Carrier's Explanation of Benefits Forms
| Form Name | Carrier's Explanation of Benefits |
| Form # | WC-739 |
| Form Revision | (Rev. 8/19) |
| Category | Forms » Insurance |
| Downloads | |
| Form State | Michigan |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |
| Form Name | Carrier's Explanation of Benefits |
| Form # | WC-739 |
| Form Revision | (Rev. 8/19) |
| Category | Forms » Insurance |
| Downloads | |
| Form State | Michigan |
| Language | English |
| State Description | n/a |
| Claimwire Description | n/a |