Thank you for your inquiry about CMS122v13 (2025 Performance Period). The intent of the measure is to look for a patient's most recent HbA1c level to be greater than 9.0%, missing, or not performed during the measurement period. In scenario one, if a patient has an HbA1c with a result value of 'See Comment' or 'Cancelled', the measure will consider the missing result as an indication of poor glycemic control, since the most recent test should have a result to ensure that the patient's HbA1c value is known. In scenario two, the measure requires a percentage (%) symbol with the HbA1c value. A missing unit of measurement is also considered insufficient and would be counted as an indication of poor control. If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs .