Revenue Performance - For Q3 2023, total revenues increased by 174million,or4.93,736 million compared to Q3 2022, driven by a 126 million increase in Research & Development Solutions[90]. - For the first nine months of 2023, total revenues rose by 445 million, or 4.2%, to 11,116millioncomparedtothesameperiodin2022,witha400 million increase in Research & Development Solutions[91]. - For the three months ended September 30, 2023, consolidated revenues increased to 3,736million,up4.93,562 million in the same period of 2022[105]. - For the nine months ended September 30, 2023, consolidated revenues reached 11,116million,a4.210,671 million in the same period of 2022[106]. - Research & Development Solutions' revenues for the third quarter of 2023 were 2,122million,anincreaseof143 million, or 7.2%, compared to 1,979 million in the same period of 2022[119]. - Technology & Analytics Solutions' revenues for the third quarter of 2023 were 1,431 million, an increase of 31million,or2.21,400 million in the same period of 2022[108]. - Contract Sales & Medical Solutions' revenues for Q3 2023 were 183million,consistentwithQ32022,withaconstantcurrencyrevenuegrowthofapproximately9 million, or 4.9%[128]. - For the first nine months of 2023, revenues were 541million,adecreaseof20 million, or 3.6%, compared to the same period in 2022, despite a constant currency revenue growth of approximately 7million,or1.22,426 million, representing 64.9% of revenues, a slight decrease from 65.2% in Q3 2022[92]. - Selling, general and administrative expenses for Q3 2023 decreased by 15millionto502 million, or 13.4% of revenues, compared to 14.5% in Q3 2022[94]. - Restructuring costs for Q3 2023 were 30million,upfrom4 million in Q3 2022, as the company continues to streamline operations[98]. - Technology & Analytics Solutions' cost of revenues increased by 31million,or3.718 million, or 9.0%, in the third quarter of 2023 compared to the same period in 2022[125]. - Cost of revenues, exclusive of depreciation and amortization, decreased by 1million,or0.61 million, or 0.6%[129]. - Selling, general and administrative expenses decreased by 3million,or17.62 million, or 11.8%[131]. Financial Position - Cash balance as of September 30, 2023, was 1,224million,anincreasefrom1,216 million as of December 31, 2022[135]. - Net cash provided by operating activities decreased by 298millionto1,402 million in the first nine months of 2023 compared to 1,700millioninthesameperiodin2022[144].−Netcashusedininvestingactivitiesdecreasedby138 million to (1,391)millioninthefirstninemonthsof2023comparedto(1,529) million in the same period in 2022[145]. - As of September 30, 2023, total indebtedness was 13,689million,excluding1,745 million of additional available borrowings under the revolving credit facility[139]. - During the nine months ended September 30, 2023, the company repurchased 3.9 million shares for 763millionundertheequityrepurchaseprogram[138].TaxandOtherFinancialMetrics−Theeffectiveincometaxrateforthethirdquarterof2023was14.621 million reversal of uncertain tax positions[103]. - The company expects to reverse the valuation allowance related to foreign tax credits, potentially creating a material discrete tax benefit in the near term[104]. Backlog and Future Expectations - Research & Development Solutions' contracted backlog increased from 27.2billionasofDecember31,2022,to28.8 billion as of September 30, 2023, with an expected revenue conversion of approximately 7.4billioninthenexttwelvemonths[118].−Thecompanyanticipatesongoingrestructuringactionsthroughout2023andinto2024toadapttochangingmarketconditionsandintegrateacquisitions[98].−InterestexpenseforQ32023increasedto181 million from 108millioninQ32022,primarilyduetohigherbaserateinterestcosts[99].−DepreciationandamortizationforQ32023increasedby49 million to $297 million, representing 7.9% of revenues, compared to 7.0% in Q3 2022[96].