Additional Services


Annual Exam  –  Spirometry  –  Continuous Glucose Monitoring  –  Immunizations 

Annual Exam

This is an important exam focused on prevention.  We review the recommendations by the Center for Disease Control with you for your age and make vaccine and testing recommendations.  We will review your yearly lab screening, EKG if appropriate and urinalysis to screen for blood or protein or infection.  We might perform either the yearly prostate or breast exam at that time.  We will schedule pap smears at appropriate intervals if needed for women.  Many insurances do not require that you pay copay at this visit.  Many insurances may discount your monthly premium if you are proactive and performing annual exams at your doctor’s office.


This is a test of lung function measuring how much you inhale, exhale, and how fast you exhale.  It is used to diagnose asthma, COPD, and other lung conditions.  If you have one of these conditions, spirometry is used to help us understand your status so that we can adjust medications accordingly.

Continuous Glucose Monitoring

The Dexcom CGM has been proven to help lower your A1c, alert you of trends in your blood sugar levels, and help you to avoid dangerous high or low blood sugars.  You are able to watch your dexcom monitor to view your blood glucose level in real time as you eat, excercise, etc.  Our Doctors love this data! When the monitor is turned in, our doctors will personally analyze your Dexcom report and will make lifestyle and medication changes to help optimize your diabetes control.  Most insurances will pay for this as often as monthly.



Fluzone and high dose fluzone vaccine *for seniors over 65 (who must have flu shots because they are at highest risk of being hospitalized or dying due to flu)

*Sage Medicine offers mercury free single dose vial injections for the safety of our patients

For active immunization of persons 6 months of age and older against influenza disease caused by influenza virus subtypes A and type B contained in the vaccine.  Each year the scientists try to predict the 3 or 4 most dangerous influenza viruses that will circulate and create a new vaccine so this vaccine is given yearly between September through end of season as late as April.  The patients who receive the flu vaccine are less likely to get the flu and if they do get the flu, they are less likely to be hospitalized or die of the flu.

Pneumovax 23 & Prevnar 13

For vaccinations of all adults 65 years of age and older and anyone 2 through 64 years of age with special chronic conditions or in special environments or settings that place them at risk for potentially life threatening pneumococcal pneumonia or pneumococcal sepsis.


All persons should receive a primary vaccine series, ideally during childhood, of tetanus/diphtheria/pertussis vaccine. Following completion of a primary series, a booster dose of tetanus- containing vaccine should be given every 10 years to maintain immunity against tetanus however some insurances are only covering Tdap under preventative health care coverage.  The Tetanus/diphtheria vaccine is often given after cut, puncture wound or dirty abrasion.  Medicare plans do not cover this vaccine.

Tdap (Adacel)

Tetanus/diphtheria/pertussis preventative vaccine

For persons 11 through 64 and adults ages 65 years and older who have or who anticipate having close contact with an infant less than 12 months of age and who previously have not received Tdap.  This vaccine is being covered by most insurances except Medicare under preventative health care coverage and is given to prevent tetanus as well.

Hepatitis B (Engeriz-B)

For anyone at risk of contracting Hepatitis B, such as health care worker, travel outside U.S., etc.

Hepatitis B vaccine is given in a three-dose schedule at 0, 1, and 6 months.  Serum antibody response (blood test) is checked 2 months after completion of vaccine series and higher dose booster is sometimes given if inadequate response.


Shingrix is a new vaccine for shingles that is up 90-98% effective, depending on age.  Most insurances approve it even if the patient has had the Zostavax greater that 3 months prior.