NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System this adjustment would be unlikely to bias results. In addition, this adjustment is only relevant to state specific rates. National rates are not affected a detailed description of the analytical steps is described in the reportVEHSS Claims Registry Data Analysis Plan Data Indicators and case Definitions VSP estimates include data indicators representing two topics of the overall VEHSS project; "Service Utilization, and"Medical Diagnoses Service Utilization-Eye Exams Service Utilization measured in VSP claims is the proportion of patients who underwent an eye exam per year of observation. The rate of exams represents the proportion of patients who have at least one eye exam during the year of observation, and is a single number representing the average for each patient group. The Eye Exam indicators analyzed in VSP claims data are listed in Table 1 Table 1. Service Utilization Topic Indicators Eye exams By provider type By ophthalmologists and other physicians Eye exams were identified in claims based on the presence of Healthcare Common Procedure Coding System(HCPCSCodes, shown in Table 2. Four procedure codes specifically denote an eye exam (92002, 92004, 92012, 92014). All instances of these procedures were counted as an eye exam Other Evaluation Management(e M)codes(99***)are not specific to eye exams, but nonetheless are frequently billed for eye exams. In this case, we included all e m codes since by definition all claims billed to VSP are for eye care services. We identified eye care providers in VSP based on the provider types(also known as taxonomy), of ophthalmologist, optometrist or optician, or a general physician who coded for an ophthalmic procedure as indicated in Table 3NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 6 this adjustment would be unlikely to bias results. In addition, this adjustment is only relevant to state￾specific rates. National rates are not affected. A detailed description of the analytical steps is described in the report “VEHSS Claims & Registry Data Analysis Plan.” Data Indicators and Case Definitions VSP estimates include data indicators representing two topics of the overall VEHSS project; ‘Service Utilization’ and ‘Medical Diagnoses.’ Service Utilization-Eye Exams Service Utilization measured in VSP claims is the proportion of patients who underwent an eye exam per year of observation. The rate of exams represents the proportion of patients who have at least one eye exam during the year of observation, and is a single number representing the average for each patient group. The Eye Exam indicators analyzed in VSP claims data are listed in Table 1. Table 1. Service Utilization Topic Indicators Category Subgroup Eye exams By provider type By ophthalmologists and other physicians By optometrists and opticians Eye exams were identified in claims based on the presence of Healthcare Common Procedure Coding System (HCPCS) Codes, shown in Table 2. Four procedure codes specifically denote an eye exam (92002, 92004, 92012, 92014). All instances of these procedures were counted as an eye exam. Other Evaluation & Management (E & M) codes (99***) are not specific to eye exams, but nonetheless are frequently billed for eye exams. In this case, we included all E & M codes since by definition all claims billed to VSP are for eye care services. We identified eye care providers in VSP based on the provider types (also known as taxonomy), of ophthalmologist, optometrist or optician, or a general physician who coded for an ophthalmic procedure as indicated in Table 3