DISTRIBUTION N/A of prescription drugs other than by patient specific prescription Yes No orders exceeds 5% of the pharmacy’s annual sales. If yes, Maryland distributors license # COMAR 10.34.22.01. Comments: MEDICATION ORDERS (COMAR 10.34.23.09.H) Medications are dispensed from the pharmacy only in response to Yes No medication orders issued by authorized prescribers or by prescriber per institution approved protocols. MEDICATION PACKAGING (COMAR 10.34.23.07) Yes No The pharmacy prepares packaged medications. (If yes complete questions below) N/A Packaged from the original manufacturer’s container: uses a lot number and expiration date assigned by the pharmacy Yes No instead of the distributor or manufacturer information in a master log if kept with respect to that are packaged within the pharmacy facility N/A from the original manufacturer’s container which includes the: N/A Yes No Yes No N/A Name of drug; Yes No N/A Strength; Yes No N/A Manufacturer; Yes No N/A Lot Number assigned by the pharmacy; Yes No N/A Lot number assigned by the distributor or manufacturer; Yes No N/A Quantity packaged; Yes No N/A Manufacturer’s expiration date; Yes No N/A Lot number assigned by the distributor or manufacturer; Yes No N/A Date of packaging; N/A Name of the pharmacy technician who performed packaging functions; and Yes No Name and initials of verifying licensed pharmacist. Packaged from Another Pharmacy: N/A licensed pharmacist packages medication received from another Yes No pharmacy licensed in Maryland or operated by the government of the United States provided that: pharmacist determines that the medication has been Yes No handled in a manner which preserves the strength, quality, purity, and identity of the drug or device during an interim period N/A between the time it was dispensed by the original pharmacy and to directly send medication to the packaging pharmacy;
DISTRIBUTION Yes No N/A of prescription drugs other than by patient specific prescription orders exceeds 5% of the pharmacy’s annual sales. If yes, Maryland distributors license # COMAR 10.34.22.01. Comments: MEDICATION ORDERS (COMAR 10.34.23.09.H) Yes No Medications are dispensed from the pharmacy only in response to medication orders issued by authorized prescribers or by prescriber per institution approved protocols. MEDICATION PACKAGING (COMAR 10.34.23.07) Yes No N/A The pharmacy prepares packaged medications. (If yes complete questions below) Packaged from the original manufacturer’s container: Yes No N/A uses a lot number and expiration date assigned by the pharmacy instead of the distributor or manufacturer information in a master log if kept with respect to that are packaged within the pharmacy facility from the original manufacturer’s container which includes the: Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Name of drug; Strength; Manufacturer; Lot Number assigned by the pharmacy; Lot number assigned by the distributor or manufacturer; Quantity packaged; Manufacturer’s expiration date; Lot number assigned by the distributor or manufacturer; Date of packaging; Name of the pharmacy technician who performed packaging functions; and Name and initials of verifying licensed pharmacist. Packaged from Another Pharmacy: Yes No N/A licensed pharmacist packages medication received from another pharmacy licensed in Maryland or operated by the government of the United States provided that: Yes No N/A pharmacist determines that the medication has been handled in a manner which preserves the strength, quality, purity, and identity of the drug or device during an interim period between the time it was dispensed by the original pharmacy and to directly send medication to the packaging pharmacy;
Comprehensive%20Inspection%20Form.docx