770 Mason St
Vacaville CA 95688
Medical School: Wayne State University School Of Medicine - 1982
Accepts Medicare: No
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: G62168
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Awards & Recognitions
Dr. Edward Levin is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:51726||Description:Complex cystometrogram||Average Price:$1,567.17||Average Price Allowed
|HCPCS Code:51727||Description:Cystometrogram w/up||Average Price:$1,363.00||Average Price Allowed
|HCPCS Code:52234||Description:Cystoscopy and treatment||Average Price:$1,088.00||Average Price Allowed
|HCPCS Code:55700||Description:Biopsy of prostate||Average Price:$1,049.00||Average Price Allowed
|HCPCS Code:52000||Description:Cystoscopy||Average Price:$958.00||Average Price Allowed
|HCPCS Code:76942||Description:Echo guide for biopsy||Average Price:$879.00||Average Price Allowed
|HCPCS Code:J9217||Description:Leuprolide acetate suspnsion||Average Price:$763.00||Average Price Allowed
|HCPCS Code:76872||Description:Us transrectal||Average Price:$636.00||Average Price Allowed
|HCPCS Code:51703||Description:Insert bladder cath complex||Average Price:$632.00||Average Price Allowed
|HCPCS Code:76775||Description:Us exam abdo back wall lim||Average Price:$510.00||Average Price Allowed
|HCPCS Code:99204||Description:Office/outpatient visit new||Average Price:$552.00||Average Price Allowed
|HCPCS Code:51741||Description:Electro-uroflowmetry first||Average Price:$376.00||Average Price Allowed
|HCPCS Code:64566||Description:Neuroeltrd stim post tibial||Average Price:$439.00||Average Price Allowed
|HCPCS Code:51701||Description:Insert bladder catheter||Average Price:$320.00||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$364.00||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$362.00||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$244.00||Average Price Allowed
|HCPCS Code:99212||Description:Office/outpatient visit est||Average Price:$147.00||Average Price Allowed
|HCPCS Code:96372||Description:Ther/proph/diag inj sc/im||Average Price:$84.00||Average Price Allowed
|HCPCS Code:J0696||Description:Ceftriaxone sodium injection||Average Price:$7.00||Average Price Allowed
HCPCS Code Definitions
- Injection, ceftriaxone sodium, per 250 mg
- Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)
- Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)
- Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique
- Complex cystometrogram (ie, calibrated electronic equipment)
- Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm)
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
- Cystourethroscopy (separate procedure)
- Complex uroflowmetry (eg, calibrated electronic equipment)
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming
- Biopsy, prostate; needle or punch, single or multiple, any approach
- Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
- Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation
- Ultrasound, transrectal
- Leuprolide acetate (for depot suspension), 7.5 mg
Medical Malpractice Cases
Medical Board Sanctions
Cardiovascular Disease (Cardiology)
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Levin has made to other doctors
Neuro-anatomic mapping of dopamine D1 receptor involvement in nicotine self-administration in rats. - Neuropharmacology
Dopaminergic signaling has long been known to be a critical factor in nicotine addiction, as well as other drugs of abuse. Dopaminergic projections from the VTA to the nucleus accumbens and prefrontal cortex have been well established to be critical to the reinforcing effects of these drugs. However, other projections of dopamine neurons are likely to have significant roles in this process. Also, the relative contributions of D1 and D2 dopamine receptors in drug addiction and its treatment remain to be fully understood. In this study, we examined the effects of blocking D1 and D2 receptors in the nucleus accumbens shell (AcS), anterior cingulate cortex (ACC), and parietal association cortex (PtA) on nicotine self-administration in rats. Female Sprague-Dawley rats were fitted with jugular catheters and allowed to self-administer nicotine (0.03Â mg/kg/infusion) on an FR1 schedule. Rats were fitted with bilateral infusion cannulae to allow infusion of D1 or D2 antagonists (SCH-23390 or haloperidol) into each targeted brain area. Acute local infusions of SCH-23390 (1-4Â Î¼g/side) into the AcS and PtA significantly reduced nicotine self-administration by up to 75%. SCH-23390 infusion into the ACC was less effective with only suggestive non-significant reductions of nicotine self-administration. Acute, local infusions of haloperidol (0.5-2Â Î¼g/side) in any of the brain regions targeted did not have significant effects on nicotine self-administration. These results demonstrate a more significant role for D1 receptor mechanisms in the process of nicotine reinforcement and help provide a more detailed neuroanatomic map of nicotine dependence in the brain.Copyright Â© 2015. Published by Elsevier Ltd.
Pharmacological analyses of learning and memory in zebrafish (Danio rerio). - Pharmacology, biochemistry, and behavior
Over the last decade, zebrafish (Danio rerio) have become valuable as a complementary model in behavioral pharmacology, opening a new avenue for understanding the relationships between drug action and behavior. This species offers a useful intermediate approach bridging the gap between in vitro studies and traditional mammalian models. Zebrafish offer great advantages of economy compared to their rodent counterparts, their complex brains and behavioral repertoire offer great translational potential relative to in vitro models. The development and validation of a variety of tests to measure behavior, including cognition, in zebrafish have set the stage for the use of this animal for behavioral pharmacology studies. This has led to research into the basic mechanisms of cognitive function as well as screening for potential cognition-improving drug therapies, among other lines of research. As with all models, zebrafish have limitations, which span pharmacokinetic challenges to difficulties quantifying behavior. The use, efficacy and limitations associated with a zebrafish model of cognitive function are discussed in this review, within the context of behavioral pharmacology.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Heterogeneity across brain regions and neurotransmitter interactions with nicotinic effects on memory function. - Current topics in behavioral neurosciences
Nicotinic acetylcholine receptors have been shown in many studies to be critically involved in memory function. The precise roles these receptors play depend on the receptor subtype, their anatomic localization, their interactions with other parts of the neural systems underlying cognition and the particular domain of cognitive function. Nicotinic agonists can significantly improve learning, memory, and attention. Nicotinic receptors in the hippocampus are innervated by cholinergic projections from the medial septum and diagonal band. Local infusions of either Î±7 or Î±4Î²2 nicotinic antagonists into either the dorsal or ventral hippocampus produce amnestic effects in rats navigating about a radial arm maze. There is cholinergic innervation of nicotinic receptors in other components of the limbic system as well. In the basolateral amygdala and the anterior thalamus, similar amnestic effects of nicotinic Î±7 and Î±4Î²2 antagonists are seen. Interestingly, there are no additive amnestic effects observed in these limbic areas when Î±7 and Î±4Î²2 receptor antagonists are combined. The particular expression patterns of Î±7 and Î±4Î²2 nicotinic receptors in these limbic and cortical areas may explain this nonadditivity, but further research is needed to determine the specific cause of this phenomenon. Nicotinic receptor mechanisms in the limbic system play an important role in cognitive impairment for a variety of neurological disorders, including Alzheimer's disease and schizophrenia. Alzheimer's disease results in a dramatic decrease in hippocampal nicotinic receptor density, affecting Î±4Î²2 receptor expression most prominently. In schizophrenia, there are anomalies in Î±7 nicotinic receptor expression, which seem to be crucial for the cognitive impairment of the disorder. Chronic nicotine exposure, such as seen with tobacco use, results in an increase in nicotinic receptor density in the limbic system. This effect appears to be related to the desensitization of nicotinic receptors seen after agonist application. Open questions remain concerning the role of desensitization versus activation of nicotinic receptors in cognitive improvement.
Bupropion-varenicline interactions and nicotine self-administration behavior in rats. - Pharmacology, biochemistry, and behavior
Varenicline and bupropion each have been shown to significantly improve cessation of tobacco addiction in humans. They act through different mechanisms and the question about the potential added efficacy with their combined used has arisen. Preclinical animal models of nicotine addiction can help with the evaluation of this combined approach and what dose combinations of varenicline and bupropion may be useful for enhancing tobacco cessation. In this study, we investigated the interacting dose-effect functions of varenicline and bupropion in a rat model of nicotine self-administration. Young adult female Sprague-Dawley rats were allowed to self-administer nicotine in 1-h sessions under an FR1 reinforcement schedule. Varenicline (0.3, 1. 3 mg/kg) and bupropion (8.33, 25, 75 mg/kg) were administered alone or together 15 min before each session. The vehicle saline was the control. Higher doses of each drug alone reduced nicotine self-administration compared to control with reductions of 62% and 75% with 3 mg/kg varenicline and 75 mg/kg bupropion respectively. Lower dose varenicline which does not by itself reduce nicotine self-administration, significantly augmented bupropion effects. The 0.3 mg/kg varenicline dose combined with the 25 and 75 mg/kg bupropion doses caused greater reductions of nicotine self-administration than either dose of bupropion given alone. However, higher dose varenicline did not have this effect. Lower dose bupropion did not augment varenicline effects. Only the high bupropion dose significantly enhanced the varenicline effect. Likewise, combining 1 mg/kg varenicline with 75 mg/kg bupropion reduced self-administration to a greater extent than either dose alone. These results demonstrate that combination therapy with varenicline and bupropion may be more beneficial than monotherapy with either drug alone.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Prenatal nicotine changes the response to postnatal chlorpyrifos: Interactions targeting serotonergic synaptic function and cognition. - Brain research bulletin
Nicotine and chlorpyrifos are developmental neurotoxicants that target serotonin systems. We examined whether prenatal nicotine exposure alters the subsequent response to chlorpyrifos given postnatally. Pregnant rats received nicotine throughout gestation at 3mg/kg/day, a regimen designed to achieve plasma levels seen in smokers; chlorpyrifos was given to pups on postnatal days (PN) 1-4 at 1mg/kg, just above the detection threshold for brain cholinesterase inhibition. We assessed long-term effects from adolescence (PN30) through full adulthood (PN150), measuring the expression of serotonin receptors and serotonin turnover (index of presynaptic impulse activity) in cerebrocortical brain regions encompassing the projections that are known targets for nicotine and chlorpyrifos. Nicotine or chlorpyrifos individually increased the expression of serotonin receptors, with greater effects on males than on females and with distinct temporal and regional patterns indicative of adaptive synaptic changes rather than simply an extension of initial injury. This interpretation was confirmed by our finding an increase in serotonin turnover, connoting presynaptic serotonergic hyperactivity. Animals receiving the combined treatment showed a reduction in these adaptive effects on receptor binding and turnover relative to the individual agents, or even an effect in the opposite direction; further, normal sex differences in serotonin receptor concentrations were dissipated or reversed, an effect that was confirmed by behavioral evaluations in the Novel Objection Recognition Test. In addition to the known liabilities associated with maternal smoking during pregnancy, our results point to additional costs in the form of heightened vulnerability to neurotoxic chemicals encountered later in life.Copyright Â© 2015 Elsevier Inc. All rights reserved.
Effects of tobacco smoke constituents, anabasine and anatabine, on memory and attention in female rats. - Journal of psychopharmacology (Oxford, England)
Nicotine has been well characterized to improve memory and attention. Nicotine is the primary, but not only neuroactive compound in tobacco. Other tobacco constituents such as anabasine and anatabine also have agonist actions on nicotinic receptors. The current study investigated the effects of anabasine and anatabine on memory and attention. Adult female Sprague-Dawley rats were trained on a win-shift spatial working and reference memory task in the 16-arm radial maze or a visual signal detection operant task to test attention. Acute dose-effect functions of anabasine and anatabine over two orders of magnitude were evaluated for both tasks. In the radial-arm maze memory test, anabasine but not anatabine significantly reduced the memory impairment caused by the NMDA antagonist dizocilpine (MK-801). In the signal detection attentional task, anatabine but not anabasine significantly attenuated the attentional impairment caused by dizocilpine. These studies show that non-nicotine nicotinic agonists in tobacco, similar to nicotine, can significantly improve memory and attentional function. Both anabasine and anatabine produced cognitive improvement, but their effectiveness differed with regard to memory and attention. Follow-up studies with anabasine and anatabine are called for to determine their efficacy as therapeutics for memory and attentional dysfunction.Â© The Author(s) 2014.
Lorcaserin, a selective 5-HT(2C) receptor agonist, decreases alcohol intake in female alcohol preferring rats. - Pharmacology, biochemistry, and behavior
Serotonergic systems in the brain have been found to be important in the addiction to alcohol. The purpose of this study was to evaluate the efficacy of a novel 5-HT2c receptor agonist, lorcaserin for reducing alcohol consumption in alcohol-preferring (P) rats. Adult female rats were allowed to drink water or alcohol (12%, v/v) using a standard two-bottle choice procedure. Once stable baselines were established, the acute (0, 0.3125, 0.625 and 1.25 mg/kg, s.c.), and chronic (0, 0.625 mg/kg, sc for 10 days) effects of lorcaserin on alcohol intake and preference were assessed at different time points. In a separate experiment, the effects of lorcaserin on locomotor activity were determined. Our results show that both 0.625 and 1.25 mg/kg lorcaserin significantly reduced alcohol intake at 2, 4 and 6 h. after the drug administration. The chronic administration of 0.625 mg/kg lorcaserin significantly reduced alcohol intake up to 6h every day after the injection and there was no sign of diminished efficacy of the drug during 10-day treatment. To determine the effects of lorcaserin on sucrose intake, rats were put on a two-bottle choice of water vs a solution of 7% sucrose. The high dose of lorcaserin (1.25 mg/kg, s.c.) reduced sucrose intake only for up to 2 h. When tested for locomotor activity, lorcaserin injected 20 min before testing significantly reduced locomotor activity at all doses. However, when it was injected 5.5h before the start of the 1-h session, neither dose had a significant effect on locomotor activity. These results show the efficacy of lorcaserin in reducing alcohol intake without a significant effect on water intake and locomotion suggesting the involvement of 5-HT2c receptors in alcohol seeking behavior. Further research is warranted to determine the possible efficacy of lorcaserin or similar drugs as treatments for the treatment of alcoholism.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Decreasing nicotinic receptor activity and the spatial learning impairment caused by the NMDA glutamate antagonist dizocilpine in rats. - European journal of pharmacology
Nicotinic systems have been shown by a variety of studies to be involved in cognitive function. Nicotinic receptors have an inherent property to become desensitized after activation. The relative role of nicotinic receptor activation vs. net receptor inactivation by desensitization in the cognitive effects of nicotinic drugs remains to be fully understood. In these studies, we tested the effects of the Î±7 nicotinic receptor antagonist methyllycaconitine (MLA), the Î±4Î²2 nicotinic receptor antagonist dihydro-Î²-erythroidine (DHÎ²E), the nonspecific nicotinic channel blocker mecamylamine and the Î±4Î²2 nicotinic receptor desensitizing agent sazetidine-A on learning in a repeated acquisition test. Adult female Sprague-Dawley rats were trained on a repeated acquisition learning procedure in an 8-arm radial maze. MLA (1-4mg/kg), DHÎ²E (1-4mg/kg), mecamylamine (0.125-0.5mg/kg) or sazetidine-A (1 and 3mg/kg) were administered in four different studies either alone or together with the NMDA glutamate antagonist dizocilpine (0.05 and 0.10mg/kg). MLA significantly counteracted the learning impairment caused by dizocilpine. The overall choice accuracy impairment caused by dizocilpine was significantly attenuated by co-administration of DHÎ²E. Low doses of the non-specific nicotinic antagonist mecamylamine also reduced dizocilpine-induced repeated acquisition impairment. Sazetidine-A reversed the accuracy impairment caused by dizocilpine. These studies provide evidence that a net decrease in nicotinic receptor activity can improve learning by attenuating learning impairment induced by NMDA glutamate blockade. This adds to evidence in cognitive tests that nicotinic antagonists can improve cognitive function. Further research characterizing the efficacy and mechanisms underlying nicotinic antagonist and desensitization induced cognitive improvement is warranted.Copyright Â© 2014 Elsevier B.V. All rights reserved.
Assessment of pregnenolone effects on alcohol intake and preference in male alcohol preferring (P) rats. - European journal of pharmacology
Neuroactive steroids can modulate a variety of neurobehavioral functions via the GABAergic system. This study was conducted to determine the importance of the neurosteroid pregnenolone on the regulation of alcohol intake. The effects of acute and chronic administration of pregnenolone on alcohol intake were assessed in alcohol preferring (P) rats. The rats were injected i.p. with the vehicle or pregnenolone (25, 50 or 75 mg/kg) and their alcohol and water intake were recorded at 2, 4, 6 and 24 h. Also, the chronic effects of 50 mg/kg (i.p.) pregnenolone on alcohol intake were determined. Our results show that although the main effect of i.p. injection of pregnenolone in reducing alcohol intake was not quite significant compared with the vehicle, pregnenolone at 75 mg/kg significantly (P<0.025) reduced alcohol intake. Regarding alcohol preference, acute administration of pregnenolone both at 50 mg/kg (P<0.05) and at 75 mg/kg (P<0.025) significantly reduced alcohol preference. In chronic experiments pregnenolone given for 10 consecutive days did not show a significant effect on alcohol intake and alcohol preference. Overall, although pregnenolone given i.p. acutely and significantly reduced alcohol intake and preference, the fact that chronic treatment did not show an effect diminishes its promise to be considered for the treatment of alcoholism. However, its profile of effects might be different in human alcoholics.Copyright Â© 2014 Elsevier B.V. All rights reserved.
IV nicotine self-administration in rats using a consummatory operant licking response: sensitivity to serotonergic, glutaminergic and histaminergic drugs. - Progress in neuro-psychopharmacology & biological psychiatry
Tobacco smoking is characterized by repeated self-administration of nicotine by placing the cigarette in the mouth. The repeated hand-to-mouth self-administration is essentially a consummatory act. We recently developed a paradigm in which rats lick one of two spouts to trigger intravenous (IV) delivery of nicotine, which combines a consummatory act with rapid delivery of nicotine to model the act of tobacco smoking. We have found that rats will lick hundreds of times per nicotine infusion. In the current study, using the operant licking nicotine self-administration model with young adult Sprague-Dawley rats (0.03mg/kg/infusion of nicotine), we tested the effect of antagonists of H1 histamine receptors pyrilamine, serotonin (5HT) type 2 receptors ketanserin and N-methyl-d-aspartate (NMDA) glutamate receptors with d-cycloserine as well as an agonist of 5HT2c receptors lorcaserin, in dose ranges that we have found in previous studies to significantly reduce IV nicotine self-administration with the operant lever press operand. The H1 antagonist pyrilamine significantly reduced operant licking for nicotine self-administration. Pyrilamine caused significant reductions in the operant licking paradigm at lower doses (10 and 20mg/kg) than those we previously observed to affect responding in the operant lever press paradigm. In contrast, the 5HT2A and C antagonist ketanserin did not show an effect of reducing nicotine self-administration in the same dose range we had found in a previous study to significantly reduce operant lever press nicotine self-administration. The 5HT2C agonist lorcaserin significantly decreased nicotine self-administration in the licking paradigm at the same dose threshold as with lever press responding. The NMDA glutamate partial agonist d-cycloserine did not produce any change in nicotine self-administration with the licking operand, in contrast to its effect on the classic lever-pressing task. The rat model incorporating consummatory aspects of tobacco addiction can provide distinct and potentially more relevant information concerning possible new avenues of treatment to combat tobacco addiction.Copyright Â© 2014 Elsevier Inc. All rights reserved.
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770 Mason St Vacaville, CA 95688
3700 Vaca Valley Pkwy Kaiser Permanente Ophthalmology Department