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Sheet1 City of BurlesonDashboard
| Selection Parameters | Values on Report |
| Client Effective Date: 1/1/2016 | | |
| Service Date Range: 12/1/2023 to 11/30/2025 | 12/2/2023 to 11/23/2025 |
| Client Renew Date: 1/1/2025 | | |
| Group ID: ALL | Client ID: 336654 |
| Client Policy Number: 0906435 | | |
| Accessing Members | Average Eligible Members | Accessing Members/Avg. Eligible Members |
| 3,8,7 | 7,7,6 | 49.87% |
| Top 10 Retail Chains | | | | | |
| | | Top 10 Private Practice Locations | | |
| Retail Chain | Unique Claimants | % of Total Claimants | | | |
| | | Practice Name | Unique Claimants | % of Total Claimants |
| Americas Best Contacts & Eyeglasses | 8,5 | 22.08% | | | |
| | | VISION PLAZA PA | 2,7 | 24.11% |
| Visionworks | 4,8 | 12.47% | | | |
| | | 116 E ELLISON ST STE C | | |
| MyEyeDr | 3,5 | 9.09% | | | |
| | | BURLESON, TX | | |
| | | BURLESON EYE CARE | 2,2 | 19.64% |
| Walmart Vision Center | 2,1 | 5.45% | | | |
| Costco Optical | 1,3 | 3.38% | | | |
| | | 201 NW RENFRO ST | | |
| | | BURLESON, TX | | |
| Warby Parker | 1,2 | 3.12% | | | |
| | | DE GRASSE and RATLIFF EYE CENTER | 7 | 6.25% |
| Sams Club Optical | 9 | 2.34% | | | |
| | | 300 MERCEDES ST | | |
| Lenscrafters | 7 | 1.82% | | | |
| | | BENBROOK, TX | | |
| Target Optical | 5 | 1.30% | | | |
| | | MOORE EYE CENTER | 5 | 4.46% |
| Texas State Optical | 4 | 1.04% | | | |
| | | 2545 NORTHWEST LOOP | | |
| 2,3,9 | | | | |
| STEPHENVILLE, TX | | |
| FORT WORTH EYE CENTER | 5 | 4.46% |
| 5329 SYCAMORE SCHOOL RD STE 113 | | |
| FORT WORTH, TX | | |
| CLEAR EYE ASSOCIATES PLUS OPTICAL | 5 | 4.46% |
| 5912 CONVAIR DR STE 208 | | |
| FORT WORTH, TX | | |
| WHITNEY FAMILY EYECARE | 4 | 3.57% |
| 1221 N BRAZOS ST | | |
| WHITNEY, TX | | |
| IDEAL EYECARE AND OPTICAL | 4 | 3.57% |
| 7216 GLENVIEW DR | | |
| RICHLAND HILLS, TX | | |
| PEDIATRIC EYE SPECIALISTS | 3 | 2.68% |
| 321 S HENDERSON ST | | |
| FORT WORTH, TX | | |
| DANN MARTIN OD PA | 3 | 2.68% |
| 5520 S COOPER ST STE 110 | | |
| ARLINGTON, TX | | |
&"Arial,Regular"&10 OVMCR-15A &"Arial,Regular"&10 Run Date Time: 12/8/2025
Sheet2 City of BurlesonDashboard
| Selection Parameters | Values on Report |
| Client Effective Date: 1/1/2016 | | |
| Service Date Range: 12/1/2023 to 11/30/2025 | 12/2/2023 to 11/23/2025 |
| Client Renew Date: 1/1/2025 | | |
| Group ID: ALL | Client ID: 336654 |
| Client Policy Number: 0906435 | | |
| Claimant Counts by Network Type | | | | | Price Protection Utilization* | | | | |
| | | | | | Category | Saving Through Price Protection | | | Service |
| Network Type | | | Claimant Count | % of Total Claimants | | | | | |
| | | | | | Price Protection Descripton | Retail | Average Surcharge | Savings | |
| From Retail | | Count | | | | | | | | |
| In Network Service | | | 3,8,5 | 100.00% | | | | | |
| | | | | | Coatings | | | | |
| Out of Network Service | | | 1 | 0.26% | | | | | |
| | | | | | Anti-Reflective Coating: Tier I | $9,1 | $2,5 | $4,1,1,2 | 62 |
| Total Claimants | | | | | | | | | |
| | | 3,8,5 | 100.00% | | | | | | |
| | | | | | Anti-Reflective Coating: Tier II | $1,0,4 | $5,0 | $5,4 | 1 |
| Anti-Reflective Coating: Tier III | $1,1,3 | $5,7 | $2,8,3,8 | 51 |
| Anti-Reflective Coating: Tier IV | $1,6,0 | $9,5 | $3,0,7,5 | 47 |
| Photochromic | $1,4,7 | $6,7 | $3,6,9,3 | 46 |
| Tint | $4,2 | $1,4 | $1,1,2 | 4 |
| UV Coating | $2,2 | $4 | $2,4,0 | 13 |
| Examination | | | | |
| Retinal Screening | $4,7 | $0 | $9,4 | 2 |
| Lenses | | | | |
| Progressive Lenses: Tier I | $2,2,2 | $5,5 | $1,5,0,3 | 9 |
| Progressive Lenses: Tier II | $2,8,2 | $1,0,0 | $2,0,0,2 | 11 |
| Progressive Lenses: Tier III | $3,5,7 | $1,5,0 | $6,0,0,3 | 29 |
| Progressive Lenses: Tier IV | $4,3,7 | $6,7 | $2,2,2,2 | 6 |
| Progressive Lenses: Tier V | $4,8,8 | $2,5,0 | $7,1,4 | 3 |
| Roll and Polish Edges | $2,9 | $1,3 | $1,6,0 | 10 |
| Materials | | | | |
| High Index (<= 1.66) | $9,7 | $3,4 | $9,4,1 | 15 |
| High Index (1.67-1.73) | $1,6,0 | $6,1 | $2,0,8,6 | 21 |
| Polycarbonate Lenses for Adults | $6,8 | $2,9 | $4,0,2,2 | 104 |
| Polycarbonate Lenses for Children | $6,2 | $3 | $2,1,3,3 | 36 |
| Price Protection Savings To Members | | | $3,5,6,5,2 | 470 |
| *Retail price values are based upon network averages. Lower retail prices than those reflected may be available at some value-based and online retailers. | | | | |
*Most other lens options are offered with at least a 20% discount off of retail. Check with your provider. May not apply at some locations.
&"Arial,Regular"&10 OVMCR-15A &"Arial,Regular"&10 Run Date Time: 12/8/2025 image3.jpg image4.jpg image7.png