be required to pay back to the Company the pre-tax proceeds received from the sale of such Shares).
SECTION 9.    Executive Share Ownership Policy.
(a)    Employees Subject to Ownership Policy. In consideration of the grant of the awards under this Agreement, the Employee agrees that, if the Employee is or becomes subject to the Ownership Policy, the Options and all Option Shares, the RSUs and all RSU Shares, the Target Performance Shares and all Earned Performance Shares shall be subject to cancellation pursuant to Section (8)(b) of this Agreement and all Options, Option Shares, RSUs, RSU Shares, Target Performance Shares, Earned Performance Shares and shares of restricted stock granted to the Employee by the Company prior to the date hereof (the “Prior Awards”) shall be subject to cancellation pursuant to Section 8(b) of this Agreement (for false attestation under the Ownership Policy), the Shares obtained on exercise of such Prior Awards after the date hereof shall be subject to the Ownership Policy pursuant to Section 9(b) of this Agreement and the terms of Sections 8 and 9(b) hereof are made a part of the terms of each of the Prior Awards.
(b)    Shares Subject to Ownership Policy. If the Employee is subject to the Ownership Policy, any Shares issued under this Agreement or pursuant to any Prior Award (in each case net of tax withholdings) are subject to such Policy. The Employee hereby acknowledges and agrees that the investment risk associated with the retention of any Shares, whether pursuant to the Ownership Policy or otherwise, is the sole responsibility of the Employee and the Employee hereby holds the Company and each other member of the Company Group harmless against any claim of loss related to the retention of the Shares.
SECTION 10.    Non-Transferability; Voting Rights and Dividends.
(a)    Non-Transferability. The awards and rights under this Agreement shall not be transferable other than by will or the laws of descent and distribution. The Options may be exercised during the lifetime of the Employee only by the Employee except in the case of the Employee’s Disability, in which case the Options may be exercised by the Employee’s legal representative.
(b)    Voting and Dividend Rights. The Employee will not have any voting, dividend or other rights as a stockholder with respect to any Option Shares, RSUs, RSU Shares, Target Performance Shares or Earned Performance Shares prior to the date on which he/she is recorded as the holder of such Option Shares, RSU Shares or Earned Performance Shares on the records of the Company; provided, however, that until RSUs convert to Shares, if the Company declares and pays a regular or ordinary dividend on its Common Stock, the Employee will be paid a dividend equivalent for vested and unvested RSUs, but no dividend equivalents will be paid on any RSUs that are canceled. The Employee understands that the Option Shares will not be issued to the Employee until after (and to the extent that) Options are exercised, that Shares will not be issued to the Employee in respect of RSUs until after (and to the extent that) RSUs convert to Shares and that, except as provided in Section 7(b), Earned Performance Shares will
10

Exhibit 10.1
not be issued to the Employee until after the final calculation of the Earnings Multiple as contemplated by Section 3 and any adjustment under Section 7, it being understood that such issuance shall occur in any event on or prior to March 15, 2024. The Employee further understands that all deliveries of Shares under this Agreement shall be net of required tax withholding as described in Section 14 below. Until Shares have been delivered to or on behalf of the Employee in respect of any RSUs or Earned Performance Shares, the Employee shall have only the rights of a general unsecured creditor.
(c)    Assignment. Until Shares are transferred to the Employee’s account at the Company’s dedicated broker or the Employee otherwise receives possession of any such Shares, the Employee shall have no right to sell, assign, transfer, pledge or otherwise encumber Shares in any manner. Any purported attempt to sell, assign, transfer, pledge or otherwise encumber any award under this Agreement will be void and shall result in the cancellation of such award. Unless otherwise provided at the time of such transfer or delivery to the Employee of any Shares issued in respect of vested RSUs or Earned Performance Shares or Shares issued upon full or partial exercise of the Options, upon such transfer or delivery to the Employee the Shares will not be subject to any restrictions on transfer other than those that may arise under the securities laws or the Company’s policies, but the Shares shall remain subject to cancellation as provided in Section 8.
SECTION 11.    Consideration. In consideration for the awards under this Agreement, the Employee hereby agrees to be bound by the Restrictive Covenant Agreement and all other Restrictive Covenants applicable to the Employee.
SECTION 12.    Clawback. By accepting the awards under this Agreement the Employee agrees that all awards hereunder, and any other awards granted to the Employee under the Plan or any other equity or cash incentive plan of the Company (whether before or after the date of this Agreement), shall be subject to cancellation and recoupment by the Company, and shall be repaid by the Employee to the Company, to the extent required by law, regulation or listing requirement, or as determined in accordance with any Company incentive compensation recoupment policy, in each case, as in effect from time to time.
SECTION 13.    The Plan. The Plan is incorporated herein by reference. The Employee acknowledges that he/she has read the terms of the Plan and that those terms shall govern in the event of any conflict with the terms of this Agreement.
SECTION 14.    Taxes. The partial or full exercise of any Option, the transfer of Shares upon conversion of any vested RSUs and the delivery of any Earned Performance Shares under this Agreement will result in the Employee’s recognition of income for U.S. federal income tax purposes and shall be subject to tax and tax withholdings as appropriate. The Company or any other member of the Company Group that employs the Employee may make such provisions and take such steps as it may deem necessary or appropriate for the withholding of all federal, state, local and other taxes required or permitted by law to be withheld with respect to the exercise of any Options. On the delivery of Shares upon conversion of any RSUs and upon payment of any Earned Performance Shares, the Company will reduce the number of Shares to be delivered to the Employee by the amount of the taxes due (with the Shares valued at
11

Exhibit 10.1
the mean of its high and low prices on the New York Stock Exchange Composite list (or such other stock exchange as shall be the principal public trading market for the Shares) on the date that the Shares are valued for purposes of reporting compensation for Federal income tax purposes). The Company or any other member of the Company Group that employs the Employee shall have the authority to make arrangements for payment of the Employee’s share of any employment/payroll taxes (including Federal Insurance Contributions Act taxes), whether imposition of such taxes occurs upon exercise of Options, conversion of RSUs, transfer of Earned Performance Shares or at some other time. In particular, the Employee authorizes his or her employer to withhold such taxes from any payroll or other payment or compensation owed to the Employee, subject to the limitations imposed under Section 409A of the Code.
SECTION 15    Consent Requirement. If the Company shall at any time determine that any consent (as hereinafter defined) is necessary or desirable as a condition of, or in connection with, the granting of the Options, the issuance or purchase of Shares or other rights hereunder, or the taking of any other action hereunder (a “Plan Action”), then no such Plan Action shall be taken, in whole or in part, unless and until such consent shall have been effected or obtained to the full satisfaction of the Company. The term “consent” as used herein with respect to any action referred to in this Section 15 means (a) any and all listings, registrations or qualifications in respect thereof upon any securities exchange or under any federal, state or local law, rule or regulation, (b) any and all written agreements and representations by the Employee with respect to the disposition of Shares, or with respect to any other matter, which the Company shall deem necessary or desirable to comply with the terms of any such listing, registration or qualification or to obtain an exemption from the requirement that any such listing, qualification or registration be made, (c) any and all consents, clearances and approvals in respect of a Plan Action by any governmental or other regulatory bodies, and (d) any and all consents or authorizations required to comply with, or required to be obtained under, applicable local law or otherwise required by the Company. Nothing herein shall require the Company to list, register or qualify the Shares on any securities exchange.
SECTION 16.    Invalidity and Enforcement. If any provision of this Agreement is deemed invalid or unenforceable, either in whole or in part, this Agreement shall be deemed amended to delete or to modify, as set forth in this Section, the offending provision or provisions and to alter the bounds of this Agreement in order to render it valid and enforceable. The Company and the Employee specifically request that any court having jurisdiction over any dispute relating to this Agreement modify, if possible, any offending provision so that such provision will be enforceable to the maximum extent permitted by law.
SECTION 17.    No Entitlements. This Agreement is not an employment agreement, and nothing in this Agreement or the Plan shall alter an Employee’s status as an “at-will” employee of the Company Group subject to the rights (if any) that the Employee may have under any employment agreement existing between any member of the Company Group and the Employee.
SECTION 18.    Enforcement by Successors and Assigns. The Company and any of its successors or assignees may enforce the Company’s rights under this Agreement.
12

Exhibit 10.1
SECTION 19.    Entire Agreement. Other than with respect to any Restrictive Covenant and the Ownership Policy, this Agreement constitutes the entire agreement between the Company and the Employee regarding the Options, the RSUs and the Performance Shares. No modification of this Agreement will have any force or effect unless such modification is in writing, signed by the Chief Executive Officer (or by the Senior Vice President, Chief Human Resources Officer or successor officer) of the Company and the Employee, and expressly indicates an intent to modify this Agreement.
SECTION 20.    Interpretation. Any dispute, disagreement or matter of interpretation which shall arise under the Agreement shall be finally determined by the Compensation Committee in its absolute discretion.
SECTION 21.    Governing Law. This Agreement and all rights hereunder shall be governed by, and construed and interpreted in accordance with, the laws of the state of New York applicable to contracts made and to be performed entirely within such state (without reference to its principles of conflicts of law). Each of the parties hereto hereby irrevocably and unconditionally submits, for itself and its property, to the exclusive jurisdiction of any New York state court or federal court of the United States of America sitting in New York City, and any appellate court from any thereof, in any action or proceeding arising out of or relating to this Agreement, or for recognition or enforcement of any judgment, and each of the parties hereto hereby irrevocably and unconditionally agrees that all claims in respect of any such action or proceeding may be heard and determined in any such New York state court or, to the extent permitted by law, in such federal court. Each of the parties hereto agrees that a final judgment in any such action or proceeding shall be conclusive and may be enforced in other jurisdictions by suit on the judgment or in any other manner provided by law. Each of the parties hereto irrevocably and unconditionally waives, to the fullest extent it may legally and effectively do so, any objection that it may now or hereafter have to the laying of venue of any suit, action or proceeding arising out of or relating to this Agreement in state or federal court in New York City. Each of the parties hereto hereby irrevocably waives, to the fullest extent permitted by law, the defense of an inconvenient forum to the maintenance of such action or proceeding in any such court.
SECTION 22.    Section 409A. It is the intention and understanding of the parties that the RSUs are either exempt from or comply with the provisions of Section 409A of the Code, and that none of the Options or the Performance Shares provide for a deferral of compensation subject to Section 409A of the Code. This Agreement shall be interpreted and administered to give effect to such intention and understanding and to avoid the imposition on the Employee of any tax, interest or penalty under Section 409A of the Code in respect of any Options, RSUs or Performance Shares. Notwithstanding any other provision of this Agreement, the Employee’s consent shall not be required for any amendment to this Agreement which, in the reasonable, good faith judgment of the Company, is necessary or appropriate to avoid the imposition on the Employee of any tax, interest or penalty under Section 409A of the Code.
SECTION 23.    Defined Terms. As used in this Equity Award Agreement, the following terms have the meanings indicated below:
13

Exhibit 10.1
(a)    Cause. “Cause” means
(i)    as to any Employee who is a party to an employment agreement with the Company or any other member of the Company Group which contains a definition of “cause,” the definition set forth in such employment agreement;
(ii)    as to any Employee who is not a party to such an employment agreement but who is eligible to receive severance under a severance plan of the Company or any other member of the Company Group (other than the Quest Diagnostics Incorporated Severance Pay Plan) which contains a definition of “cause”, the definition set forth in such severance plan; and
(iii)    as to any other Employee:
(A)    repeated failure or refusal to perform duties and responsibilities of his or her job as required by the Employee’s employer (other than any such failure resulting from the Employee’s incapacity due to physical or mental illness);
(B)    violation of any fiduciary duty or duty of loyalty owed to the Company or any other member of the Company Group, including without limitation any acts of theft or dishonesty;
(C)    conduct or misconduct that is or threatens to be injurious to the Company or any other member of the Company Group or that harms or threatens to harm the reputation or financial position of the Company or any other member of the Company Group;
(D)    the commission of conduct that meets the definition of any felony under state or federal law, or conviction of, or plea of nolo contendere to, any other criminal charge that is or threatens to be injurious to the Company or any member of the Company Group;
(E)    willful conduct that violates the Company’s Corporate Compliance Manual, compliance bulletins or other written policies;
(F)    (x) obstructing or impeding, (y) endeavoring to influence, obstruct or impede or (z) failing to cooperate with a Company investigation, whether or not related to the Employee’s employment, or the willful destruction of or willful failure to preserve documents or other material known to be relevant to any such investigation;
(G)    being found liable in any Securities and Exchange Commission or other civil or criminal securities law action; or
14

Exhibit 10.1
(H)    other egregious conduct that has or could have a serious and detrimental impact on the Company or any other member of the Company Group.
(b)    Company Group. The “Company Group” means (i) the Company, (ii) any company or other entity in which the Company owns at least a 50% interest within the meaning of Section 424(f) of the Code, and (iii) any company or other entity in which the Company owns at least a 20% interest within the meaning of Section 424(f) of the Code and which the Administrator has designated as a member of the Company Group for purposes of awards under the Plan. References to employment by or with the Company Group shall be understood to refer to employment by or with the Company or any other member of the Company Group.
(c)    Disability. “Disability” means permanent and total disability as determined under the Company’s long-term disability program for employees then in effect.
(d)    Good Reason. “Good Reason” means:
(i)    as to any Employee who is a party to an employment agreement with the Company or any other member of the Company Group which contains a definition of “good reason,” the definition set forth in such employment agreement;
(ii)    as to any Employee who is not a party to such an employment agreement but who is eligible to receive severance under a severance plan of the Company or any member of the Company Group which contains a definition of “good reason,” the definition set forth in such severance plan; and
(iii)    as to any other Employee, the termination of the Employee’s employment by the Employee after one of the following events, provided that the Employee’s termination of employment occurs within sixty (60) days after the occurrence of any such event:
(A)    any material change in the duties, responsibilities or status (including reporting responsibilities) of the Employee that is inconsistent in any material and adverse respect with the Employee’s position(s), duties, responsibilities or authority with his or her employer immediately prior to such Change in Control (including any material and adverse diminution of such duties or responsibilities); provided, however, that Good Reason shall not be deemed to occur upon a change in duties, responsibilities (other than reporting responsibilities) or status that is solely and directly a result of the Company no longer being a publicly traded entity and does not involve any other event set forth in this paragraph (d);
(B)    a material reduction in the Employee’s aggregate rate of annual base salary, annual bonus opportunity and equity incentive
15

Exhibit 10.1
compensation target opportunity (including any material and adverse change in the formula for such targets) as in effect immediately prior to such Change in Control;
(C)    the Employee’s employer requiring the Employee to be based at any office or location more than fifty (50) miles from the office where the Employee is located at the time of the Change in Control and as a result causing the Employee’s commute from his residence at the time of the Change in Control to the new location to increase by more than fifty (50) miles; or
(D)    a material reduction in the Employee’s retirement, welfare, perquisite (if any) and other benefits taken as a whole, unless the Employee is permitted to participate in other plans providing the Employee with materially equivalent benefits in the aggregate (at materially equivalent or lower cost with respect to welfare benefit plans);
provided, however, that an event described in (A) through (D) above shall permit an Employee to terminate his or her employment for Good Reason only if written notice of such event has been provided by the Employee to his or her employer and the employer failed to cure such action within thirty (30) days following receipt of such notice.
(e)    Replacement Award. “Replacement Award” means an equity award that is made by the surviving entity in a Change in Control in substitution for Options, RSUs or Performance Shares covered by this Equity Award Agreement and that, in the sole judgment of the Compensation Committee, affords the Employee economic opportunity and protections in the event of termination of employment that are at least as favorable to the Employee in the aggregate as the economic opportunity and protections afforded by the terms of the Options, RSUs or Performance Shares, as the case may be, set forth in this Equity Award Agreement.
(f)    Retirement. “Retirement” means the voluntary cessation of employment by the Employee upon the attainment of age sixty (60) and the completion of not less than five (5) completed years of service with the Company or any other member of the Company Group; provided, however, that there is no basis for the Company or any member of the Company Group to terminate the employment of the Employee for Cause at the time of the Employee’s voluntary cessation of employment.
SECTION 24.    Leave of Absence and Transfer.
(a)    Leave of Absence. Unless the Administrator expressly provides otherwise, the Employee’s employment with the Company Group will be deemed to have terminated when the Employee is no longer employed by or in a service relationship with the Company or another member of the Company Group (including by reason of a member of the Company Group ceasing to be such a member); provided, however, that the Employee’s employment will not be deemed to have terminated during a bona fide leave of absence approved by the Employee’s direct employer for medical, personal, educational and/or other permissible
16

Exhibit 10.1
purposes pursuant to policies of the Company Group as in effect from time to time if such absence does not exceed six months or, if longer, so long as the Participant retains a right by statute or by contract to return to employment or other service relationship with the Company Group. The Employee’s leave of absence shall be considered “bona fide” only if there is a reasonable expectation that the Employee will return to perform services for the employer.
(b)    Transfers. If the Employee shall be transferred from the Company to another member of the Company Group or vice versa or from one member of the Company Group to another, the Employee’s employment shall not be deemed to have terminated for purposes of this Equity Award Agreement. If, while the Employee is employed by a member of the Company Group, such entity shall cease to be a member of the Company Group (whether by virtue of a sale, spin-off or other disposition or otherwise) and the Employee is not thereupon transferred to and employed by the Company or another member of the Company Group, then the Employee’s employment will be treated as a termination due to a divestiture on the date that the Employee’s employer ceases to be a member of the Company Group, and the provisions of Section 7(c)(ii) (Performance Shares) shall govern, as applicable.
SECTION 25.    Acknowledgements. By accepting this Equity Award Agreement, the Employee agrees that he/she has received and reviewed a copy of:
(a)    the Prospectus (link to Prospectus) relating to the Company’s Employee Equity Participation Program;
(b)    the Quest Diagnostics Incorporated 2020 Annual Report on Form 10-K (link to 2020 Annual Report);
(c)    the Company’s Policy for Purchasing and Selling Securities (the “Policy”) (link to Trading Policy). The Employee further agrees to fully comply with the terms of the Policy; and
(d)    the Eligibility Policy.

17

Exhibit 10.1
Appendix A
Quest Diagnostics Incorporated
Performance Shares Award Terms
2021 – 2023 Performance Period

Base Business Net RevenuesThe net revenues of the Company’s business excluding COVID-19 revenues.
Base Business Net Revenues for the Baseline Year – The Company’s net revenues during the Baseline Year were $6,714.5 million.
Baseline Year – 2020.
COVID-19 Net Revenue: – The Company’s net revenues during the Performance Period that are related to the Company’s COVID-19 testing products and services, including, without limitation, revenues related to COVID-19 testing, including Nuclear Acid Amplification (including PCR), serology, antigen, viral sequencing, genotyping and other immunological testing solutions.
Final Year – The Company’s Fiscal Year ended December 31, 2023.
Performance Period – January 1, 2021 through December 31, 2023.
ROIC – NOPAT/Invested Capital.
NOPAT – (Income from continuing operations – net income attributable to non-controlling interests) + (gross interest expense x (1 – statutory tax rate)).
Invested Capital – Average total Quest Diagnostics stockholders equity + average total debt.
Average ROIC – Average of the Annual Average ROIC for each year in the Performance Period.
Annual Average ROIC – For a given year within the Performance Period, NOPAT/Invested Capital.
Peer Index – The companies listed in the S&P 500 Health Care Industry Index at the start of the Performance Period. The Compensation Committee may, in its sole discretion, adjust the Peer Index in the event of: (i) the merger of two members of the Peer Index; (ii) the acquisition of a member of the Peer Index by another member of the Peer Index; (iii) the acquisition of a member of the Peer Index by a company that is not a member of the Peer Index; and (iv) a split of a member of the Peer Index (in which case the Compensation Committee may, in its sole discretion, include both companies in the Peer Index). A Peer Company shall remain in the Peer Index following its bankruptcy or delisting (and shall be listed at the bottom of the Peer Index).
Relative TSR – The percentile rank of the Company’s TSR as compared to the TSR of each member of the Peer Index, determined by dividing the number of members of the Peer Index
18

Exhibit 10.1
with TSR equal to or lower than the Company’s TSR for the Performance Period by the total number of members of the Peer Index minus 1.
Total Shareholder Return or TSR – The change in a company’s stock price over the Performance Period (counting any dividends paid as if such dividends were reinvested at the time of issuance) divided by that company’s stock price at the beginning of the Performance Period, expressed as a percentage. The stock price at the beginning of the Performance Period shall be calculated using the relevant company’s 20 trading-day average closing stock price leading up to, but not including, January 1, 2021. The stock price at the end of the Performance Period shall be calculated using the relevant company’s 20 trading-day average closing stock price leading up to, and including, December 31, 2023.
Performance Share Vesting Period – February 18, 2021 through February 18, 2024.
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Exhibit 10.1
Appendix B
International Supplement

This International Supplement amends certain terms and conditions of, and is made a part of, the Quest Diagnostics Incorporated Equity Award Agreement dated as of [Grant Date], 2021 (the “Agreement”) to which this International Supplement is attached as Appendix B. This International Supplement applies to awards made to individuals who are not United States citizens or residents, as such term is defined by the Internal Revenue Code, and who are employed outside the United States. Capitalized terms that are used without definition in this International Supplement have the meanings set forth in the Agreement.
A.    Provisions applicable to all individuals who are not United States citizens or residents.
1.    Disability. Section 4(d) is amended to provide that if the Employee’s employment shall terminate as a result of a medical condition for which the Employee receives disability income benefits from a governmental program, all Options and all RSUs shall vest. All references in the Agreement to Section 4(d), including without limitation the reference to Section 4(d) set forth in Section 6(c), shall be understood as referring to Section 4(d) as so amended.
2.    Taxes. The first two sentences of Section 14 are replaced in their entirety to read as follows: “Depending on applicable tax rules, the Employee may recognize income for income tax purposes upon the grant, vesting, exercise or settlement of the awards covered by this Agreement, and the Employee shall be subject to tax and tax withholdings as appropriate.” References in Section 14 to Federal income tax and Federal Insurance Contribution Act taxes shall be understood as references to the comparable taxes in the jurisdiction in which the Employee is employed.
B.    Provisions applicable to individuals who are citizens or residents of Finland.

1.Definition of Termination Date. The definition of “Termination Date” in Section 4(c) is replaced in its entirety with the defined term “Expiry Date”, which shall mean the date of the Employee’s expiry of employment. All references in the Agreement to Termination Date shall be understood as referring to Expiry Date.

2.Leave of Absence and Transfer. Each use of the term “terminated” in Section 24 is replaced with the term “expired.” Section 24 is amended to provide that, in addition to the enumerated permissible bona fide leaves of absence, an Employee’s employment will not be deemed to have expired as a result of a bona fide leave of absence permitted pursuant to statute.

3.Definition of Good Reason. Section 23(d)(iii) is amended to provide that the events set forth in Sections 23(d)(iii)(A) through (D) shall provide grounds for a termination by the Employee with Good Reason if the Employee serves notice of Employee’s termination of employment within sixty (60) days of the occurrence of any such event and the employer fails to
20

Exhibit 10.1
cure the event giving rise to Good Reason within thirty (30) days following receipt of such notice.


21

Exhibit 10.1
Appendix C

RESTRICTIVE COVENANT AGREEMENT
22

Exhibit 31.1
CERTIFICATION OF CHIEF EXECUTIVE OFFICER PURSUANT TO
SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002
I, Stephen H. Rusckowski, certify that:

1.I have reviewed this quarterly report on Form 10-Q of Quest Diagnostics Incorporated;
2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
a.designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b.designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c.evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
d.disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
a.all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
b.any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

April 23, 2021
By /s/ Stephen H. Rusckowski
Stephen H. Rusckowski
Chairman, Chief Executive Officer and
President




Exhibit 31.2
CERTIFICATION OF CHIEF FINANCIAL OFFICER PURSUANT TO
SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002
I, Mark J. Guinan, certify that:

1.I have reviewed this quarterly report on Form 10-Q of Quest Diagnostics Incorporated;
2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
a.designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
b.designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
c.evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
d.disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
a.all significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and
b.any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

April 23, 2021
By /s/ Mark J. Guinan
Mark J. Guinan
Executive Vice President and
Chief Financial Officer



Exhibit 32.1
CERTIFICATION OF CHIEF EXECUTIVE OFFICER PURSUANT TO 18 U.S.C. § 1350,
AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

Pursuant to 18 U.S.C. § 1350, the undersigned certifies that, to the best of my knowledge, the Quarterly Report on Form 10-Q for the period ended March 31, 2021 of Quest Diagnostics Incorporated, as being filed with the Securities and Exchange Commission concurrently herewith, fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. § 78m or 78o(d)) and that the information contained in the Quarterly Report fairly presents, in all material respects, the financial condition and results of operations of Quest Diagnostics Incorporated.
Dated: April 23, 2021 /s/ Stephen H. Rusckowski
Stephen H. Rusckowski
Chairman, Chief Executive Officer and
President




Exhibit 32.2
CERTIFICATION OF CHIEF FINANCIAL OFFICER PURSUANT TO 18 U.S.C. § 1350,
AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

Pursuant to 18 U.S.C. § 1350, the undersigned certifies that, to the best of my knowledge, the Quarterly Report on Form 10-Q for the period ended March 31, 2021 of Quest Diagnostics Incorporated, as being filed with the Securities and Exchange Commission concurrently herewith, fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. § 78m or 78o(d)) and that the information contained in the Quarterly Report fairly presents, in all material respects, the financial condition and results of operations of Quest Diagnostics Incorporated.
Dated: April 23, 2021 /s/ Mark J. Guinan
Mark J. Guinan
Executive Vice President and
Chief Financial Officer