Anthem BlueCross of California
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Groups of 2-50
Groups of 51+
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Health & Wellness
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Anthem Blue Cross : EPSDT Information
If you want more information on Anthem Blue Cross’ State Sponsored Business provider resources for EPSDT services and the state of California’s state-sponsored programs, please call a Community Resource Coordinators’ office near you:
Los Angeles/San Diego
United States Health and Human Services Administration for Children and Families Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Preventive Care Forms
The following forms are provided:
Chart Under 1 Month
Chart - 1 to 2 Months
Chart - 3 to 4 Months
Chart - 5 to 6 Months
Chart - 7 to 9 Months
Chart - 10 to11 Months
Chart - 12 to 15 Months
Chart - 16 to 23 Months
Chart - 2 Years
Chart - 3 Years
Chart - 4 to 5 Years
Chart - 6 to 8 Years
Chart - 9 to 12 Years
Chart - 13 to 16 Years
Chart - 17 to 20 Years
Note: Documents are in MS Word format
HEDIS Measure: Physician Documentation Guidelines and Administrative Codes
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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.