Tracking Details - #4351
Tracking Information
Case No: 3129
Order Date:
02/04/2026
Due Date:
—
Template Packet: New York HIPAA Authorization Packet
Scope:
—
Location: 21 Century Radiology & Imaging
3140 Coney Island Avenue
Brooklyn, NY 11235
Phone: (718) 891-2100
• Fax: (718) 513-1588
Patient: Hugh Jackman
DOB: 11/11/1950
• SSN: ***-**-4516
Requested Records
| Record | Status |
|---|---|
| Billing | Fulfilled |
| Films | Fulfilled |
| File Name | Uploaded Date | Uploaded By |
|---|---|---|
| HIPAA_Authorization_3129_20260204074415.pdf | 2026-02-04 |
Tracking Step Log
| Step | Due Date | Remarks | Publish | Entered |
|---|---|---|---|---|
| Received Order, In Progress | Yes | 2/4/2026 7:44 AM | ||
| Generation Dept - Printed Packet | 2/4/2026 | Yes | 2/4/2026 12:44 PM | |
| Fax sent | 2/4/2026 | No | 2/4/2026 3:13 PM | |
| Fax delivery confirmed | 2/4/2026 | Fax delivered (manual) | No | 2/4/2026 3:14 PM |
| Assigned To: | 2/6/2026 | Assigned To: UserNo=1006 [INITIAL] | No | 2/4/2026 3:14 PM |
| Received - All Records | Received - Records | Yes | 3/3/2026 2:01 AM |
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