It has been about a month since the last earnings report for IQVIA Holdings (IQV). Shares have added about 8.6% in that time frame, outperforming the S&P 500.Will the recent positive trend continue leading up to its next earnings release, or is IQVIA due for a pullback? Before we dive into how investors and analysts have reacted as of late, let's take a quick look at its most recent earnings report in order to get a better handle on the important drivers. IQVIA Surpasses Q3 Earnings & Revenues EstimatesIQVIA Holdings reported solid third-quarter 2022 results, wherein both earnings and revenues surpassed the respective Zacks Consensus Estimate.Adjusted earnings per share (excluding 99 cents from non-recurring items) of $2.48 beat the consensus mark by 3.8% and improved 14.3% on a year-over-year basis. The reported figure is above the guided range of $2.34-$2.42.Total revenues of $3.56 billion outpaced the consensus estimate by 0.5% and increased 5% year over year on a reported basis and 10.5% on a constant-currency basis. The reported figure touches the upper end of the guided range of $3.515-$3.565 billion.Segmental RevenuesRevenues from Technology & Analytics Solutions totaled $1.4 billion, up 4.7% on a reported basis and 11.6% on a constant-currency basis.Research & Development Solutions’ revenues of $1.98 billion increased 6.8% on a reported basis and 10.7% on a constant-currency basis.Revenues from Contract Sales & Medical Solutions totaled $183 million, down 9% on a reported basis but up 1% on a constant-currency basis.Operating PerformanceAdjusted EBITDA was $814 million, up 11.8% year over year.Balance Sheet and Cash FlowIQVIA exited third-quarter 2022 with a cash and cash equivalents balance of $1.27 billion compared with $1.43 billion at the end of the prior quarter. Long-term debt (less current portion) was $12.24 billion compared with $12.6 billion at the end of the prior quarter.IQV generated $863 million of cash from operating activities in the reported quarter, while CapEx was $165 million. Free cash flow was $698 million.During the reported quarter, IQVIA repurchased shares worth $150 million. As of Sep 30, 2022, IQVIA had $1.38 million of its share buyback authorization outstanding.Fourth-Quarter 2022 GuidanceIQVIA expects fourth-quarter revenues in the range of $3.654-$3.754 billion. Adjusted earnings per share are expected between $2.72 and $2.82. Adjusted EBITDA is anticipated between $904 million and $934 million.2022 GuidanceFor 2022, IQVIA’s expectation of low-to-mid-teens organic revenue growth at constant currency, excluding COVID-related work, remains unchanged. IQVIA now expects revenues between $14.33 billion and $14.43 billion compared with the prior guidance of $14.40-$14.55. Adjusted earnings per share are expected between $10.10 and $10.20 (prior guidance: $10.00 and $10.20). Adjusted EBITDA is anticipated between $3.33 billion and $3.36 billion (prior guidance: from $3.345 billion to $3.395 billion).How Have Estimates Been Moving Since Then?In the past month, investors have witnessed a downward trend in fresh estimates.VGM ScoresAt this time, IQVIA has a strong Growth Score of A, though it is lagging a lot on the Momentum Score front with an F. However, the stock was allocated a grade of C on the value side, putting it in the middle 20% for this investment strategy.Overall, the stock has an aggregate VGM Score of B. If you aren't focused on one strategy, this score is the one you should be interested in.OutlookEstimates have been broadly trending downward for the stock, and the magnitude of these revisions indicates a downward shift. It's no surprise IQVIA has a Zacks Rank #4 (Sell). We expect a below average return from the stock in the next few months. Zacks Names "Single Best Pick to Double" From thousands of stocks, 5 Zacks experts each have chosen their favorite to skyrocket +100% or more in months to come. From those 5, Director of Research Sheraz Mian hand-picks one to have the most explosive upside of all. It’s a little-known chemical company that’s up 65% over last year, yet still dirt cheap. With unrelenting demand, soaring 2022 earnings estimates, and $1.5 billion for repurchasing shares, retail investors could jump in at any time. This company could rival or surpass other recent Zacks’ Stocks Set to Double like Boston Beer Company which shot up +143.0% in little more than 9 months and NVIDIA which boomed +175.9% in one year.Free: See Our Top Stock and 4 Runners Up >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report IQVIA Holdings Inc. (IQV): Free Stock Analysis ReportTo read this article on Zacks.com click here.Zacks Investment Research