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MEDICAREDEDUCTIBLE AND COINSURANCECommon Billing Errors Medicaid Primary If problems are encountered with the Medicare Crossover claim process, the DMAS-30 invoice form should be completed and forwarded to: Title XVIII Common Mistakes Locator 7 - Other Coverage Locator 8 - Type Coverage Locator 17- Charges to Medicare Locator 18- Allowed By Medicare Locator 19- Paid By Medicare Locator 20- Deductible Locator 21- Coinsurance Locator 22- Paid By Carrier Other Than Medicare Locator 23- Patient Pay Amount (LTC Only) Title XVIII- Block 01 Title XVIII- Block 06 Block 7 Pati