A month has gone by since the last earnings report for Cardinal Health (CAH). Shares have lost about 4% in that time frame, outperforming the S&P 500.Will the recent negative trend continue leading up to its next earnings release, or is Cardinal due for a breakout? 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 catalysts. Cardinal Health Beats on Q1 Earnings, Pharmaceutical Segment StrongCardinal Health delivered first-quarter fiscal 2019 adjusted earnings of $1.29 per share, which beat the Zacks Consensus Estimate of $1.06. Adjusted earnings increased 18% year over year.Revenues increased 7.9% on a year-over-year basis to $35.21 billion and beat the Zacks Consensus Estimate of $33.54 billion.Segmental AnalysisPharmaceutical SegmentIn the fiscal first quarter, pharmaceutical revenues increased 8.6% to $31.42 billion on a year-over-year basis. The segment witnessed strong growth in the Specialty business and gained a large number of Pharmaceutical Distribution customers.However, strong growth in the segment was partially offset by the divestiture of the company's China distribution business.Pharmaceutical witnessed a 12.8% decline in profits to $409 million, thanks to generic pharmaceutical pricing.Medical SegmentIn the quarter under review, revenues in the segment improved 2.1% to $3.80 billion, courtesy of the Patient Recovery business acquisition.Medical segment profits increased 4.7% to $135 million.Margin AnalysisGross Profit inched down 0.3% year over year to $1.67 billion.As a percentage of revenues, gross margin in the quarter was 4.7%, down 40 basis points (bps) on a year-over-year basis.Distribution, selling, general and administrative expenses were $1.16 billion in the quarter under review, up 8.8% year over year. Adjusted operating margin for Cardinal Health in the quarter under review was 3.3% of net revenues, flat year over year.GuidanceThe company reiterated guidance for fiscal 2019 adjusted earnings per share.Adjusted earnings from continuing operations are expected in the range of $4.90-$5.15. The Zacks Consensus Estimate was pegged at $5.02, which lies within the guidance.How Have Estimates Been Moving Since Then?In the past month, investors have witnessed a downward trend in fresh estimates. The consensus estimate has shifted -16.38% due to these changes.VGM ScoresCurrently, Cardinal has a great 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 A on the value side, putting it in the top quintile for this investment strategy.Overall, the stock has an aggregate VGM Score of A. 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. Notably, Cardinal has a Zacks Rank #3 (Hold). We expect an in-line return from the stock in the next few months.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 Cardinal Health, Inc. (CAH): Free Stock Analysis Report To read this article on Zacks.com click here. Zacks Investment Research