A distributed medication requisition management system, comprising: a requisition generator to generate a medication requisition for a contained medication unit based on an order of the contained medication unit, requisition fulfillment logic to provide decision data for identifying a selected remote fulfillment site from a plurality of remote fulfillment sites (60a, 60b), wherein the decision data is based at least in part on medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data received from each of the plurality of remote fulfillment sites (60a, 60b), wherein the requisition fulfillment logic is at least in part customizable by a patient care provider, and/or wherein the requisition fulfillment logic processes the medication requisition in relation to both the medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data, and wherein the requisition fulfillment logic comprises selectable weighting parameters associated with each of the medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data, and a requisition router that communicates the medication requisition to the selected remote fulfillment site, wherein the selected remote fulfillment site comprises a work station to prepare and present a work flow that is specific to the medication requisition at the work station and is configured to record medication requisition metadata related to preparation of the contained medication unit in accordance with the work flow, wherein the contained medication unit is prepared at the selected remote fulfillment site; a plurality of medication requisition management clients resident at a plurality of fulfillment sites (60a, 60b, 200) capable of fulfilling the medication requisition; and a medication requisition database in operative communication with the fulfillment sites (60a, 60b, 200) that receives and stores the medication requisition metadata regarding fulfillment of the medication requisition at the selected remote fulfillment site, wherein the selected fulfillment site (60a, 60b, 200) provides the medication requisition metadata to be stored in the medication requisition database in corresponding relation to the medication requisition and the medication requisition metadata is maintained in the medication requisition database and updated by a fulfillment site before, during, or after fulfillment of the medication requisition. a requisition generator to generate a medication requisition for a contained medication unit based on an order of the contained medication unit, requisition fulfillment logic to provide decision data for identifying a selected remote fulfillment site from a plurality of remote fulfillment sites (60a, 60b), wherein the decision data is based at least in part on medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data received from each of the plurality of remote fulfillment sites (60a, 60b), wherein the requisition fulfillment logic is at least in part customizable by a patient care provider, and/or wherein the requisition fulfillment logic processes the medication requisition in relation to both the medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data, and wherein the requisition fulfillment logic comprises selectable weighting parameters associated with each of the medication requisition fulfillment processing power cost data and medication requisition fulfillment timing data, and a requisition router that communicates the medication requisition to the selected remote fulfillment site, wherein the selected remote fulfillment site comprises a work station to prepare and present a work flow that is specific to the medication requisition at the work station and is configured to record medication requisition metadata related to preparation of the contained medication unit in accordance with the work flow, wherein the contained medication unit is prepared at the selected remote fulfillment site; a plurality of medication requisition management clients resident at a plurality of fulfillment sites (60a, 60b, 200) capable of fulfilling the medication requisition; and a medication requisition database in operative communication with the fulfillment sites (60a, 60b, 200) that receives and stores the medication requisition metadata regarding fulfillment of the medication requisition at the selected remote fulfillment site, wherein the selected fulfillment site (60a, 60b, 200) provides the medication requisition metadata to be stored in the medication requisition database in corresponding relation to the medication requisition and the medication requisition metadata is maintained in the medication requisition database and updated by a fulfillment site before, during, or after fulfillment of the medication requisition. a medication requisition database in operative communication with the fulfillment sites (60a, 60b, 200) that receives and stores the medication requisition metadata regarding fulfillment of the medication requisition at the selected remote fulfillment site, wherein the selected fulfillment site (60a, 60b, 200) provides the medication requisition metadata to be stored in the medication requisition database in corresponding relation to the medication requisition and the medication requisition metadata is maintained in the medication requisition database and updated by a fulfillment site before, during, or after fulfillment of the medication requisition.