This is wrt Stroke 6 measure

Denominator states"
AND NOT: "Occurrence A of Medication, Active: Lipid-lowering Agent" ends before start of
OR: "Occurrence A of Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before start of "Occurrence A of Encounter, Performed: Non-Elective Inpatient Encounter"
OR: "Occurrence A of Encounter, Performed: Non-Elective Inpatient Encounter"
AND: "Occurrence A of Medication, Active: Lipid-lowering Agent" starts before or during
OR: "Occurrence A of Encounter, Performed: Emergency Department Visit"
OR: "Occurrence A of Encounter, Performed: Non-Elective Inpatient Encounter"

Here AND NOT has two OR conditions which would be considered as AND as per AND NOT logic .example AND NOT(A or B)= A and B

but if we consider the above conditions as per AND NOT logic then the validation becomes incorrect ie Medication Lipid lowering agent ends after start of Emergency department AND ends after start of Non elective Encounter Inpatient.So as per this logic only patient though Emergency department to Non elective Encounter Inpatient would be validated for this condition .Patient coming directly through Non elective Encounter Inpatient would not be validated for the above condition.

Kindly suggest how we need to consider above OR conditions defined in AND NOT ie whether we need to consider it as AND NOT (A or B)=A AND B or AND NOT (A or B)=A or B.