Thank you for your inquiry regarding CMS131v13 (2025 Performance Period). The measure looks for diabetic patients aged 18-75 who had an outpatient visit during the measurement period and received an eye screening for diabetic retinal disease. In your example, a retinal eye exam on 04/01/25 and a diabetes diagnosis on 05/05/25 would meet the numerator criteria, as long as a diagnosis of retinopathy overlaps the measurement period. For help interpreting the measure specification or understanding data requirements, please refer to the "Guide for Reading eCQMs" for additional guidance. For questions regarding implementing the measure, please see 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