Patent Publication Number: US-10777310-B2

Title: Methods and systems for automated pharmaceutical dispensing

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation application of U.S. patent application Ser. No. 15/610,123 filed on May 31, 2017; said application Ser. No. 15/610,123 is a continuation of U.S. patent application Ser. No. 14/807,596 filed on Jul. 23, 2015 and issued as U.S. Pat. No. 9,697,335 on Jul. 4, 2017; said applications are incorporated herein by reference in their entirety. 
    
    
     FIELD 
     The present application relates generally to the technical field of automated filling centers. In a specific example, the present application may relate to a high volume fulfillment center, e.g., a high volume pharmacy and to systems and devices used in filling prescriptions and prescription orders at a high volume pharmacy. 
     BACKGROUND 
     A high-volume pharmacy may process and fill a large number of prescriptions and prescription orders. Automated systems may be used by a high volume pharmacy to process and fulfill prescriptions. 
     Frequently, more than one prescription drug is required to complete a prescription order. Portions of the prescription order may be fulfilled in different areas of the high-volume pharmacy. After fulfillment, the fulfilled prescriptions may be gathered into a complete prescription order for shipping. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a block diagram of an example system, according to an example embodiment; 
         FIG. 2  is a block diagram of an example automated dispensing device that may be deployed within the system of  FIG. 1 , according to an example embodiment; 
         FIG. 3  is a top, perspective view of a pallet that may be deployed within the system of  FIG. 1 , according to an example embodiment; 
         FIG. 4  is a perspective view of an automated dispensing subsystem that may be deployed within the automated dispensing device of  FIG. 2 , according to an example embodiment; 
         FIG. 5  is a front view of the automated dispensing subsystem of  FIG. 4 ; 
         FIG. 6  is a side, cross-sectional view of the automated dispensing subsystem of  FIG. 4 ; 
         FIG. 7  is a side perspective view of a funnel that may be deployed in a filling cabinet of an automated dispensing subsystem, according to an example embodiment; 
         FIG. 8  is an interior view of a cell that may be deployed in a filling cabinet of an automated dispensing subsystem, according to an example embodiment; 
         FIG. 9  is a view of an insert that may be deployed in a filling cabinet of an automated dispensing subsystem, according to an example embodiment; 
         FIG. 10  is a side view of a buffer tube that may be deployed within the automated dispensing subsystem of  FIG. 4 , according to an example embodiment; 
         FIG. 11  is a view of a portion of the buffer tube of  FIG. 12 ; 
         FIG. 12  is a top view of a pallet assembly of the automated dispensing subsystem of  FIG. 4 , according to an example embodiment; 
         FIG. 13  is a side view of a pallet assembly of  FIG. 12 ; 
         FIG. 14  is a diagram of a control subsystem that may be deployed within the automated dispensing device of  FIG. 2 , according to an example embodiment; 
         FIG. 15  is an example process flow illustrating a method of configuring a pallet, according to an example embodiment; and 
         FIG. 16  is a block diagram of a machine in the example form of a computer system within which a set of instructions for causing the machine to perform any one or more of the methodologies discussed herein may be executed or stored. 
     
    
    
     DETAILED DESCRIPTION 
     Example systems and methods for automated pharmaceutical dispensing are described. In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of example embodiments. It will be evident, however, to one of ordinary skill in the art that these embodiments may be practiced without these specific details. 
     Generally, a prescription order is generated for a high volume pharmacy. The prescription order may include more than one prescription drug for fulfillment. Each prescription drug in a prescription order is an order component of the prescription order. Generally, the order components are pill bottles or other containers and packaging having a measured quantity of a prescription drug therein. These containers may be filled by a mostly manual process, through a semiautomatic process, or a more fully automated process. Various factors may affect the availability of filling drugs through these processes in a pharmacy. A more fully automated process may be employed in a mail order pharmacy to fill containers with most frequently used drugs. 
       FIG. 1  is a block diagram of an example system  100 , according to an example embodiment. While the system  100  is generally described as being deployed in a high volume pharmacy (e.g., a mail order pharmacy, a direct delivery pharmacy, an automated pharmacy, and the like), the system  100  may otherwise be deployed. The system  100  may include an order processing device  102  in communication with a benefit manager device  106  over a network  104 . In an example embodiment, the order processing device  102  may implement functions described in U.S. patent application Ser. No. 12/874,107, which is hereby incorporated by reference, to move a patient to a high volume pharmacy. Additional devices which may be in communication with the benefit manager device  106  and/or the order processing device  102  over network  104  include: database(s)  108  which may store one or more than one of order data  110 , member data  112 , claims data  114 , drug data  116 , prescription data  118 , and plan sponsor data  120 ; pallet sizing and pucking device(s)  122 ; loading device(s)  124 ; inspect device(s)  126 ; unit of use device(s)  128 ; automated dispensing device(s)  130 ; manual fulfillment device(s)  132 ; review device(s)  134 ; imaging device(s)  136 ; cap device(s)  138 ; accumulation device(s)  140 ; literature device(s)  141 ; packing device(s)  142 ; and unit of use packing device(s)  144 . The system  100  may also include additional devices, which may communicate with each other over network  104  or directly. 
     The order processing device  102  may receive information about prescriptions being filled at a pharmacy in which the order processing device  102  is deployed. In general, the order processing device  102  is a device located within or otherwise associated with a pharmacy location to enable fulfillment of a prescription by dispensing prescription drugs. In some embodiments, the order processing device  102  may be a device separate from a pharmacy that enables communication with other devices located within a pharmacy. For example, the order processing device  102  may be in communication with another order processing device  102  and/or other devices  122 - 144  located with a pharmacy. In some embodiments, an external pharmacy order processing device  102  may have limited functionality (e.g., as operated by a patient requesting fulfillment of a prescription drug) when an internal pharmacy order processing device  102  may have greater functionality (e.g., as operated by a pharmacy). 
     The order processing device  102  may track a prescription order as it is fulfilled. A prescription order may include one or more than one prescription to be filled by the pharmacy. The order processing device  102  may make pharmacy routing decisions and/or order consolidation decisions for a prescription order. The pharmacy routing decisions include what device or devices in the pharmacy are responsible for filling at least a portion of the prescription order, where the order consolidation decisions include whether portions of a prescription order or multiple prescription orders should be shipped together for a patient or a patient family. The order processing device  102  may operate on its own or in combination with the benefit manager device  106 . The order processing device  102  may track and/or schedule the literature or other paperwork associated with each order or multiple prescription orders that are being shipped together. 
     Examples of the devices  102 ,  106  include a set-top box (STB), a receiver card, a mobile telephone, a personal digital assistant (PDA), a display device, a portable gaming unit, a tablet, and a computing system; however other devices may also be used. For example the devices  102 ,  106  may include a mobile electronic device, such an IPHONE or IPAD device by Apple, Inc. mobile electronic devices powered by ANDROID by Google, Inc. and a BLACKBERRY device by Blackberry Limited. The devices  102 ,  106  may also include other computing devices, such as desktop computing devices, notebook computing devices, netbook computing devices, gaming devices, and the like. The devices  102 ,  106  may include a processor, a memory to store data and instructions, and communication functionality. Other types of electronic devices that can use rules and instructions to execute various functions may also be used. 
     Examples of the network  104  include Mobile Communications (GSM) network, a code division multiple access (CDMA) network, 3rd Generation Partnership Project (3GPP), an Internet Protocol (IP) network, a Wireless Application Protocol (WAP) network, a WiFi network, or an IEEE 802.11 standards network, as well as various combinations thereof. The network  104  may include optical communications. The network  104  may be a local area network or a global communication network, such as the Internet. Other conventional and/or later developed wired and wireless networks may also be used. In some embodiments, the network  104  may include a prescribing network such as the electronic prescribing network operated by Surescripts of Arlington, Va. 
     The benefit manager device  106  is a device operated by an entity at least partially responsible for creation and/or management of the pharmacy or drug benefit. While this benefit manager operating the benefit manager device  106  is typically a pharmacy benefit manager (PBM), other entities may operate the benefit manager device  106  either on behalf of themselves, the PBM, or another entity. For example, the benefit manager may be operated by a health plan, a retail pharmacy chain, a drug wholesaler, a data analytics or other type of software-related company, or the like. In some embodiments, a PBM that provides the pharmacy benefit may also provide one or more than one additional benefits including a medical or health benefit, a dental benefit, a vision benefit, a wellness benefit, a radiology benefit, a pet care benefit, an insurance benefit, a long term care benefit, a nursing home benefit, and the like. The PBM may, in addition to its PBM operations, operate one or more than one pharmacy. The pharmacies may be retail pharmacies, mail order pharmacies, or otherwise. 
     Some of the operations of the PBM that operates the benefit manager device  106  may include the following. A member (or a person on behalf of the member) of a pharmacy benefit plan administered by or through the PBM attempts to obtain a prescription drug at a retail pharmacy location where the member can obtain drugs in a physical store from a pharmacist or pharmacist technician, or in some instances through mail order drug delivery from a mail order pharmacy location. The member may also obtain a prescription drug directly or indirectly through the use of a machine, such as a kiosk, vending unit, mobile electronic device, or a different type of mechanical, electrical, electronic communication device and/or computing device. 
     The member may have a co-pay for the prescription drug that reflects an amount of money that the member is responsible to pay the pharmacy for the prescription drug. The money paid by the member to the pharmacy may come from the personal funds of the member, a health savings account (HSA) of the member or the member&#39;s family, a health reimbursement arrangement (HRA) of the member or the member&#39;s family, a flexible spending accounts (FSA) of the member or the member&#39;s family, or the like. An employer of the member may directly or indirectly fund or reimburse the member or an account of the member for the co-pay. 
     The amount of the co-pay paid by the member may vary by the benefit plan of a plan sponsor or client with the PBM. The member&#39;s co-pay may be based on a flat co-pay (e.g., $10), coinsurance (e.g., 10%), and/or a deductible (e.g., for first $500 of annual prescription drug spend) for certain prescription drugs, certain types and/or classes of prescription drugs, and/or all prescription drugs. 
     In certain instances, the member may not pay the co-pay or may only pay for a portion of a co-pay for a prescription drug. For example, if the usual and customary cost for a generic version of a prescription drug is $4, and the member&#39;s flat co-pay is $20 for the prescription drug, the member may only pay $4 to receive the prescription drug. In another example involving a worker&#39;s compensation claim, no co-pay may be due by the member for the prescription drug. The co-pay may also vary based on the delivery channel used to receive the prescription drug. For example, the co-pay for receiving prescription drug from a mail order pharmacy location may be less than the co-pay for receiving prescription drug from a retail pharmacy location. 
     In conjunction with receiving the co-pay (if any) from the member and dispensing the prescription drug to the member, the pharmacy submits a claim to the PBM for the prescription drug. The PBM may perform certain adjudication operations including verifying the eligibility of the member, reviewing an applicable formulary of the member to determine appropriate co-pay, coinsurance, and deductible for the prescription drug, and performing a drug utilization review (DUR) on the member. The PBM then provides a response to the pharmacy following performance of at least some of the aforementioned operations. As part of the adjudication, the plan sponsor (or the PBM on behalf of the plan sponsor) ultimately reimburses the pharmacy for filling the prescription drug when the prescription drug was successfully adjudicated. The aforementioned adjudication operations generally occur before the co-pay is received and the prescription drug dispensed. However, the operations may occur simultaneously, substantially simultaneously, or in a different order. In addition, more or less adjudication operations may be performed as at least part of the adjudication process. 
     The amount of reimbursement paid to the pharmacy by a plan sponsor and/or money paid by the member may be based at least in part on the type of pharmacy network in which the pharmacy is included. Other factors may be used to determine the amount in addition to the type of pharmacy network. For example, if the member pays the pharmacy for the prescription without using the prescription drug benefit provided by the benefit manager, the amount of money paid by the member may be higher and the amount of money received by the pharmacy for dispensing the prescription drug and for the prescription drug itself may be higher. Some or all of the foregoing operations may be performed by executing instructions on the benefit manager device  106  and/or an additional device. 
     In some embodiments, at least some of the functionality of the order processing device  102  may be included in the benefit manager device  106 . The order processing device  102  may be in a client-server relationship with the benefit manager device  106 , a peer-to-peer relationship with the benefit manager device  106 , or in a different type of relationship with the benefit manager device  106 . 
     The order processing device  102  and/or the benefit manager device  106  may be in communication directly (e.g., through local storage or peer-to-peer connection(s)) and/or through the network  104  (e.g., in a cloud configuration or software-as-a-service) with a database  108  (e.g., as may be retained in memory or otherwise). The database  108  may be deployed on the order processing device  102 , the benefit manager device  106 , on another device of the system  100 , or otherwise. The database  108  may store order data  110 , member data  112 , claims data  114 , drug data  116 , prescription data  118 , and/or plan sponsor data  120 . Other data may be stored in the database  108 . 
     The order data  110  may include data related to the order of prescriptions including the type (e.g., drug name and strength) and quantity of each prescription in a prescription order. The order data  110  may also include data used for completion of the prescription, such as prescription materials and/or the type and/or size of container in which the drug is or is preferably dispensed. In general, prescription materials are a type of order materials that include an electronic copy of information regarding the prescription drug for inclusion with or otherwise in conjunction with the fulfilled prescription. The prescription materials may include electronic information regarding drug interaction warnings, recommended usage, possible side effects, expiration date, date of prescribing, or the like. The order data  110  may be used by a high volume fulfillment center to fulfill a pharmacy order. In some embodiments, the order data  110  includes verification information associated with fulfillment of the prescription in the pharmacy. For example, the order data  110  may include videos and/or images taken of (i) the prescription drug prior to dispensing, during dispensing, and/or after dispensing, (ii) the prescription container (e.g., a prescription bottle and sealing lid) used to contain the prescription drug prior to dispensing, during dispensing, and/or after dispensing, (iii) the packaging and/or packaging materials used to ship or otherwise deliver the prescription drug prior to dispensing, during dispensing, and/or after dispensing, and/or (iv) the fulfillment process within the pharmacy. Other type of verification information such as bar code data read from pallets used to transport prescriptions within the pharmacy may also be stored as order data  110 . 
     The member data  112  includes information regarding the members associated with the benefit manager. The information stored as member data  112  may include personal information, personal health information, protected health information, and the like. Examples of the member data  112  include name, address, telephone number, e-mail address, prescription drug history, and the like. The member data  112  may include a plan sponsor identifier that identifies the plan sponsor associated with the member and/or a member identifier that identifies the member to the plan sponsor. The member data  112  may include a member identifier that identifies the plan sponsor associated with the patient and/or a patient identifier that identifies the patient to the plan sponsor. The member data  112  may also include, by way of example, dispensation preferences such as type of label, type of cap, message preferences, language preferences, or the like. The member data  112  may be accessed by various devices in the pharmacy, e.g., the high volume fulfillment center, to obtain information utilized for fulfillment and shipping of prescription orders. In some embodiments, an external order processing device  102  operated by or on behalf of a member may have access to at least a portion of the member data  112  for review, verification, or other purposes. 
     In some embodiments, the member data  112  may include information for persons who are patients of the pharmacy but are not members in a benefit plan being provided by the benefit manager. For example, these patients may obtain drug directly from the pharmacy, through a private label service offered by the pharmacy, the high volume fulfillment center, or otherwise. In general, the use of the terms member and patient may be used interchangeably herein. 
     The claims data  114  includes information regarding pharmacy claims adjudicated by the PBM under a drug benefit program provided by the PBM for one, or more than one, plan sponsors. In general, the claims data  114  includes an identification of the client that sponsors the drug benefit program under which the claim is made, and/or the member that purchased the prescription drug giving rise to the claim, the prescription drug that was filled by the pharmacy (e.g., the national drug code number), the dispensing date, generic indicator, GPI number, medication class, the cost of the prescription drug provided under the drug benefit program, the copay/coinsurance amount, rebate information, and/or member eligibility. Additional information may be included. In some embodiments, other types of claims beyond prescription drug claims may be stored in the claims data  114 . For example, medical claims, dental claims, wellness claims, or other type of health care-related claims for members may be stored as a portion of the claims data  114 . 
     In some embodiments, the claims data  114  includes claims that identify the members with whom the claims are associated. In some embodiments, the claims data  114  includes claims that have been de-identified (e.g., associated with a unique identifier but not with a particular, identifiable member). 
     The drug data  116  may include drug name (e.g., technical name and/or common name), other names by which the drug is known by, active ingredients, an image of the drug (e.g., in pill form), and the like. The drug data  116  may include information associated with a single medication or multiple medications. 
     The prescription data  118  may include information regarding prescriptions that may be issued by prescribers on behalf of patients, who may be members of the drug benefit plan, for example to be filled by a pharmacy. Examples of the prescription data  118  include patient names, medication or treatment (such as lab tests), dosing information, and the like. The prescriptions may be electronic prescriptions, paper prescriptions that have been scanned, or otherwise. In some embodiments, the dosing information reflects a frequency of use (e.g., once a day, twice a day, before each meal, etc.) and a duration of use (e.g., a few days, a week, a few weeks, a month, etc.). 
     In some embodiments, the order data  110  may be linked to associated member data, claims data  114 , drug data  116 , and/or prescription data  118 . 
     The plan sponsor data  120  includes information regarding the plan sponsors of the benefit manager. Examples of the plan sponsor data  120  include company name, company address, contact name, contact telephone number, contact e-mail address, and the like. 
     The order processing device  102  may direct at least some of the operations of the devices  122 - 144 , recited above. In some embodiments, operations performed by one of these devices  122 - 144  may be performed sequentially, or in parallel with the operations of another device as may be coordinated by the order processing device  102 . In some embodiments, the order processing device  102  tracks a prescription with the pharmacy based on operations performed by one or more of the devices  122 - 144 . 
     In some embodiments, the system  100  may transport prescription drug containers (e.g., between one or more than one of the devices  122 - 144  in the high volume fulfillment center) by use of pallets. The pallet sizing and pucking device  122  may configure pucks in a pallet. A pallet may be a transport structure for a number of prescription containers, and may include a number of cavities. A puck may be placed in one or more than one of the cavities in a pallet by the pallet sizing and pucking device  122 . A puck may include a receptacle sized and shaped to receive a prescription container. Such containers may be supported by the pucks during carriage in the pallet and during movement through the fulfillment process. Different pucks may have differently sized and shaped receptacles to accommodate containers of differing sizes, as may be appropriate for different prescriptions. Pucks allow the standardization of equipment engaging differently sized drug containers such that some automated equipment can move the drug container by gripping the puck that is supporting the container and allow the use of a standardized pallet that holds a plurality of pucks have a same outer dimension while having differently sized receptacles therein to hold differently sized drug containers. The pucks may also operate to ensure that a drug container is centered in a location on the pallet. 
     The arrangement of pucks in a pallet may be determined by the order processing device  102  based on prescriptions which the order processing device  102  decides to launch. In general, prescription orders in the order database  110  reside in one or more than one queues, and are generally launched in a first-in-first-out order. However, the order processing device  102  may use logic and a variety of factors to determine when and how prescriptions are to be launched. For example, some non-limiting factors which may alter the first-in-first-out order of launching prescriptions in a pharmacy include the age of the order, whether the order required an outreach to a physician or some other intervention, whether there are any performance guarantees with plan sponsors or members, the available inventory of a given pharmaceutical in view of existing prescriptions already launched which will require that pharmaceutical, the zip code to which the order will be shipped, the workload and volume of various parts of the pharmacy, whether valid paperwork for the order has been received, and/or similar orders for the same pharmaceutical that are already to be launched. The logic may be implemented directly in the pallet sizing and pucking device  122 , in the order processing device  102 , in both devices  102 ,  122 , or otherwise. Once a prescription is set to be launched, a puck suitable for the appropriate size of container for that prescription may be positioned in a pallet by a robotic arm or pickers. The pallet sizing and pucking device  122  may launch a pallet once pucks have been configured in the pallet. The loading device  124  may load prescription containers into the pucks on a pallet by a robotic arm, pick and place mechanism, or the like. In one embodiment, the loading device  108  has robotic arms or pickers to grasp a prescription container and move it to and from a pallet. The loading device  124  may also print a label which is appropriate for a container that is to be loaded onto the pallet, and apply the label to the container. The pallet may be located on a conveyor assembly during these operations. In an example embodiment, the drug containers may be positioned in the pucks by the loading device  124  prior to the pucks being placed in the pallet. The inspect device  126  may verify that containers in a pallet are correctly labeled and in the correct spot on the pallet. The inspect device  126  may scan the label on one or more than one container on the pallet. Labels of containers may be scanned or imaged in full or in part by the inspect device  126 . Such imaging may occur after the container has been lifted out of its puck by a robotic arm, picker, or the like, or may be otherwise scanned or imaged while retained in the puck. In some embodiments, images and/or video captured by the inspect device  126  may be stored in the database  108  as order data  110 . 
     The unit of use device  128  may temporarily store, monitor, label and/or dispense unit of use products. In general, unit of use products are prescription drug products that may be delivered to a patient or member without being repackaged at the pharmacy. These products may include pills in container, pills in a blister pack, inhalers, and the like. Pills to be placed in a container may include, and not be limited to, capsules, tablets, caplets, lozenges, and other solid medium with a pharmaceutical component that may be ingested by a person or other mammal. Prescription drug products dispensed by the unit of use device  128  may be packaged individually or collectively for shipping, or may be shipped in combination with other prescription drugs dispensed by other devices in the high volume fulfillment center. 
     The automated dispensing device  130  may include one or more than one devices that dispense prescription drugs or pharmaceuticals into prescription containers in accordance with one or multiple prescription orders. In general, the automated dispensing device  130  may include mechanical and electronic components with, in some embodiments, software and/or logic to facilitate pharmaceutical dispensing that would otherwise be performed in a manual fashion by a pharmacist and/or pharmacist technician. For example, the automated dispensing device  130  may include high volume fillers that fill a number of prescription drug types at a rapid rate and blister pack machines that dispense and pack drugs into a blister pack or other pre-packaged form of pills. Prescription drugs dispensed by the automated dispensing devices  130  may be packaged individually or collectively for shipping, or may be shipped in combination with other prescription drugs dispenses by other devices in the high volume fulfillment center. 
     The automated dispensing device  130  may be used, for example, to dispense commonly prescribed dispense drugs in an automatic or semiautomatic method into containers. Drugs may be dispensed in connection with filling one or more than one prescriptions (or portions of prescriptions). Drugs dispensed by the automated dispensing device  130  may be tablets, pills, capsules, caplets, or other types of drugs suitable for dispensing by a the automated dispensing device  130 . 
     The manual fulfillment device  132  may provide for manual fulfillment of prescriptions. For example, the manual fulfillment device  132  may receive or obtain a container and enable fulfillment of the container by a pharmacist or pharmacy technician. In some embodiments, the manual fulfillment device  132  provides the filled container to another device in the system  100 . In an example embodiment, the container may be joined with other containers in a prescription order for a patient or member, e.g., on a pallet or at the accumulation device  140 . In general, a manual fulfillment may include operations at least partially performed by a pharmacist or pharmacy technician. For example, a person may retrieve a supply of the prescribed drug, may make an observation, may count out a prescribed quantity of drugs and place them into a prescription container, or the like. Some portions of the manual fulfillment process may be automated by use of a machine. For example, counting of capsules, tablets, or pills may be at least partially automated (e.g., through use of a pill counter). Prescription drugs dispensed by the manual fulfillment device  132  may be packaged individually or collectively for shipping, or may be shipped in combination with other prescription drugs dispenses by other devices in the high volume fulfillment center. 
     The review device  134  may process prescription containers to be reviewed by a pharmacist for proper pill count, exception handling, prescription verification, and the like. Fulfilled prescriptions may be manually reviewed and/or verified by a pharmacist, as may be required by state or local law. A pharmacist or other licensed pharmacy person who may dispense certain drugs in compliance with local and/or other laws may operate the review device  134  and visually inspect a prescription container that has been filled with a prescription drug. The pharmacist may review, verify, and/or evaluate drug quantity, drug strength, and/or drug interaction concerns, or otherwise perform pharmacist services. The pharmacist may also handle containers which have been flagged as an exception, such as containers with unreadable labels, containers for which the associated prescription order has been cancelled, containers with defects, and the like. In an example embodiment, the manual review can be performed at the manual station. 
     The imaging device  136  may image containers after they have been filled with pharmaceuticals. The imaging device  136  may measure the fill height of the pharmaceuticals in the container based on the obtained image to determine if the container is filled to the correct height given the type of pharmaceutical and the number of pills in the prescription. Images of the pills in the container may also be obtained to detect the size of the pills themselves and markings thereon. The images may be transmitted to the order processing device  102 , and/or stored in the database  110  as part of the order data  110 . 
     The cap device  138  may be used to cap or otherwise seal a prescription container. In some embodiments, the cap device  138  may secure a prescription container with a type of cap in accordance with a patient preference (e.g., a preference regarding child resistance), a plan sponsor preference, a prescriber preference, or the like. The cap device  138  may also etch a message into the cap or otherwise associate a message into the cap, although this process may be performed by a subsequent device in the high volume fulfillment center. Etching may be performed according to the teachings in U.S. patent application Ser. No. 14/313,042, which is hereby incorporated by reference. The accumulation device  140  accumulates various containers of prescription drugs in a prescription order. The accumulation device  140  may accumulate prescription containers from various devices or areas of the pharmacy. For example, the accumulation device  140  may accumulate prescription containers from the unit of use device  128 , the automated dispensing device  130 , the manual fulfillment device  132 , and the review device  134 , at the high volume fulfillment center. The accumulation device  140  may be used to group the prescription containers prior to shipment to the member or otherwise. In some embodiments, the literature device  141  folds or otherwise prepares the literature for inclusion with a prescription drug order (e.g., in a shipping container). In some embodiments, the literature device  141  that prints the literature may be separate from the literature device that prepares the literature for inclusion with a prescription order. 
     The packing device  142  packages a prescription order in preparation for shipping the order. The packing device  142  may box, bag, or otherwise package the fulfilled prescription order for delivery. The packing device  142  may further place inserts, e.g., literature or other papers into the packaging received from the literature device  141  or otherwise. For example, bulk prescription orders may be shipped in a box, while other prescription orders may be shipped in a bag which may be a wrap seal bag. The packing device  142  may label the box or bag with the address and a recipient&#39;s name. The label may be printed and affixed to the bag or box, be printed directly onto the bag or box, or otherwise associated with the bag or box. The packing device  142  may sort the box or bag for mailing in an efficient manner (e.g., sort by delivery address). The packing device  142  may include ice or temperature sensitive elements for prescriptions which are to be kept within a temperature range during shipping in order to retain efficacy or otherwise. The ultimate package may then be shipped through postal mail, through a mail order delivery service that ships via group and/or air (e.g., UPS, FEDEX, or DHL), through delivery service, through a local delivery service (e.g., a courier service), through a locker box at a shipping site (e.g., an AMAZON locker or a post office box), or otherwise. 
     The unit of use packing device  144  packages a unit of use prescription order in preparation for shipping the order. The unit of use packing device  144  may include manual scanning of containers to be bagged for shipping to verify each container in the order. In an example embodiment, the manual scanning may be performed at a manual station. 
     While the system  100  in  FIG. 1  is shown to include single devices  102 ,  106 ,  122 - 144  multiple devices may be used. The devices  102 ,  106 ,  122 - 144  may be the same type or model of device or may be different device types or models. When multiple devices are present, the multiple devices may be of the same device type or models or may be a different device type or model. The types of devices  102 ,  106 ,  122 - 144  shown in  FIG. 1  are example devices. In other configurations of the system  100 , lesser, additional, or different types of devices may be included. 
     Moreover, the system  100  shows a single network  104 ; however, multiple networks can be used. The multiple networks may communicate in series with each other to link the devices  102 ,  106 ,  122 - 144  or in parallel to link the devices  102 ,  106 ,  122 - 144 . Multiple devices may share processing and/or memory resources. The devices  102 ,  106 ,  122 - 144  may be located in the same area or in different locations. For example, the devices  102 ,  106 ,  122 - 144  may be located in a building or set of adjoining buildings. The devices  102 ,  106 ,  122 - 144  may be interconnected (e.g. by conveyors), networked, and/or otherwise in contact with one another or integrated with one another e.g., at the high volume fulfillment center. In addition, the functionality of a device may be split among a number of discrete devices and/or combined with other devices. 
     The system  100  may include a single database, or multiple databases, maintained by respective devices operated by or on behalf one or a number of different persons and/or organizations. The communication may occur directly (e.g., through local storage) and/or through the network  104  (e.g., in a cloud configuration or software-as-a-service) with a device that stores a respective database. 
       FIG. 2  illustrates an automated dispensing device  130 , according to an example embodiment. The automated dispensing device  130  may be deployed in the system  100  of  FIG. 1 , or may otherwise be used. The automated dispensing device  130  may include a control subsystem  202  and an automated dispensing subsystem  204 . The control subsystem  202  may include one or more module and enables the automated dispensing device  130  to control the automated dispensing subsystem  204 , while the automated dispensing subsystem  204  may include one or more device and enables the automated dispensing device  130  with dispensing operations (e.g., dispensing a measured quantity pharmaceuticals into a container). 
     An example deployment of the automated dispensing device  130  is within the system  100 . In such a deployment, the system  100  includes one or more than one conveyor or other devices to facilitate transporting containers or pallets of containers through mechanical devices within the system  100 , such as devices to label, fill, cap, and check containers. The automated dispensing device  130  may be otherwise deployed. 
       FIG. 3  illustrates a pallet  302 , according to an example embodiment. The pallet  302  may be used in the system  100  of  FIG. 1  (e.g., by the automated dispensing device  130 ), or may be otherwise used. 
     The pallet  302  may be a transport structure for a number of prescription containers  304 , and may include a number of cavities  306 . While the pallet  302  is shown to include 25 cavities in a five by five cavity row/column configuration, other numbers of categories and/or cavity configurations of varying shapes, size, and/or dimensions may be used. In some embodiments the pallet may be substantially square and, in such an embodiment, have a width and length of between approximately 18 inches and 22 inches (e.g., approximately 18 inches, 19 inches, 20 inches, 21 inches, or 22 inches). In some embodiments, the width and/or length may be greater than approximately 22 inches or less than approximately 18 inches. 
     In an example embodiment, the cavities  306  are spaced on the pallet  302  such that the center point of adjacent cavities  306  is between approximately 3 inches and 4 inches (e.g., approximately 3 inches, 3.25 inches, 3.5 inches, 3.75 inches or 4 inches). In another example embodiment, the distance between center points of adjacent cavities  306  is more than approximately 4 inches. In yet another example embodiment, the center points of cavities  306  are less than approximately 3 inches apart. 
     The pallet  302  may be made in whole or in part of metal, such as aluminum. Other suitable materials may be used for the pallet  302 , such as plastic. The pallet  302  may be rigid so that the cavities remain in a known location that can be tracked while the pallet moves through the system  100 . The pallet  302  may include bumpers. 
     In some embodiments, other carriers beyond the pallet  302  and/or no carrier may be used to move containers or groups of containers through the system  100  or via the automated dispensing subsystem  204 . 
     The pallet  302  may retain one or more than one containers  304 . A container  304  is generally cylindrical and may be of one or a variety of sizes utilized by a pharmacy for fulfillment of a prescription. For example, a pharmacy may have two different sized containers or three different sized containers. Any number of different sized containers may be used with the pallet  302 . While the container  304  is generally denoted as being used with the pallet  302 , the containers  304  may otherwise be used in the system  100  or in a different system. Shapes beyond cylindrical shapes may be used for the containers  304 . Examples of other shapes include regular prisms, elliptical cylinders, and combinations thereof. The receptacle of a puck may be sized to receive and support the outer shape of the container. The containers  304  may be disposed in the pallet  302  such that they are close to one another but do not touch. 
     The pallet  302  may include a radio-frequency identification (RFID) tag  308 . The RFID tag  308  may be an active RFID tag, such as an active RFID tag with a close reading range. In some embodiments, the RFID tag  308  is an active, narrowband, read/write RFID tag. 
     The RFID tag  308  of a particular pallet  302  may store data (or otherwise facilitate the access of data, e.g., from the database  108 ) associated with the containers  304  that have been, are, and/or will be placed within the pallet  302 , such as the order data  110 , the member data  112 , the claims data  114 , the drug data  116 , the prescription data  118 , and/or the plan sponsor data  120  associated with such containers  304 . Other data may be stored by and/or or associated with the RFID tag  314 , such as the age of the pallet  302 , the number of times the pallet  302  has been used to transport containers  304  through the system  100 , the number of errors associated with the pallet  302 , and the like. The RFID tag  314  may also store the position of individual containers on the pallet  302 . In an example embodiment, the RFID tag  308  of the pallet  302 , while deployed within an automated dispensing subsystem  204 , stores data associated with one or more of the following data fields: (1) container identifiers, (2) identifier of the particular automated dispensing subsystem  204 , (3) identifiers of the particular cells from which a particular container will be filled (as described below), (4) container properties (e.g., the status of containers  304  on the pallet  302 , such as whether the containers  304  have passed an inspection station and have been identified as containers  304  to be filled in the particular automated dispensing subsystem  204 ), and (5) the pallet route within the automated dispensing subsystem  204 . 
     The pucks  310  may be used to modify the size of the cavities  306  to allow the pallet  302  to accommodate different sizes of the containers  304 . 
       FIGS. 4-6  illustrate the automated dispensing subsystem  204 , according to an example embodiment. The automated dispensing subsystem  204  may be deployed within the automated dispensing device  130 , or may otherwise be deployed. The automated dispensing subsystem  204  enables dispensing of a number of different types of pharmaceuticals in an automatic or semiautomatic manner. 
     The automated dispensing subsystem  204  includes a filling cabinet  402 , a prefill assembly  404 , and a pallet assembly  406 . The filling cabinet  402  stores pharmaceuticals to be dispensed into containers via the prefill assembly  404  and dispenses measured quantities of pharmaceuticals into the prefill assembly  404 . The prefill assembly  404  stores the measured quantities of pharmaceuticals and dispenses the measured quantities of pharmaceuticals received from the filling cabinet  402  into containers  304  on the pallet  302  while in the pallet assembly  406 . 
     A pallet conveyor  412  may transport the pallets  302  through some or all of the devices within the system  100 , such as the automated dispensing device  130 . The pallet assembly  406  receives the pallets  302  via the pallet conveyor  412  and moves the pallets  302  within the pallet assembly  406  such that pharmaceuticals dispensed by the automated dispensing subsystem  204  are dispensed into the containers  304  on the pallet  302 . 
     The pallet conveyor  412  may be a chain conveyor or a belt driven conveyor, e.g., a belted Bosch TS2 belt-driven conveyors; other types of conveyors may be used for the pallet conveyor  412 , such as a chain conveyor. In some embodiments, the pallet conveyor  412  is a low friction, high speed conveyor. 
     Although pallets are generally described herein as employed to move a group of containers through the system  100  or within the automated dispensing subsystem  204 , trays or other types of carriers may be employed to move a group of containers  304  through the system  100  or within the automated dispensing subsystem  204 . 
     The filling cabinet  402  may be physically housed, located, positioned or installed above the prefill assembly  404  and the pallet assembly  406 . For example, the filling cabinet  402  may be located on a first floor (e.g., in a building) and the prefill assembly  404  and the pallet assembly  406  may be located on a second floor (e.g., in the same building) below the filling cabinet  402 . These components of the automated dispensing subsystem  204  may be otherwise positioned, e.g., in a position to utilize gravity to move pharmaceuticals from the filling cabinet  402  to the prefill assembly  404  and then to the containers on  304  the pallet  302 . For example, some portion of the filling cabinet  402  may extend below the first floor. 
     The filling cabinet  402  may include multiple cells  414 . The cells  414  may each be adapted to hold a different pharmaceutical. The cells  414  may be adapted to receive inserts  416 . For example, the inserts  416  may be slidably inserted into the cells  414 . The inserts  416  may be adapted to hold pharmaceuticals to be dispensed into the containers  304  via the automated dispensing subsystem  204 . The cells  414  may receive pharmaceuticals, retain such pharmaceuticals, and dispense measured quantities of such pharmaceuticals into the prefill assembly  404 . The insert  416  may be adapted to be removably received within the cell  414 . For example, the insert  416  may pull out of the cell  414  like a drawer or a fixable pouch. In some embodiments, the cells  414  and the inserts  416  may be provided on opposite sides of the filling cabinet  402 . Thus, the first and second sides of the filling cabinet  402  may be separately accessible. The filling cabinet  402  may include fifty cells  414  per side, so in an embodiment in which cells  414  are provided on opposite sides of the filling cabinet  402 , the filling cabinet  402  may include up to and including 100 cells. In other embodiments, fewer or more than 50 cells may be included per side and/or fewer or more than 100 cells may be included per filling cabinet  402 . Each cell  414  may receive an insert  416  filled (or to be filled) with a different pharmaceutical or multiple cells  414  may each receive an insert  416  filled (or to be filled) with the same pharmaceutical. For example, more than one insert  416  may be filled with a commonly prescribed pharmaceutical. 
     The insert  416  may include a face plate  418  with a door  420 . The door  420  may be adapted to lock and to unlock to be opened. For example, the door  420  may be adapted to be locked unless and until it is unlocked. The door  420  may be adapted to unlock pursuant to a process that mitigates risk of unauthorized access to the pharmaceuticals within the insert  416  and/or to mitigate risks that unintended pharmaceuticals will be added to the insert  416 . In an example embodiment, the door  420  of the cell  414  will unlock when identifying information associated with a pharmaceutical container is detected (e.g., by a pharmacist using a hand-held scanning device to read a bar code or other computer-readable element on the pharmaceutical container) that matches identifying information associated with the cell  414  (e.g., by a pharmacist using a hand-held scanning device to read a bar code or other computer-readable element on the face plate  418  of the insert  416 ) and information about the pharmacist who fills the cell  414  (e.g., by a pharmacist using a hand-held scanning device to read a bar code or other computer-readable element on the pharmacist&#39;s badge). The inserts  416  may be otherwise accessed to receive pharmaceuticals to be held and dispensed. 
     The cell  414  may be adapted to receive a funnel  602 . A first portion  606  of the funnel  602  disposed within the cell  414  may be adapted to receive a dispensing tube  604  of the insert  416 , through which pharmaceuticals may be dispensed from the insert  416  into the funnel  602 . This may be through the large opening in the funnel  602 . A second portion  608  of the funnel  602  may exist outside of the cell  414  and be in communication with a tube  502  connected to a rear opening  610  of the funnel  602 , e.g., as illustrated in  FIG. 6 . The second portion  608  may be the stem of the funnel  602 , which acts as a discharge for the pharmaceuticals being dispensed. 
     A frame portion  424  supports multiple tubes  502  connected to the discharge of the funnels  602  of the filling cabinet  402 . For purposes of viewability,  FIGS. 5 and 6  illustrate just two tubes  502 . In general, however, the tubes  502  are included to enable the cells  414  to dispense drugs. The tubes  502  may be static dissipative flex tubes and may be grounded to allow for static to flow to ground the tubes  502 . 
     The prefill assembly  404  includes multiple buffer tubes  426 . Each of the tubes  502  is connected to a buffer tube  426  of the prefill assembly  404 . The buffer tube  426  may be removable to, for example, facilitate cleaning or replacement. The buffer tube  426  may be shaped as a long-draw funnel or include a long-draw funnel. A long draw funnel may facilitate dispensing of pharmaceuticals while minimizing jams. In an example embodiment, a long draw funnel may be greater than six inches in length, greater than a foot in length, or greater than two feet in length and decrease in diameter over at least a portion of its length. However, the long draw funnel will maintain a diameter than will allow a pharmaceutical to pass therethrough. 
     The pharmaceuticals may be dispensed from the buffer tube  426  into a container  304  disposed on the pallet  302  when the container  304  is held under the buffer tube  426  within the pallet assembly  406 . 
       FIG. 7  illustrates a funnel  602  that may be disposed within a cell  414 . The first end  606  may include a funnel gate  702 . The funnel  602  may be made of plastic, metal, polymer, and/or other suitable materials. The funnel gate  702  may be open when the insert  416  is in the cell  414 . For example, the dispensing tube  604  of the insert  416  may engage and open the funnel gate  702  when the insert is inserted into the cell  414 . The funnel gate  702  may be weighted or biased such that it will shut when the insert  416  is pull out or removed from the cell  414  of the filling cabinet  402 , for example to be cleaned or replaced. Thus, the funnel gate  702  may prevent pharmaceuticals from dropping through the funnel  602  (for example, into the tube  502 ) when the insert  416  is pulled out or removed from the cell  414 . 
     In an example embodiment, the funnel  602  may be between approximately 8 inches and approximately 10 inches long, as measured from the top of the funnel gate  702  to the rear opening  610  of the funnel  602 . For example, the funnel  602  may be approximately 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9 or 10 inches long. The width of the discharge end of the funnel  602  (which may be a diameter if the funnel  602  is substantially circular) may be between approximately 1 and approximately 2 inches. In an example embodiment, the discharge end of the funnel  602  may have an interior diameter of approximately 1.3 inches and an exterior diameter of approximately 1.5 inches. 
     The funnel  602  may be formed and/or placed within the cell  414  such that the connections between the dispensing tube  604  of the insert  416  and the funnel  602  (e.g., when the dispensing tube  604  engages the funnel gate  702 ) and between the tube  502  and the discharge end of the funnel  602  are tight. Such connections may be tight when any gap or space between the connections is smaller than the smallest drug that may be dispensed through the funnel  602 . For example, tolerances for any such gap or space may be less than one millimeter. 
       FIG. 8  illustrates the inside  802  of the cell  414 . The funnel  602  with the funnel gate  702  is disposed at a back wall  804  of the inside  802  of the cell  414 . The funnel gate  702  is in the closed position in  FIG. 8 . The cell  414  is adapted to receive the insert  416  slid into the cell  414  along rails  806 ,  808 . When inserted into the cell  414 , the dispensing tube  604  of the insert  416  may engage and push open the funnel gate  702 . 
       FIG. 9  illustrates an insert  416  according to an example embodiment. A chute  902  may be in communication with the door  420  on the face plate  418  of the insert to receive pharmaceuticals, e.g., when the insert  416  is filled by a pharmacist as described above. The chute  902  may empty into a rotating hopper  904  in communication with a vibratory bowl  906 . A level sensor  908  may be adapted to receive information about the quantity of pharmaceuticals in the vibratory bowl  906  and/or the hopper  904 . Signals from the level sensor  908  may cause the hopper to spin to release additional quantities of pharmaceuticals into the vibratory bowl  906  and/or to stop spinning. 
     The insert  416  may employ vibratory technologies to facilitate a rapid dispensing stream of pharmaceuticals from the insert  416  into the funnel  602 . The insert  416  may be adapted to count pharmaceuticals as they exit the vibratory bowl  906 . Pharmaceuticals may be counted via a scanner array through which the pharmaceuticals pass as they exit the vibratory bowl  906 . Pharmaceuticals may be otherwise counted. In an example embodiment, the insert  416  is a counting cell canister manufactured by Kirby Lester, LLC. Other devices may be used to perform the functions of an insert  416 . 
     Counted pharmaceuticals (for example, a number of pharmaceuticals to be dispensed in accordance with a prescription) may be dispensed from the vibratory bowl  906  through the open funnel gate  702  of the funnel  602  into the tube  502 . 
       FIG. 10  illustrates the buffer tube  426  according to an example embodiment. The buffer tube  426  may be deployed in the prefill assembly  404 , connected to an exit from the insert  416  (e.g., via tube  502 ), or may otherwise be used. The buffer tube may be adapted to receive, retain, and release a measured quantity of a pharmaceutical, in connection with dispensing the pharmaceutical into a container  304  to fill a prescription for the pharmaceutical. 
     An opening  1001  at the top of the buffer tube  426  is adapted to receive the tube  502  connected to the rear opening  610  (exit or lower opening) of a particular funnel  602  disposed in a particular cell  414 . Thus, a particular buffer tube  426  is associated with a particular cell  414 ; pharmaceuticals dispensed from the insert  416  of the cell  414  will exit the cell  414  through the funnel  602 , pass into the tube  502 , and enter the buffer tube  426  at the opening  1001 . 
     Measured quantities of pharmaceuticals dispensed from the insert  416  of the cell  414  connected to the buffer tube  426  may be staged by the buffer tube  426  for dispensing into containers  304 . In general, measured quantities of pharmaceuticals represent exact counts of pills or other masses of pharmaceuticals. 
     The buffer tube  426  may include a first buffer tube gate  1002 , a second buffer tube gate  1004 , and a third buffer tube gate  1006 . In other embodiments, more than three buffer tube gates may be included in a buffer tube; yet other embodiments of a buffer tube  426  include fewer than three buffer tube gates. For example, a buffer tube  426  may have one buffer tube gate. The number of buffer tube gates may vary based on the use or uses for which the buffer tube  426  is deployed. 
     A first solenoid  1008 , a second solenoid  1010 , and a third solenoid  1012 , respectively, may be adapted to open and close the buffer tube gates  1002 ,  1004 ,  1006 , respectively, in response to a communication from a first switch  1014 , a second switch  1016 , and a third switch  1018 , respectively. The buffer tube gates  1002 ,  1004 ,  1006  may flutter to facilitate movement of pharmaceuticals through the gates  1002 ,  1004 ,  1006  and into the holding areas  1030 ,  1032 ,  1034  or a container  304 , as applicable. For example, the buffer tube gates  1002 ,  1004 ,  1006  may flutter by opening and closing in quick succession, e.g., once, twice, three times, or more than three times. 
     The first buffer tube gate  1002 , when closed, may retain pharmaceuticals within a first holding area  1030 ; the second buffer tube gate  1004 , when closed, may retain pharmaceuticals within a second holding area  1032 ; and the third buffer tube gate  1006 , when closed, may retain pharmaceuticals within a third holding area  1034 . 
     The first and second buffer tube gates  1002 ,  1004 , when open, may release pharmaceuticals from the holding areas  1030 ,  1032 , respectively, into the next holding area  1032 ,  1034 , respectively. The third buffer tube gate  1006 , when open, may release pharmaceuticals from the third holding area  1034 , through a buffer tube exit  1036 , into a container  304  on the pallet  302  in the pallet assembly  406 . When in use, a buffer tube  426  having a plurality of gates may have only one gate open at a time. Alternatively more than one gate may open simultaneously or substantially simultaneously, e.g., if there are no measured quantities of pharmaceuticals in either of the holding areas  1030 ,  1032 , both the buffer tube gates  1002 ,  1004  may be opened such that the pharmaceuticals dispense directly into holding area  1034 , or all buffer tube gates  1002 ,  1004 ,  1006  may be open such that the measured quantity of pharmaceuticals dispenses from the cell  414  directly through the buffer tube exit  1036  into the container  304 . 
     The buffer tube  426  may be employed to stage dispensing of measured quantities of pharmaceuticals received from the cell  414  connected to the buffer tube  426 . For example, a first measured quantity of pharmaceuticals to be dispensed according to a prescription may be retained in the first holding area  1030 , a second measured quantity of pharmaceuticals to be dispensed according to a prescription may be retained in the second holding area  1032 , and a third measured quantity of pharmaceuticals to be dispensed according to a prescription may be retained in the third holding area  1034 . 
     In some instances, the first, second, and/or third measured quantities of pharmaceuticals may be portions of the entire quantity of pharmaceuticals to be dispensed in accordance with a particular prescription, such as a prescription for a number of pills or tablets that exceeds the quantity of pills or tablets suitable for a container  304  used in the system  100 . 
     In other instances, each of the first, second, and/or third measured quantities may be associated with a different prescription and such measured quantities may be the entire quantity of pharmaceuticals associated with such particular prescriptions. For example, the first, second, and/or third measured quantities of pharmaceuticals may each represent a 30 day supply of drugs. These staged drugs may be each be dispensed in separate, individual containers  304  to supply 30 day fills, may be dispensed into a single container  304  to supply a 90 day fill, or otherwise. 
     The buffer tube  426  and/or one or more of the holding areas  1030 ,  1032 ,  1034  may hold a volume consistent with the capacity of the container  304  used in the system  100 . For example, the buffer tube  426  and/or one or more of the holding areas  1030 ,  1032 ,  1034  may hold a volume of approximately 200 cc. In other embodiments, the volume may be more than 200 cc or less than 200 cc. 
       FIG. 11  is a close-up illustration of a portion of the second solenoid  1010  (at A of  FIG. 10 ) when the buffer tube gate  1004  is in a closed position. As illustrated in  FIG. 11 , the second solenoid  1010  includes a spring-actuated plunger  1020 . When a spring  1104  is at or near its free-length position (e.g., wherein minimal or no compressive load is imposed upon the spring  1104 ), the spring-actuated plunger  1020  engages an arm  1106  of the buffer tube gate  1004 , thereby retaining the buffer tube gate  1004  in a closed position. When activated by the switch  1016 , the solenoid  1010  compresses the spring  1022  by the spring-actuated plunger  1020  of the solenoid moving upward into (or toward) the body of the second solenoid  1010  and the second buffer tube gate  1004  will open. For example, spring-biased plungers  1026 ,  1028  of the solenoids  1008 ,  1012 , respectively, are illustrated in the open-gate position in  FIG. 10 . 
       FIGS. 12 and 13  illustrate a top view and a side view, respectively, of the pallet assembly  406  of the automated dispensing subsystem  204 , according to an example embodiment. A pallet assembly frame  1202  provides support in the pallet assembly  406 , including the pallet conveyor  412  and an x-y movement apparatus  1204 . The x-y movement apparatus  1204  moves the pallet  302  within the pallet assembly  406  of the automated dispensing subsystem  204 . The x-y movement apparatus  1204  includes an x-component  1206  and a y-component  1208 . 
     The x-component  1206 , in operation, moves a pallet  302  in a direction perpendicular to the pallet conveyor  412 . The x-component  1206  includes an x-axis support arm  1210  that supports the pallet  302  as it moves within the pallet assembly  406  and an x-component motor  1214  that actuates the x-component  1206  of the x-y movement apparatus  1204 . 
     The y-component  1208 , in operation, moves a pallet  302  in a direction parallel to the pallet conveyor  412 . The y-component  1208  includes a y-axis support arm  1212  that supports the pallet  302  as it moves within the pallet assembly  406  and a y-component motor  1216  that actuates the y-component  1208  of the x-y movement apparatus  1204 . 
     The x-y movement apparatus  1204  may engage and move a pallet  302  within the pallet assembly  406  of the automated dispensing subsystem  204  such that the containers  304  in the pallet  302  are moved below the buffer tubes  426  in communication with the cells  414  containing pharmaceuticals to be dispensed into such containers  304 , via the system  100 . 
     The pallet assembly  406  may include a lift apparatus  1302 . The lift apparatus  1302  may engage the pallet  302  and lift it such that a container  304  on the pallet  302  is aligned to receive pharmaceuticals from the buffer tube  426  in communication with the cell  414  holding pharmaceuticals to be dispensed into that particular container  304 . In an example, the container  304  is positioned directly (or substantially directly) below the buffer tube exit  1036  of the buffer tube  426  in communication with the cell  414  holding pharmaceuticals to be dispensed into that particular container  304 . A container  304  may be positioned such that the opening of the container  304  is very close to the buffer tube exit  1036 , e.g., less than approximately 0.01 inches, 0.009 inches, 0.008 inches, 0.007 inches, 0.006 inches, 0.005 inches, or 0.004 inches from the buffer tube exit  1036 . 
     Pharmaceuticals may be dispensed from the buffer tube  426  into the container  304  when the appropriate container  304  is held under the buffer tube exit  1036  by the lift apparatus  1302  of the pallet assembly  406 . In an example embodiment, such pharmaceuticals are held in held the third holding area  1034  of the buffer tube  426  and are dispensed into the container  304  when the third buffer tube gate  1006  is actuated by the third switch  1018 . In another example embodiment, such pharmaceuticals are held in the first or second holding area  1030 ,  1032  of the buffer tube  426  when the container  304  is position below the buffer tube exit  1036  and released through the first and/or second buffer tube gates  1002 ,  1004  prior to being released through the third buffer tube gate  1006  and into the container  304 . 
     The automated dispensing subsystem  204  may include an RFID reader  1218 . The RFID reader  1218  may read data on the RFID tag  308  of the pallet  302  to obtain data associated with the particular pallet  302  and/or containers  304  within the pallet  302 , such as order data  110 , member data  112 , claims data  114 , drug data  116 , prescription data  118 , and/or plan sponsor data  120  associated with prescriptions (or portions of prescriptions) to be filled using containers  304  on that pallet  302 . The RFID reader  1218  may write data to the RFID tag  308  of a pallet  302  (or otherwise cause data to be associated with the pallet  302 ), such as order data  110 , member data  112 , claims data  114 , drug data  116 , prescription data  118 , and/or plan sponsor data  120  associated with pharmaceuticals dispensed into containers  304  on the pallet  302  via the automated dispensing device  130 . Although only one RFID reader  1218  is illustrated on  FIG. 12 , more than one RFID reader  1218  may be employed in an automated dispensing subsystem  204 . When more than one RFID reader  1218  is employed in an automated dispensing subsystem  204 , each RFID reader  1218  may be adapted to read the RFID tag  308  on a pallet  302  at a different stage. For example, an RFID reader may read the RFID tags  308  of pallets as they queue for entry into the automated dispensing subsystem  204 , another may read the RFID tags  308  of pallets as they enter the automated dispensing subsystem  204 , and another may read the RFID tags  308  of pallets  302  as they exit the automated dispensing subsystem  204 . 
     The RFID reader  1218  and/or another RFID reader may read the container identifiers of the containers on the pallet, the automated dispensing subsystem identifier, and the container properties of the containers on the pallet from the RFID tag  308  of a pallet  302  when it queues for entry into the automated dispensing subsystem  204  and may write the container identifiers of the containers  304  to be filled at the automated dispensing subsystem  204  and the identifiers of the particular cells from which the containers will be filled to the RFID tag  308  of the pallet  302 . The RFID reader  1218  and/or another RFID reader may read the container identifiers of the containers  304  to be filled at the automated dispensing subsystem  204  and the identifiers of the particular cells from which the containers  304  will be filled from the RFID tag  308  of the pallet  302  when it enters the automated dispensing subsystem  204 . The RFID reader  1218  and/or another RFID reader may read the pallet route within the system  100  and the pallet route within the automated dispensing subsystem  204  as it exits the automated dispensing subsystem  204  and may clear the pallet route within the automated dispensing subsystem  204  as it exits the automated dispensing subsystem  204  (e.g., to prevent the pallet  302  from re-entering the same automated dispensing subsystem  204  in an embodiment of the system  100  that employs more than one automated dispensing subsystem  204 ). 
       FIG. 14  illustrates an example control subsystem  202  that may be deployed in the order processing device  102 , the automated dispensing device  130 , or otherwise deployed in the system  100 . One or more modules are communicatively coupled and included in the control subsystem  202  to enable control of the automated dispensing operations of the automated dispensing device  130 . The modules of the control subsystem  202  that may be included are a filling cabinet module  1402 , a dispensing module  1404 , and a sequencing module  1406 . Other modules may also be included. 
     In some embodiments, the modules of the control subsystem  202  may be distributed so that some of the modules are deployed in the order processing device  102  and some modules are deployed in the automated dispensing device  130 . In one embodiment, the modules are deployed in memory and executed by a processor coupled to the memory. The functionality contained within the modules  1402 - 1406  may be combined into a lesser number of modules, further divided among a greater number of modules, or redistributed among existing modules. Other configurations including the functionality of the modules  1402 - 1406  may be used. 
     The filling cabinet module  1402  may track quantities of pharmaceuticals placed into the insert  416  in the cell  414  and dispensed from the insert  416 . The filling cabinet module  1402  may control operations of the filling cabinet  402 . For example, the filling cabinet module  1402  may generate an alert when the quantity of pharmaceuticals in the insert  416  has dropped below a pre-determined level. The level at which an alert is be generated may be dependent upon parameters specific to the particular pharmaceutical, e.g., based on factors such as the size of the pharmaceutical, the typical prescribed quantity of the pharmaceutical, the relative popularity of the pharmaceutical, or other factors. For example, an alert may be generated if the quantity of pharmaceutical is below about 100 units (e.g., pills, capsules or tablets), below about 150 units, below about 200 units, below about 250 units, below about 300 units, or below about 350 units. Other types of thresholds may be used. Regardless of whether an alert has been generated, pharmaceuticals may continue to be dispensed from the insert  416  until it is empty. Alerts generated by the filling cabinet module  1402  may be prioritized. For example, alerts may be prioritized based on criterion such as general popularity of the pharmaceutical held in the cell  414 , pending orders in the system  100  for such pharmaceutical, quantity of pharmaceuticals remaining in the cell  414 , combinations thereof, or may be otherwise prioritized. The filling cabinet module  1402  may identify a particular cell  414  as being unavailable to the automated dispensing subsystem  204  when the insert  416  is pulled out or removed from the cell  414  of the filling cabinet  402 . 
     The dispensing module  1404  may access data, such as the order data  110 , the member data  112 , the claims data  114 , the drug data  116 , the prescription data  118 , and/or the plan sponsor data  120 , associated with a particular pallet  302 . Data may be accessed from the RFID tag  308  of the pallet  302 , the sequencing module  1406 , or the database  108 , for example. Based on such data, the dispensing module  1404  may identify the quantity of pharmaceuticals within a particular cell  414  to be dispensed into a particular container  304  on a particular pallet  302  and may control the operations of the inserts  416  and/or the buffer tubes  426  and/or may otherwise control the operations of the automated dispensing subsystem  204  to cause pharmaceuticals to be dispensed from a cell  414  and, ultimately, into the container  304  on the pallet  302 . The dispensing module  1404  may receive the container identifiers of the containers  304  to be filled at the automated dispensing subsystem  204  and may return the identifiers of the cells  414  from which the containers  304  will be filled, the identifier of the automated dispensing subsystem  204 , the dispense type, and the dispense quantity. 
     For example, the dispensing module  1404  may cause the hopper  904  of the insert  416  disposed within the cell  414  to rotate, it may cause the vibratory bowl  906  of the insert  416  to vibrate, it may count pharmaceuticals as they exit the vibratory bowl  906  into the funnel  602 , it may cause the vibratory bowl  906  to cease vibrating after a particular quantity of pharmaceuticals has been counted by the counter, and/or it may otherwise initiate one or more than one operations of the filling cabinet  402  to cause a particular quantity of pharmaceuticals to be dispensed from the insert  416  into the buffer tube  426  associated with that particular cell  414 . 
     The dispensing module  1404  may control operations of the buffer tubes  426  of the prefill assembly  404 . The dispensing module  1404  may control the operations of one or more than one of the switches  1014 ,  1016 ,  1018  to cause a quantity of pharmaceuticals dispensed from the insert  416  of the cell  214  to be retained within a particular holding area  1030 ,  1032 ,  1034  or released from a particular holding area into the next holding area or into the container  304 , as the case may be. For example, the dispensing module  1404  may engage the third switch  1018  to cause the third buffer tube gate  1006  to open, thereby releasing the contents of the third holding area  1034  into the container  304  disposed below the opening  1036  of the buffer tube  426 . The dispensing module  1404  may then engage the second switch  1016  to cause the second buffer tube gate  1004  to open, thereby releasing the contents of the second holding area  1032  into the third holding area  1034 . 
     Thus, in this example, embodiment, up to three prescriptions (or portions of prescriptions) may be retained within the holding areas  1030 ,  1032 ,  1034  of the buffer tube  426  in preparation for dispensing into the container  304 , thereby reducing the amount of time necessary to fill the container  304  with the measured quantity of pharmaceuticals after it has been placed below the opening  1036  of the buffer tube  426  (for example, as compared to a subsystem in which pharmaceuticals are not counted until the container  304  had been positioned to receive the pharmaceuticals). In an example embodiment, the three prescriptions in the holding areas  1030 ,  1032 ,  1034 , may hold differing quantities of pharmaceuticals. 
     The sequencing module  1406  may accesses data, such as the order data  110 , the member data  112 , the claims data  114 , the drug data  116 , the prescription data  118 , and/or the plan sponsor data  120 , associated with a particular pallet  302 . Data may be accessed from the RFID tag  308  of a pallet  302  or the database  108 , for example. Data associated with a particular pallet may be accessed by an RFID reader  1218  of the automated dispensing subsystem  204  or may be otherwise accessed. Based on such data, the sequencing module  1406  may determine which cells  414  within the automated dispensing subsystem  204  to dispense associated pharmaceuticals into the containers  304  on the particular pallet  302 . The sequencing module  1406  may determine the sequence in which the particular pallet  302  will move between dispensing positions associated with such cells  414  (e.g., underneath the openings  1036  of the buffer tubes  426 ). The sequence may be selected based on factors such as proximity of the cells  414  and/or the buffer tubes  426  from which containers  304  on the pallet  302  will be filled, availability or likely availability of a particular cell  414  (for example, as determined based on whether an alert has been generated for the particular cell  414  by the filling cabinet module  1402 , or otherwise generated, and/or the level of such alert), and/or other factors. 
     The sequence may be selected to minimize wait time at the cell  414 . For example, the sequence may be selected (and the operations of the automated processing subsystem  204  may be controlled) such that the container  304  to be filled with a pharmaceutical from the cell  414  arrives at the dispensing position associated with such cell  414  after the pharmaceutical to be dispensed into the container  304  is in a particular holding area of the buffer tube  426  in communication with the cell  414 , such as at least the third holding area  1034 , at least the second holding area  1032 , or at least the first holding area  1032 . By way of further example, if the pallet  302  includes more than one container  304  to be filled with a particular pharmaceutical, the sequencing module  1406  may order the filling of the containers on the pallet  302  such that a first container is filled with pharmaceuticals dispensed from the buffer tube  426  in communication with the cell  414  containing the pharmaceutical at a first time and a second container is filled with pharmaceuticals dispensed from such buffer tube  426  at a second time, and wherein at least one other container is filled from the buffer tube  426  in communication with a different cell  414  between the filling of the first container  304  and the second container  304 . 
     If the automated dispensing subsystem  204  includes more than one cell  414  with a particular pharmaceutical, then in such an embodiment, the sequencing module  1406  may determine which of such cells  414  will be used to dispense such pharmaceutical. For example, the sequencing module  1406  may identify a first cell  414  from which a first container  304  will be filled with that particular pharmaceutical and a second cell  414  from which a second container  304  will be filled with that particular pharmaceutical. Other factors may be used to establish the sequence in which the containers  304  in a particular pallet  302  will be filled. 
     Multiple automated filling subsystem  204  may be deployed in the automated filling device  130  of the system  100 . In such an embodiment, one or more of the modules  1402 - 1406  of the control subsystem  202  and/or the order processing device  102  may determine which one or more automated filling subsystem  204  will be used to fill the containers  304  on a particular pallet  302  and may control the operations of the one or more automated filling subsystems  204  and/or the system  100  to cause pharmaceuticals to be dispensed into the containers  304  on such pallet  302  from cells  414  of such one or more than one automated filling subsystems  204 . 
       FIG. 15  illustrates a method  1500  for dispensing pharmaceuticals into the container  304 , according to an example embodiment. The method  1500  may be performed by the automated dispensing device  130 , partially by the order processing device  102  and partially by the automated dispensing device  130 , or may be otherwise performed. 
     At block  1502 , the insert  416  of the cell  414  is filled with a particular pharmaceutical. At block  1504 , a first measured quantity of the pharmaceutical is dispensed from the cell  414  into the buffer tube  426  connected to the cell  414  via the tube  502 . At block  1506 , the first measured quantity of pharmaceuticals is held within the first holding area  1030  of the buffer tube. At block  1508 , the first measured quantity of the pharmaceutical is released by the first buffer tube gate  1002  into the second holding area  1032  of the buffer tube  426 . A second measured quantity of the pharmaceutical is dispensed from the cell  414  into the buffer tube  426  at block  1510  and, at block  1512 , is held within the first holding area  1030 . The first measured quantity of the pharmaceutical is released by the second buffer tube gate  1004  into the third holding area  1034  of the buffer tube  426  at block  1514 , the second measured quantity of the pharmaceutical is released by the first buffer tube gate  1002  into the second holding area  1032  of the buffer tube  426  at block  1516 , and a third measured quantity of the pharmaceutical is dispensed from the cell  414  into the buffer tube  426  at block  1518 . At block  1520 , the third measured quantity of pharmaceuticals is held within the first holding area  1030 . At block  1522 , the first measured quantity of pharmaceuticals is released by the third buffer tube gate  1006  from the third holding area  1034  into the container  304  aligned to receive the first measured quantity of pharmaceuticals from the buffer tube  426 . 
       FIG. 16  shows a block diagram of a machine in the example form of a computer system  1600  within which a set of instructions may be executed causing the machine to perform any one or more of the methods, processes, operations, or methodologies discussed herein. The devices  102 ,  106 ,  122 - 144  may include the functionality of the one or more computer systems  1600 . 
     In an example embodiment, the machine operates as a standalone device or may be connected (e.g., networked) to other machines. In a networked deployment, the machine may operate in the capacity of a server or a client machine in server-client network environment, or as a peer machine in a peer-to-peer (or distributed) network environment. The machine may be a server computer, a client computer, a personal computer (PC), a tablet PC, a gaming device, a set-top box (STB), a Personal Digital Assistant (PDA), a cellular telephone, a web appliance, a network router, switch or bridge, or any machine capable of executing a set of instructions sequential or otherwise) that specifies actions to be taken by that machine. Further, while only a single machine is illustrated, the term “machine” shall also be taken to include any collection of machines that individually or jointly execute a set (or multiple sets) of instructions to perform any one or more of the methodologies discussed herein. 
     The example computer system  1600  includes a processor  1602  (e.g., a central processing unit (CPU) a graphics processing unit (GPU) or both), a main memory  1604  and a static memory  1606 , which communicate with each other via a bus  1608 . The computer system  1600  further includes a video display unit  1610  (e.g., a liquid crystal display (LCD) or a cathode ray tube (CRT)). The computer system  1600  also includes an alphanumeric input device  1612  (e.g., a keyboard), a cursor control device  1614  (e.g., a mouse), a drive unit  1616 , a signal generation device  1618  (e.g., a speaker) and a network interface device  1620 . 
     The drive unit  1616  includes a computer-readable medium  1622  on which is stored one or more sets of instructions (e.g., software  1624 ) embodying any one or more of the methodologies or functions described herein. The software  1624  may also reside, completely or at least partially, within the main memory  1604  and/or within the processor  1602  during execution thereof by the computer system  1600 , the main memory  1604  and the processor  1602  also constituting computer-readable media. 
     The software  1624  may further be transmitted or received over a network  1626  via the network interface device  1620 . 
     While the computer-readable medium  1622  is shown in an example embodiment to be a single medium, the term “computer-readable medium” should be taken to include a single medium or multiple media (e.g., a centralized or distributed database, and/or associated caches and servers) that store the one or more sets of instructions. The term “computer-readable medium” shall also be taken to include any medium that is capable of storing or encoding a set of instructions for execution by the machine and that cause the machine to perform any one or more of the methodologies of the present invention. The term “computer-readable medium” shall accordingly be taken to include, but not be limited to, solid-state memories, and optical media, and magnetic media. In some embodiments, the computer-readable medium is a non-transitory computer-readable medium. 
     The term “based on” or using, as used herein, reflects an open-ended term that can reflect others elements beyond those explicitly recited. 
     Certain systems, apparatus, applications or processes are described herein as including a number of modules. A module may be a unit of distinct functionality that may be presented in software, hardware, or combinations thereof. When the functionality of a module is performed in any part through software, the module includes a computer-readable medium. The modules may be regarded as being communicatively coupled. 
     In an example embodiment, a pharmaceutical order filling system includes an order processing device that receives a pharmaceutical order, an automated dispensing device that includes a filling cabinet with a cell containing an available quantity of a pharmaceutical to be dispensed according to the pharmaceutical order. The system also includes a prefill assembly with a buffer tube that is in communication with the cell of the filling cabinet and that is configured to stage dispensing of measured quantities of pharmaceuticals, wherein the automated dispensing device is communicatively coupled to the order processing device and configured to dispense a first measured quantity of the available quantity of the pharmaceutical into the buffer tube and to dispense the first measured quantity of the pharmaceutical from the buffer tube into a container. 
     In another example embodiment, a pharmaceutical order filling system includes an automated dispensing device in which a filling cabinet, a prefill assembly and a pallet assembly cooperatively communicate. The filling cabinet includes a plurality of cells, each of which contains a quantity of a particular pharmaceutical, the prefill assembly includes a plurality of buffer tubes, each buffer tube of the plurality of buffer tubes being in respective communication with a particular cell of the plurality of cells, and the pallet assembly includes an x-y movement apparatus adapted to engage and move a pallet within the pallet assembly, wherein a plurality of containers are disposed on the pallet. In this example embodiment, the automated dispensing device is configured to dispense a measured quantity of a pharmaceutical from one of the cells into a holding area of a buffer tube uniquely associated with that cell and to dispense the measured quantity of the pharmaceutical from the holding area of the buffer tube into a container positioned below the buffer tube. 
     In yet another example embodiment, a pharmaceutical order filling system includes an order processing device to receive pharmaceutical orders prescribing a plurality of pharmaceuticals, an automated dispensing device that is cooperatively coupled to the order processing device. The automated dispensing device includes a filling cabinet, a prefill assembly, and a pallet assembly. The filling cabinet includes a plurality of cells, one of which contains a quantity of one of the pharmaceuticals. The system also includes a sequencing module to determine an order for dispensing a measured quantity of each of the plurality of pharmaceuticals into a plurality of containers. 
     The inventive subject matter may be represented in a variety of different embodiments of which there are many possible permutations. 
     Thus, methods and systems for automated pharmaceutical dispensing have been described. Although embodiments of the present invention have been described with reference to specific example embodiments, it will be evident that various modifications and changes may be made to these embodiments without departing from the broader spirit and scope of the embodiments of the invention, Accordingly, the specification and drawings are to be regarded in an illustrative rather than a restrictive sense. 
     The methods described herein do not have to be executed in the order described, or in any particular order. Moreover, various activities described with respect to the methods identified herein can be executed in serial or parallel fashion.