What the heck? They can't bill both an annual preventive wellness visit and an office visit on the same day, unless those were separate visits and the doctor or their billing team added a modifier to one of the charges indicating they were separate visits.

It looks like the doctor's office billed your insurance twice for one visit, and I'm surprised the insurance company appears to have paid both charges. Also, one charge is for new patients and the other is for established pts lol.

Anyway, btw, if the insurance company is willing to pay 58-24.96=$33.04 for an alcohol screening, then the doctor needs to charge at least $$33.04 if they want to maximize their revenue. If they only charged $10, then the insurance would only pay out $10 even though they would be willing to pay up to $33.04 if asked.

So, if some insurance company your doctor works with is willing to pay $50, then it's easiest for the doctor to just bill all insurances $58 and adjust off whatever isn't paid. There are other reasons a doctor's office might bill such a seemingly high amount for alcohol screening, but this seems like one of the likeliest.