Is the "Occurrence A Encounter, Performed: Ambulatory/ED Visit" used in the numerator logic supposed to be only the earliest encounter that satisfied the "Occurrence A" logic in the Initial Patient Population?

Looking at Initial Patient Population section of measure CMS 146, there is a section that starts with "AND NOT" that uses the concept of "Occurrence B Encounter, Performed: Ambulatory/ED Visit". It seems that the intent of this section is to make sure that the "Occurrence A Encounter, Performed: Ambulatory/ED Visit" used in the numerator is the EARLIEST encounter that qualified the patient for the Initial Patient Population, but we want to confirm.