A patient with a blood pressure of 139/90 meets the 4th numerator option ("Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Intervention") because the systolic BP is between 130 and 139.

This same patient meets the 5th numerator option ("Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Intervention") because the diastolic BP is greater than or equal to 90.

This is probably not the intent of the measure.

Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89

•  
• ( "Qualifying Encounter During Measurement Period" QualifyingEncounter
  let EncounterLastSystolicBP: Last(["Physical Exam, Performed": "Systolic blood pressure"] SystolicBP
  where Global."NormalizeInterval"(SystolicBP.relevantDatetime, SystolicBP.relevantPeriod)ends during QualifyingEncounter.relevantPeriod
  sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
  ),
  EncounterLastDiastolicBP: Last(["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP
  where Global."NormalizeInterval"(DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod)ends during QualifyingEncounter.relevantPeriod
  sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
  )
  where EncounterLastSystolicBP.result in Interval[130 'mm[Hg]', 139 'mm[Hg]']
  or EncounterLastDiastolicBP.result in Interval[80 'mm[Hg]', 89 'mm[Hg]']
  and not ( EncounterLastSystolicBP.result >= 140 'mm[Hg]'
  or EncounterLastDiastolicBP.result >= 90 'mm[Hg]'
  )
  )
  intersect "Encounter with Hypertensive Reading Within Year Prior"

The query is probably missing parenthesis around this part of the where clause:

EncounterLastSystolicBP.result in Interval[130 'mm[Hg]', 139 'mm[Hg]'] or EncounterLastDiastolicBP.result in Interval[80 'mm[Hg]', 89 'mm[Hg]']

You can check the ELM if you want to see a clearer picture of the "order of operations".