Thank you for your inquiry about CMS122v13 (2025 Performance Period). A patient with a HbA1c with a null value will still meet numerator criteria. In scenario 1, if a patient had multiple hbA1c completed on the same day, a null value will be the lowest assessment reading pulled into the definition "Has Most Recent Glycemic Status Assessment Without Result" to meet numerator criteria. In scenario 2, the hbA1c reading with a result of 8% will be the lowest result considered and not meet the numerator criteria. Please see the logic below. 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 . Numerator "Has Most Recent Glycemic Status Assessment Without Result" or "Has Most Recent Elevated Glycemic Status Assessment" or "Has No Record Of Glycemic Status Assessment" Has Most Recent Glycemic Status Assessment Without Result "Lowest Glycemic Status Assessment Reading on Most Recent Day" is not null and "Lowest Glycemic Status Assessment Reading on Most Recent Day".result is null