Pharmacy Basics
Workbook
January 2020
Last Updated 01/16/2020
Course Code: 204010
Pharmacy Basics: Workbook
Table of Contents
Introduction ................................................................................................................................3
Pharmacy Settings......................................................................................................................5
Delivering Patient Care ..............................................................................................................8
The Pharmacy Workflow ...........................................................................................................8
Eight Service Standards .............................................................................................................9
Knowledge Check ....................................................................................................................11
Regulations and Regulatory Agencies .....................................................................................12
Medication Identification .........................................................................................................16
Types of Medication ................................................................................................................20
Schedule III-V Dispensing.......................................................................................................28
Prescription Labels...................................................................................................................31
Third Party Billing ...................................................................................................................35
The Customer Receipt..............................................................................................................36
Course Completion ..................................................................................................................49
Next Steps ................................................................................................................................49
Appendix #1: Knowledge Check Answer Key .......................................................................50
Appendix #2: Reporting Thefts or Losses of Controlled Substances ......................................53
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Pharmacy Basics: Workbook
Introduction
In this training course, you will build upon what you have learned in the Pharmacy
Introduction web-based course. You will have an opportunity to explore the
Pharmacy and the tools that we use at the different workstations.
Upon completion of this course, you will be able to:

List various pharmacy settings and identify CVS Health pharmacy settings

Describe key information included on the stock bottle

Identify the various types of medication dosage forms

Recognize the elements of prescription labels

Recognize medication schedules

Identify Action and Patient Care Notes and recognize the importance of
communicating information to patients effectively

Identify the different communication vehicles used in the pharmacy
This training guide is provided in a self-paced format. You will need to complete this
workbook in a pharmacy where you will have an opportunity to explore and ask
questions. If you need help completing any of the activities or locating any of the
required materials, ask a Pharmacy Team Member for assistance. Answers to each
knowledge check are in the appendix at the end of this workbook.
It will take you approximately 1 hour to complete this workbook.
This course is a prerequisite to the Foundations of Pharmacy class.
Please bring your completed workbook to class, as your Trainer may
review your work at the start of the class.
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Introduction Continued
The following icons are used throughout the workbook:
This icon indicates a knowledge check.
This icon identifies an activity.
This icon indicates which materials from the
pharmacy are needed to complete the activity.
It is important for you to read each section and complete all of the activities and
knowledge checks. Successful completion of this training will provide you with
knowledge that you need to understand the work that occurs in the pharmacy.
Materials
You will need the following materials to complete the activities (To
comply with HIPAA regulations, ensure all patient information is
removed from sample materials.):
 A complete printed prescription label
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Pharmacy Basics: Workbook
Pharmacy Settings
Welcome to Pharmacy Basics training where you will discover the basic information
needed to be successful in the practice of pharmacy. Let’s start with understanding
all of the various settings where the practice of pharmacy occurs. As a technician,
you practice pharmacy in at least one of the 9 types of pharmacy settings. You
should know which of these you work in within the larger context of the practice of
pharmacy.
In addition to know which type of pharmacy setting you work in, it is helpful to know
which other pharmacy settings exist at CVS Health. You may have patients that are
served through a few different types of pharmacy settings where CVS Health
operates, and being aware of these other settings will help you better serve patients
on their path to better health.
Pharmacy Settings Knowledge Check
The reference guide on the next page lists the different pharmacy
settings with brief key points for each one. Read through the next
two pages and then answer the questions below. Write your
answer in the column on the right.
Question
Your Answer
1. Which type of pharmacy setting do you work in if you work at
a pharmacy CVS retail store?
2. Which other types of pharmacy settings do you think there are
at CVS Health? As you answer this question, think about our
services such as Omnicare and other ways that our patients
receive their filled prescriptions from CVS Health.
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Pharmacy Settings QRG
Pharmacy Basics: Workbook
This Quick Reference Guide (QRG) gives an overview of Pharmacy Settings:
Community Retail Pharmacy
1
Processes prescription services to the public
2
Includes chain, independent, mass merchandiser, and food store pharmacies
3
Designated units are the pharmacy counter, drop-off window, storage area,
equipment area, and waiting bin area
Ambulatory Care Pharmacy
1
Is affiliated with a healthcare facility to reduce readmissions
2
Assists discharged patients with their medication regimen
Compounding Community Pharmacy
1
Are community pharmacies that specialize in compounding services
2
Fills prescriptions for commercially available prescription products
Home Health Care/Home Infusion Pharmacy
1
Provides medication and consulting services in patients’ homes
2
Provides home infusion of IV pumps as primary service
Hospice Pharmacy
1
Assesses the appropriateness of medication orders to comfort a patient who is
terminally ill
2
Ensures patients and caregivers understand and follow the directions with use
of medication
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Quick Reference Guide (QRG) Continued
Hospital Pharmacy
1
Assists licensed pharmacists with the preparation and distribution of prescription
medications in hospitals
2
Helps fill orders for patients and ensures delivery of medication to correct units
3
Ensures the right amount of stock to meet patients’ needs
Long-term Care Pharmacy
1
Offers services to meet needs of people with chronic illness or disability
2
Distributes medications that have been ordered
3
Maintains an individualized pharmaceutical plan for residents in long-term care
facilities
Mail-Order Pharmacy
1
Sends medications to patients through mail or other delivery services
2
Used in situations where the need for medication is known in advance
3
Provides customer service where pharmacists can consult with patients
Nuclear Pharmacy
1
Are specially licensed and regulated pharmacies that prepare radioactive
materials called radiopharmaceuticals
2
Promotes health by effectively using these radioactive drugs for diagnosis and
therapy
3
Dispenses doses to a hospital or clinic nuclear medicine department where the
dose is administered to the patient
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Delivering Patient Care
In the Pharmacy Introduction web-based training, you learned that as a member of
the Pharmacy team, you play an integral role in ensuring that each customer
receives the specialized care and exceptional service that he or she deserves. At
CVS/pharmacy, we refer to this specialized care as Patient Care, a proactive,
patient-centered approach to caring for customers. All that we do is with the patient
in mind. As a result of having the right conversation, with the right patient, at the right
time, Pharmacy Team Members have the ability to help patients improve their
medication adherence and overall health.
One way Pharmacy Teams can demonstrate patient care is by providing friendly and
efficient customer service. However, at CVS we truly differentiate ourselves by the
services and programs that we deliver to our patients. Throughout this course and
your additional training, you will learn more about the various ways we provide
exceptional service to our customers.
The Pharmacy Workflow
In the Pharmacy Introduction web-based training, you learned how the workflow (or
prescription filling process) helps to support CVS’ ability to provide exceptional
customer service and ensure the safety of our patients.
The following graphic illustrates the flow of a prescription once it is received in the
pharmacy:
Customer service and quality checks are embedded throughout the prescription
filling process. All of the tasks that you perform have a direct impact on the
experience of your customers and on the safety of your patients. The work that you
do and interactions you have are critical to our continued success as an
organization.
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Pharmacy Workflow Continued
By understanding and adhering to the roles and responsibilities at each workstation,
you will be able to work efficiently, so you can care more for customers. CVS is
committed to ensuring you have the knowledge, skills, and tools you need to
succeed in your new role.
Eight Service Standards
Pharmacy workflow consists of Eight Service Standards that must be followed to
ensure we provide the best possible service to our customers. To maximize their
effectiveness, all of these elements must be incorporated into the regular practices
of your store. An Eight Service Standards job aid should be displayed in your store
as a reminder of the essential elements of workflow that must be followed.
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Eight Service Standards Continued
Let’s take a closer look at the Eight Service Standards:
Work Efficiently
There are four critical behaviors that will enable Team Members to be more efficient:
1. Schedule to the model and follow the myWorkstation Assignment tool. This
ensures that the right person is in the right place at the right time to best
serve customers.
2. Follow the Priority Cards at each workstation. This ensures that customers
receive top priority and all work is completed.
3. Work the Action Queues top down. This ensures customer expectations are
met.
4. Use the process and systems. This ensures Pharmacy Teams are following
workflow, which reinforces our commitment to patient safety and service
excellence.
Care More
By working efficiently, Team Members care more by:
1. Promptly acknowledge all customers. This ensures customers are served in
a friendly and courteous manner.
2. Provide undivided attention to a customer. This ensures customers feel
welcomed and card for.
3. Immediately follow up on issues and use Electronic Action Notes. This
ensures we are demonstrating respect for customers and building trusted
relationships.
4. Help at Pick-up if there are 3 or more customers in line. This ensures
customers know they are a top priority.
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Knowledge Check
Recall what you learned in the Pharmacy Introduction web-based
training. Identify the workstation that corresponds to the roles and
responsibilities outlined below.
Workstation
Roles and Responsibilities
This workstation, which is staffed by a Pharmacist, is where
final accuracy checks are completed prior to dispensing a
prescription to the patient.
The Team Member assigned to this workstation fills
prescriptions to keep the process flowing and to ensure
medication(s) are filled when promised.
At this workstation the Team Member is responsible for both
Drop-off and Pick-up tasks.
This is a critical piece of the prescription fulfillment process.
When a customer brings a prescription to the pharmacy, the
interaction at this workstation is the customer’s first indication
of the service level that will be provided by the pharmacy
team.
Team Members serve customers picking up their
prescription(s) in the store.
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Regulations and Regulatory Agencies
CVS is committed to quality assurance; the safety of our patients is our top priority.
In addition to caring about the safety of our patients, we use quality assurance
activities to meet several federal and state regulations. We will take a closer look at
6 laws and regulatory agencies that impact the way we work. You will read about
what the law or agency does, why it is necessary, and how it impacts you at work.
HOW
WHY
WHAT
1. Food and Drug Administration (FDA)

Agency that regulates the development, testing, purity, safety, and
effectiveness of prescription and over-the-counter (OTC) medications
o Approves medications for sale in the United States
o Regulates advertising and labeling of prescription and OTC
medications


Ensures patient health and safety
Ensures that patients can easily obtain the medications they are
prescribed

When new medications are approved by the FDA and introduced into the
marketplace, you will begin to receive and fill prescriptions for those
medications
When the FDA recalls medications, the Pharmacist on duty is responsible
for ensuring our patients are safe

2. Comprehensive Drug Abuse Prevention and Control Act of 1970
(Controlled Substance Act (CSA)) and state controlled substance laws
WHAT


HOW
WHY

Law that regulates the manufacturing, distribution, prescribing, and
dispensing of controlled substances
The federal CSA is enforced by the Drug Enforcement Administration
(DEA)
States also have laws and regulations relating to controlled substances

Because controlled substances pose a high risk of addiction, extra
precautions are taken to monitor these medications and protect patients
from the negative side effects
 When filling prescriptions for controlled substances, additional steps must
be taken, such as ensuring that each prescription has the Prescriber DEA
number included on it
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Regulations and Regulatory Agencies Continued
WHAT
3. Consumer Product Safety Commission (CPSC)
 Agency that oversees the Poison Prevention Packaging Act.
 Requires that most prescriptions for oral use are dispensed in childresistant containers (i.e., safety caps)
To protect young children from opening and consuming potentially
harmful medications


All prescriptions filled at CVS will have a child-resistant safety cap
A patient or prescriber may request a non-safety cap, and the patient will
have to sign to acknowledge this request via the Electronic Signature
Log
HOW
WHY



Law that requires record-keeping (e.g., patient profiles) for all medications
used by a patient
Requires Pharmacists (or Pharmacy Support Staff Members, as allowed
by law) to make an Offer to Counsel for all new prescriptions

Ensures that patients have an opportunity to obtain information about their
medications

At the Pick-up and Drive-thru workstations, you will make the Offer to
Counsel (in accordance to state law) to each patient for each prescription
as prompted by the pharmacy register
o However, only Pharmacists (or Interns under the supervision of a
Pharmacist) are allowed to counsel patients
The patient will have to sign via the Electronic Signature Log to accept or
decline consultation
HOW
WHY
WHAT
4. Omnibus Budget Reconciliation Act of 1990 (OBRA ’90)

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Regulations and Regulatory Agencies Continued
5. State Boards of Pharmacy
WHY


Agencies that license and/or register Pharmacists and Pharmacy Support
Staff and they have the power to revoke, suspend, or place on probation
the licenses and/or registrations of those who are found guilty of violating
laws or regulations
Regulate technical functions of pharmacy departments
Also employ inspectors to examine pharmacies for compliance

State Boards of Pharmacy license and regulate pharmacies and Pharmacy
staff in order to protect patients’ health
HOW
WHAT


Regulations and required actions vary across states. Your Trainer will
address your state’s requirements in your classroom training
WHY WHAT
6. Health Insurance Portability and Accountability Act (HIPAA) of 1996 and
Privacy Rule of April 14, 2003

Both HIPAA and the Privacy Rule are laws that were enacted to protect
the privacy of patients

Compliance with this regulation helps maintain the privacy and security of
patients’ protected healthcare information

You and all new employees must complete HIPAA (Handling PHI and
Other Confidential Info) training
You will provide a written Notice of Privacy Practices (NoPP) to all new
pharmacy patients
o Patients will sign the Electronic Signature Log to acknowledge that they
received the NoPP
HOW




You and all Pharmacy Team Members must be careful and considerate
when conversing with each other or with other customers, providers,
insurance plans
At all times you must adhere to the confidential trash procedures that were
covered in the New Employee Compliance training
Incidental Use and Disclosure: CVS employees must make reasonable
efforts to avoid being overheard discussing patient medications and
health-related topics and reasonably limit the information disclosed when
discussing Protected Health Information (PHI)
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Activity #1: Regulation Scenarios
Now that you have learned about the different regulatory agencies
and legislation that affect pharmacies, you will have a chance to
apply your knowledge. Below are 6 scenarios that happen every
day in a pharmacy. Read each scenario and identify the agency or
law that applies to the scenario. Write your answer in the column on
the right.
Scenario
Regulation or
Agency
1. A patient gives you her medication vial. She explains that she
would like to exchange the safety cap for a non-safety cap
because she is unable to open the vial.
2. A license and/or registration for each Pharmacist and
Pharmacy Support Staff Member that works in the store are
displayed on the wall.
3. You make the Offer to Counsel (per state regulations) to
ensure the patient is fully informed about his/her prescriptions.
4. You read about a new medication that has recently been
approved and ask your Pharmacist when your store might get
the medication. Your Pharmacist tells you it will be available in a
few weeks.
5. You place Blue Trash Bags at all pharmacy workstations to
ensure all Confidential Pharmacy trash (excluding food &
beverage), Pharmacy records, Front Store confidential
materials, and MinuteClinic trash (where applicable) are
disposed of properly.
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Medication Identification
Now that you have reviewed the different workstations, let’s take a closer look at
some of the items we use at those workstations. The first item we’ll look at is a
medication stock bottle.
Prescription medications arrive from the CVS Warehouse or Outside Vendor in the
manufacturer’s packaging. These are called stock bottles.
When filling a prescription at Production, it is very important that you match the
information on the stock bottle to the information on the prescription label to ensure
that you are filling the order with the correct medication. Because of this need for
accuracy, you must know what information can be found on a stock bottle and what
that information means.
Refer to the graphic below to see what information is available on the stock bottle.
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Activity #2
Below you will find a graphic of the front and back of another stock
bottle.
The table on the following page describes the information that the
Food and Drug Administration (FDA) requires on all medication stock
bottles. Read the description of each item contained on a stock bottle,
and then locate that item on the sample graphic.
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Activity #2 Continued
Item
Product name
Medication
Strength
Storage
Requirement
Package
Quantity
Medication
Dosage Form
Manufacturer’s
Name
Controlled
Substance
Mark
Lot Number
Expiration Date
Description
Example from
Previous Page
All medications have a name. Most
medications are available as brand or
generic. Brand medications are often
designated by a registered trademark ® after
their names.
This indicates the amount (often milligrams
or grams) of the active ingredient. Most
medications come in a variety of strengths,
which is always clearly visible on the stock
bottle label.
Medications may have different storage
requirements:

Most medications are stored at room
temperature

Some medications must be refrigerated
(e.g., Insulin)
Different package sizes are available for
many different medications.
Medications are available in many different
dosage forms (e.g., tablets, liquids,
ointments, etc.).
This name must be listed on the medication
stock package.
Controlled Substance medication must have
the letter “C” and the Roman numeral
schedule number (II-V) assigned by the Drug
Enforcement Administration (DEA) on the
stock bottle.
This number indicates the particular batch
produced by the manufacturer.
Every prescription medication is given an
expiration date when manufactured.
N/A
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Activity #2 Continued
Item
National Drug
Code (NDC)
Number
Description
Example from
Previous Page
This 11 digit number is assigned by the
manufacturer and placed on all prescription
stock packages:
National Drug Code
12345 - 6789 - 12

The first five digits of the NDC number
identify the manufacturer

The middle four digits identify:

o
Medication name
o
Strength
o
Dosage form
The last two digits identify the package
size
NOTE: If the stock bottle only shows 10
digits, you need to add the leading zero to the
appropriate section. For example,
7321 - 9234 - 01 should be converted to
07321 - 9234 – 01.
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Types of Medication
Understanding the information on the stock bottle will help you find the correct
medication, but it is also important that you understand the different kinds of
medications in the pharmacy. The medication type can affect how prescriptions are
dispensed and what processes you must follow when completing the order.
Dosage Forms
Active ingredients, along with inactive ingredients, make up a particular dosage
form. The various dosage forms are designed to improve taste, appearance,
stability, and absorption.
Some medications are available in more than one dosage form. When assigned to
Drop-off or Production, it is critical you validate you are dispensing the correct
dosage form.
There are four categories of dosage forms, which are detailed in the tables below.
1. Oral Solids: These medications are taken by mouth.
Tablets
Tablets are solid dosage forms which can vary in shape and size.
Unless otherwise noted, tablets should be swallowed whole, with
water.
Capsules
Capsules are generally small and oblong with a gelatin coating
and are filled with medication.
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Dosage Forms Continued
2. Oral Liquids: These medications are taken by mouth.
Solutions
These liquids are made up of solid medicinal ingredients that
are typically dissolved in water. Solutions are usually clear, but
may have some color.
Suspensions
These liquids have medication particles that are suspended in
liquid; the medication is not dissolved as it is with solutions.
Suspensions must be shaken before being poured into smaller
containers.
Reconstitutables These medications come as a powder and require a specific
amount of distilled water be added. After reconstituting, these
medications typically need to be refrigerated and should be
discarded after 10-14 days.
According to CVS policy only the Pharmacist or Intern, under
the direct supervision of a Pharmacist, is allowed to
reconstitute. Reconstitution should take place only after the
customer has arrived to pick up the prescription.
3. Topicals: These medications are applied directly to the skin.
Creams
Creams are made of water, oil, and other substances. Creams
are less greasy than ointments and are usually absorbed by the
skin.
Ointments
This topical product is typically a greasy preparation, usually
with a petroleum jelly base.
Lotions
Lotions are similar to creams, but contain more liquid. Like
creams, they are less greasy than ointments and are absorbed
by the skin. Lotions are typically prescribed when needed to
cover a larger part of the body.
Patches
Patches deliver medication through the skin. They typically
contain enough medication to leave on anywhere from 12 hours
to several days.
Gels
Gels are suspensions that are set to form a jelly. Gels tend to
have a drying effect on the skin.
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Dosage Forms Continued
4. Other: The following medications are administered in various ways.
Aerosols
Aerosols are sprayable products used to deliver medications.
This dosage form is most commonly used for delivering
medications to the top of the skin, or for inhaling into the lungs
or nasal passages.
Suppositories
Suppositories are typically manufactured in cylindrical, egg, or
pear shapes and are made for insertion into the rectum or the
vagina.
Otic
preparations
Otic (ear) medications are typically dispensed from bottle
droppers.
Ophthalmic
preparations
Ophthalmic (eye) medications are dispensed in bottle droppers
or in an ointment form; these medications must be sterile (i.e.,
free of bacterial contamination).
Injectibles
Injectibles are sterile preparations injected with syringes. The
most common type stocked in our pharmacies is Insulin.
Generic Medications
Most medications are available as brand or generic. According to the U.S. Food and
Drug Administration (FDA), a generic drug is a copy that is identical to a brand-name
drug in dosage, safety, strength, how it is taken, quality, performance and intended
use. FDA-approved generic drugs are bioequivalent and therapeutically equivalent
to their brand-name counterparts.
Dispensing generic medications has become the most effective way we can help our
customers manage prescription costs while ensuring their health outcomes. New
lower-cost, therapeutically equivalent generics are becoming available at a faster
rate than ever and our customers, both those who pay full price for their medications
as well as those with insurance coverage, are relying on those generics to control
their prescription expenses.
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Activity #3
Scavenger Hunt. Search your Pharmacy for examples of each of the
following types of medications.
Record the medication name and NDC number in the space allocated
below. Always ensure the medication is placed back in the proper area
when you are finished.
Name
NDC Number
Tablet
Capsule
Liquid
Ointment
Ophthalmic preparation
Otic preparation
Aerosol
Reconstitutable
Lotion
Insulin
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Controlled Substances
As a member of the Pharmacy Team, it is important you are able to recognize
prescriptions for controlled substances. Controlled substances are drugs that have
a high potential for addiction and abuse. As a result, the manufacture, possession
and/or use of controlled substances is strictly regulated by the federal and state
governments.
Controlled substances are classified into five schedules by federal law. They are:
Schedule
Schedule I
(CI)
Schedule II
(CII)
Schedule
III (CIII)
Schedule
IV (CIV)
Schedule V
(CV)
Description
These substances have a high potential for abuse.
Currently, no medicinal use is indicated for them. They are
not found in retail pharmacies, and it is illegal to possess
them in the United States.
These medications have a high potential for abuse and also
for severe physical and psychological dependence.
Prescriptions for CII substances are subject to the most
stringent regulations.
These medications have potential for abuse, but less
potential than those Schedule I or II medications. Abuse of
these substances may lead to moderate to low physical
dependence or severe psychological dependence.
These medications have a lower potential for abuse than
Schedules I, II, and III and are less likely to cause physical or
psychological dependence.
These medications have limited potential for abuse. These
medications are generally used as cough suppressants or as
anti-diarrheals.
There are very specific and stringent regulations pertaining to the handling and
dispensing of controlled medications. Some of the requirements and limitations
vary depending on the Schedule.
Ordering and Receiving Schedule II substances
Schedule II controlled substances (CII) are ordered with an official DEA order form
(DEA 222 form). Only Pharmacists that have been granted a valid Power of
Attorney (POA) can execute a DEA 222. Under no circumstances should a
Pharmacist who does not have a valid POA execute or submit a DEA 222. All
executed POA forms must be kept on file at the Pharmacy in which the POA is
executing 222 forms in sequential order in the appropriate folder in the Regulatory
Records Box. It is imperative that once you receive these forms, you ensure
that they contain your store’s address and DEA information. Once verified that
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Controlled Substances Continued
the forms are for your location, it is required that these forms are stored,
submitted and filed properly.
At CVS/pharmacy and according to policy, only Pharmacists are allowed to
handle CII medications, and they must remain locked in the safe at all times.
Dispensing Controlled Substances
CVS Pharmacists must dispense controlled substances only pursuant to valid
prescriptions that comply with federal and state laws. A prescription is considered
valid as long as both of the following requirements have been met.
1. The prescription must have been issued for a legitimate medical
purpose by a prescriber, acting in the usual course of his or her
professional practice.
o If you have a question regarding the validity of a prescription,
ask your Pharmacist.
o The Pharmacist should document these inquiries on the
back of the prescription as allowed by state law (including
the name of the person who was spoken to and the time of
the conversation).
o Even if the prescriber indicates that the prescription should
be filled as written, the Pharmacist must use his or her
professional judgment to determine whether the prescription
was issued for a legitimate medical purpose and in the
normal course of professional practice.
o Even if a prescription contains all of the required information
and otherwise meets the federal and state prescription
requirements, it must not be dispensed unless it was
written for a legitimate medical purpose. Only the
Pharmacist can determine whether a prescription is valid
and can be dispensed. The authority of mid-level
practitioners to prescribe controlled substances varies by
state; you must comply with state law regarding prescribing
authority.
2. A controlled substance prescription must contain all required
information and meet all federal and state requirements.
It is the responsibility of the Pharmacist to ensure all prescriptions are valid, prior
to dispensing medication.
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Controlled Substances Continued
As a Technician, you must verify that the information has been filled out
completely on the prescription. If the prescription was written for a legitimate
medical purpose, it must contain all required information including:
•
•
•
•
•
•
•
•
Patient’s full name and address
Prescriber’s full name, address and DEA registration number
Date the prescription is issued
Drug name, strength, dosage form and quantity
Directions for use
Number of authorized refills, if any
Manual signature of the prescriber
You must also verify the prescription is written on a tamper proof Rx
blank, where required
NOTE: The full list of required data elements can be found in the CVS/pharmacy
Accepting Prescription policy on RxNet.
Pharmacy Support Staff should also be alert for any sign that the prescription is
forged or has been altered. Look for “red flags” when working in the Pharmacy
and receiving and filling prescriptions for controlled substance(s). All Pharmacy
colleagues identifying a potential red flag must bring it to the attention of the
Pharmacist.
NOTE: When entering prescription information into RxConnect, all Pharmacy
colleagues must ensure that correct prescriber information is entered, including
the correct prescriber office address. There can be multiple prescribers with
similar names and you must make sure that the correct prescriber is identified
and selected.
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Controlled Substances Continued
Schedule II Dispensing:
A Pharmacist may dispense a controlled substance listed under Schedule II only
pursuant to an original hard-copy prescription that is manually signed by a
practitioner; the original prescription can be an e-prescription in states where
electronic prescribing is approved.
•
Unless they are emergency prescriptions or it is a prescription from a long
term care facility or hospice, CII prescriptions may not be dispensed until
the Pharmacy receives the original prescription (even if a faxed copy was
received in advance).
•
Must be in writing and manually signed by the prescriber; the original
prescription can be an e-prescription in states where electronic prescribing
is approved.

A partial fill for a CII is allowed if a Pharmacist cannot supply the full
quantity written, provided that the Pharmacist notes the quantity supplied
on the prescription and the remaining portion is dispensed within seventytwo (72) hours. If the remaining portion cannot be filled within the
seventy-two (72) -hour period the Pharmacist must notify the prescriber
and get a new prescription.
o Partial fills may also be allowed for patients in long term care facilities
or with terminal diagnoses. This usually requires proper
documentation on the prescription and may not be permitted by your
state’s law.
Federal law permits an emergency CII prescription to be phoned into the
pharmacy, with the amount dispensed limited to that necessary to treat the
patient during the emergency period. Please note that company policy
further restricts the maximum supply that may be dispensed in this
situation to a seventy-two (72) hour supply.
•
•
If the Pharmacy does not receive the written prescription, the Pharmacy
team must notify the DEA.
•
Schedule II prescriptions may not be refilled. However, in some
cases, DEA regulations allow practitioners to write multiple prescriptions
for Schedule II drugs (e.g., methylphenidate) to be dispensed over a
number of months. To be valid, such multiple prescriptions must meet the
following requirements, among others:
•
The total amount prescribed and dispensed pursuant to all of the
prescriptions must be limited to a 90-day supply with the original date
written on it.
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Controlled Substances Continued
•
Each prescription must be issued on a separate prescription blank.
•
Each separate prescription must be issued for a legitimate medical
purpose by an individual practitioner acting in the usual course of his or
her professional practice
•
The practitioner must provide written instructions on each prescription
indicating the earliest date the Pharmacy may fill the prescription (in the
form of “do not fill until __________”)
o Date listed on the Rx must not be predated
•
The issuance of multiple prescriptions must be permissible under
applicable state law. Many states limit the prescribing of Schedule II
drugs to a 30-day supply.
•
In an emergency, a CII prescription may be phoned into the Pharmacy,
but the amount dispensed must be limited to the amount necessary, or
as required by your state law, to treat the patient during the emergency
period and the prescriber must follow up with a written prescription within
seven (7) days, or less if required by your state’s law. The Pharmacist
must notify the local DEA field office if the prescriber fails to provide a
written prescription within the required amount of time required by law.
o NOTE: If your state law is more stringent than the federal regulation,
the state law must be followed.
Schedule III-V Dispensing
•
Schedule III and V (C III-V) controlled substances may be dispensed
pursuant to the following:
o A written prescription signed by the prescriber
o A faxed prescription as long as the original fax is manually signed
by the prescriber
•
For faxed prescriptions, an electronic, stamped or typed
signature is not a valid signature
o An oral prescription provided that the prescription is promptly
reduced to writing by the Pharmacist and contains all information
on a written prescription except for the signature of the prescriber
•
These verbal prescriptions are maintained with other CIII-V
prescriptions
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Controlled Substances Continued
Note: If your state law is more stringent than the federal regulation, the state law
must be followed.
•
Schedule III and IV prescriptions may be refilled if authorized on the
prescription. However, under federal law, the prescription may only be
refilled five times within six months after the original date of issue. After
five refills or six months, whichever comes first, a new prescription is
required.
•
Remember that state law may be more stringent.
Note: Partial refills are permitted in some states as long as they do not exceed the
amount prescribed in 6 months.
•
Under federal law, Schedule V prescriptions may only be refilled if
authorized on the prescription by the prescriber.
Note: Some states impose additional limits on controlled substance refills. Partial
refills are permitted in some states as long as they do not exceed the amount
prescribed in 6 months.
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Knowledge Check
Circle the correct answer for each question below.
1. Controlled substances are medications that:
a. Cannot be refilled
b. Are not available at CVS/pharmacy
c. Have potential for abuse
d. Are usually over-the-counter medications
2. If the prescription was written for a legitimate medical purpose, it
must contain:
a. Patient’s full name and address
b. Prescriber’s full name, address and DEA Registration
number
c. Drug name, strength, dosage form, quantity and
directions
d. Number of authorized refills, if any
e. Signature of the prescriber and the date issued
Activity #4
Some states have additional requirements related to the
handling/dispensing of controlled substances. It is important that you
recognize the different schedules and understand the regulations
pertaining to each.
Ask the Pharmacist to:
1. Review any state specific requirements pertaining to controlled
medications in your state.
a. One example includes state agencies with specific
requirements for the reporting of thefts or losses of controlled
substances. Refer to Appendix #2 for the detailed information
to review with your Pharmacist.
2. Show you samples of each schedule type and how they are
identified on the bottle.
Record your notes below:
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Pharmacy Basics: Workbook
Prescription Labels
Now that you understand medication types and medication stock bottle labels, let’s
take a look at the information provided on prescription labels.
Materials
In this section, you will review the information found on the prescription
label. Ask a Pharmacy Team Member to help you print a label that
you can use for the activities in this section. Once this activity is
complete, discard the label in the appropriate blue trash bag to ensure
confidentiality.
The prescription label is produced from the laser printer after prescription information
is entered into the Pharmacy Computer System.
The label has four sections, and each section is used in a different way (refer to the
label you obtained from a Pharmacy Team Member):

Section 1: The top section of the label contains the medication label, auxiliary
stickers, and ReadyFill Sticker (if applicable).

Section 2: The middle section of the label is the customer receipt. This section
contains promised date and time, order total, CareCheck Plus offerings,
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Materials Continued
Electronic Action Note (if applicable), Patient Care Note (if applicable) and
HIPAA Acknowledgement (if applicable).

Section 3: The bottom section of the label contains the medication monograph
which provides a brief description including uses and side effects.

Section 4: The back of the label contains the CVS Notice of Privacy.
The purpose of the CVS Notice of Privacy Practices (NoPP) is to comply with
HIPAA by informing our patients of the ways we may use their health information
and the reasons we may disclose this information to others. The NoPP prints
each time we fill a prescription for a new customer and in available in several
languages.
NoPP procedures vary depending on the state you are working in. Your Trainer
will discuss the CVS NoPP procedures with you in your classroom training.
Medication Guides
Medication Guides are also attached to prescription labels to address issues that are
specific to particular drugs and drug classes. They contain FDA-approved
information that can help patients avoid serious adverse events. FDA requires that
Medication Guides be issued with certain prescribed drugs and biological products
when the Agency determines that:
•
Certain information is necessary to prevent serious adverse effects
•
Patient decision-making should be informed by information about a known
serious side effect with a product, or
•
Patient adherence to directions for the use of a product is essential to its
effectiveness.
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Activity #5
Review Section 1 of your sample label. This section of the label
includes:

Medication label

Auxiliary stickers

ReadyFill stickers (if applicable)
Does your sample include a ReadyFill sticker? Discuss what the ReadyFill program
is with the Pharmacist or a Trainer.
Record your notes below.
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The Medication Label
The medication label is removed from the prescription label and affixed to the
customer’s medication bottle, vial, or package. It contains the following information:

Patient name and address

CVS store number, address, and telephone number

Prescription number

Refill information

Pharmacist who verified the prescription

Date the prescription was filled

Date the prescription was written

Quantity of medication dispensed

Date medication should be discarded

Name, strength, dosage form, and manufacturer of medication

Directions for taking medication

Barcode

Prescriber

Medication description

Cautionary statements

Auxiliary stickers
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Activity #6
Use the medication label section of your label to answer the questions below.
1. What is the name of the medication?
2. When was the prescription filled?
3. How many refills are available on the prescription?
4. When should the medication be discarded?
Third Party Billing
At CVS/pharmacy, over 92% of all prescriptions filled are processed using a third
party insurance plan. The term “third party” refers to any plan, group, or person
other than the customer that pays for all or part of the cost of a prescription.
In the pharmacy, third party typically refers to a plan or group rather than an
individual. Common types of third parties include insurance plans funded privately,
funded through a customer’s employer, or funded through state or federally-funded
programs.
Third parties can also include non-insurance based discounts, such as our own
Health Savings Pass or medication coupons given to a patient at the doctor’s office
or a prescription discount card.
CVS bills prescriptions on-line through the computer system for most third party
insurances. By doing so, the patient only has to pay for the co-pay portion of the
prescription for which he/she is responsible.
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The Customer Receipt
The middle portion of the prescription label is called the customer receipt. This
receipt is placed on the outside of the prescription bag and is used to file
prescriptions numerically in the Waiting Bins.
The receipt typically includes the:
1. First two letters of the
patient’s last name and date
filled
2. Waiting Bin Numeric
Assignment
3. Pharmacy address
4. Patient information
5. Prescription information
6. Third Party Plan code and
name
7. Safety cap indicator
8. Prescription number,
including two-digit refill
number
9. Promised date and time
10. Order total
11. Barcode used to scan
prescription into the register
12. Quantity of medication being
dispensed
13. Refills remaining on the
prescription
14. Dispense as Written (DAW)
code
15. ReadyFill Indicator
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The Customer Receipt Continued
The information indicated on the previous page may vary depending on the type of
receipt. There are three types of customer receipts which can often be identified by
the Third Party (TP) code located under the Prescriber name:
1. Cash: For these types of receipts, customers pay the full retail price of the
prescription. A Third Party Code of 1 or TP: 1 indicates a prescription was not
billed to a Third Party.
2. Discounts: In some states, CVS offers a 10% Senior Citizen discount to
individuals 60 years of age or older on all prescriptions that are not billed to an
insurance plan. The discount will automatically be applied to the patient’s
prescription (if applicable). Also, CVS Health employees receive a discount on
eligible cash prescriptions. TP: 1 designation will also appear on these receipts,
as the medication was not billed to a Third Party.
3. Third Party: Many CVS customers have third party coverage that helps pay for
their medication. Usually, these customers are responsible for a co-pay. The copay may be a fixed amount or a percentage of the full price. The amount they
must pay will be listed on the receipt. The Third Party Code for these
prescriptions will display the name of the customer’s prescription insurance that
was used.
The receipt portion of the prescription label is placed on the outside of the bag.
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The Customer Receipt Continued
The lower portion of the customer receipt may also contain information about
different programs, offers, or privacy practices. Examples of what you might see are:

CareCheck Plus offering: A program that targets
certain prescriptions as they are processed through
the Pharmacy Computer System. This program
educates the patient about his or her health condition
and/or the medication that they have been
prescribed. It may provide coupons for over-thecounter products that are directly related to the
product being dispensed or specific information
concerning the patient’s medication or medical
condition. Other messages printed by CareCheck
Plus may relate to corporate initiatives such as FLU
messaging, requesting donations for ALS at the
register, or Minute Clinic messages.

HIPAA Acknowledgement: The first time a patient
receives a prescription at CVS we must provide our
Notice of Privacy Practices (NoPP) and obtain the
patient’s electronic signature to acknowledge receipt
of it. If the patient is not picking up his/her own
prescription an acknowledgement is included on the
label so that it can be provided at another time.

Electronic Action Note: An Action Note is used by
the Pharmacy Staff to document any issues,
resolutions, and steps taken contact the patient and
resolve the issue. This information must be
communicated to the customer.

Patient Care Note: Patient Care Notes allow
pharmacy teams to interact with patients effectively to
help improve health outcomes through adherence to
prescribed therapy. You will learn more about Patient
Care Notes and the specific programs they support.
As an example, these notes may indicate that the
Pharmacist must counsel the patient, or the Team
Member at Pick-up may need to communicate
program specific information to the patient. In some
instances Patient Care Notes will print on the
prescription label and in others, they will need to be
stapled to the outside of the prescription bag.
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The Customer Receipt Continued
Always review the customer receipt thoroughly prior to ringing the sale to ensure the
patient name on the pharmacy register matched the customer receipt. You will be
prompted by the pharmacy register when Counseling is required. Inform the patient
that the Pharmacist has important information about one of their prescriptions, direct
them to the counseling area and notify the Pharmacist that counseling is required.
Activity #7
In order to help you recognize and understand the parts of a
prescription label receipt, use your sample label to answer the
questions below.
1. What is the type of the receipt?
2. What is the price the patient will pay for the prescription?
3. What is the prescription number?
4. What quantity of medication was dispensed?
5. What type of cap (safety or non-safety) will the patient receive?
6. How many prescriptions are in the order?
7. Is the prescription enrolled in ReadyFill?
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Pharmacy Basics: Workbook
Electronic Action Notes
An Action Note is used to document information that needs to be communicated to
the customer. Electronic Action Notes document any issue with a prescription,
attempts to resolve the issue, and attempts to contact the customer regarding the
issue. Team Members at Drop-off or Production may be prompted by the pharmacy
computer system to contact the patient with an issue and complete an Electronic
Action Note. The Action Note will print on the label receipt.
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Pharmacy Basics: Workbook
Action Note Responsibilities
The proper use of an Action Note benefits our customers as well as everyone in the
pharmacy. It is important to know the Action Note at each workstation.
Workstation
Action Note Responsibility
Drop-off
The Team Member at Drop-off is most often the originator of the
Action Note. When an issue arises, the Team Member at Drop-off
is prompted by the pharmacy computer system to:
Production
Quality
Assurance

Contact the patient to reset expectations

Enter the result of your attempt to contact the patient into the
pharmacy computer system
The Team Member at Production may be the first person to identify
a partial fill or out-of-stock situation. When this occurs, the Team
Member must edit the prescription to reflect the partial or out-ofstock and:

Contact the patient to reset expectations

Enter the result of your attempt to contact the patient into the
pharmacy computer system
If an issue arises, the QA Pharmacist is prompted by the pharmacy
computer system to:

Contact the patient to reset expectations

Pick-up
Drive-thru
Enter the result of the attempt to contact the patient into the
pharmacy computer system
The Team Member at Pick-up is responsible for communicating
information on an Action Note, as prompted by the pharmacy
register.
The Team Member at Drive-thru has the same responsibility as
Pick-up.
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Viewing an Action Note for a Prescription
You can access and review Action Note information in:
•
•
The Pharmacy computer system: If a patient calls to inquire about a recent
call to their home, it may be due to an issue with their medication. You can
access their Patient Profile to view the Action Note.
•
When the Action Note indicator is orange, it indicates that the issue
regarding the prescription has not yet been communicated to the
customer.
•
When the indicator is gray, it means that the Action Note and the issue
has been communicated to the customer.
At the Pharmacy register at time of pick-up: At Pick-up and Drive-thru,
Team Members will have visibility to Action Notes and the information needed
to communicate the issue to the customer.
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Communication Vehicles
Pharmacy Team Members have various ways of communicating with each other,
other stores, Field Management, and the Customer Support Center. In this section,
you will learn about a few examples of how information is exchanged.
Spark
Spark is the CVS Enterprise Portal used to access web-based tools designed to
improve communication, provide access to key business information, and support
our commitment to flawless execution. Spark provides stores with a single point of
access to tools such as:

E-mail: Stores receive emails from the Contact
Support Center as well as Field Management. It is
important for emails to be read and printed on a
daily basis for other Team Members to review.

Hub: A central location that allows Store Teams
to review workload, assign accountability and
completion dates, create store-specific tasks,
print to-do lists, and mark tasks completed once
they are performed.

RxNet: An intranet site available that contains various reference and
resource materials for the Pharmacy Team.

Bulletin Board: Contains Announcements and Reference Materials.

Links: Access to key websites and applications.

Reports: Access to Store Level reporting for various programs and
processes.
Once logged in to the CVS Enterprise Portal, you can easily access all of the
applications available on the Spark home page without having to log into each
application separately with different passwords.
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Activity #8
Ask a Pharmacy Team Member to help you access Spark from the
Pharmacy Computer System.
1. View any tasks in the Hub for you to complete and record those
tasks in the space below.
2. Access the store e-mail and send a message to your Pharmacy
Trainer. Enter the following in the Subject line: “ (Your name) Completing Pharmacy Basics Workbook”.
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RxNet
RxNet is a CVS Intranet site available from Spark. The following items are a few
examples of the information available on RxNet:

Patient Care Initiative (PCI) Programs Page: Provides
access to CVS Health program information aimed at improving
patient outcomes

RxConnect Support Page: Support site for the pharmacy
computer system

Quality Assurance: Site dedicated to patient safety including
best practices, procedures and incident reporting

Clinical Services Page: Professional support such as the Drug
Information Center, Immunization Program, and Compounding
Corner

Inventory Management Tab: Provides access to the Inventory
Management Guide, ordering information, and Drug Recalls

Payer Relations: A resource for key third party information

Pharmacy Operations Manual: A reference tool that provides
the Pharmacy Team with the direction necessary to run the
department

Pharmacy Workload Calendar: A monthly calendar that
identifies the key activities that must be completed by the
Pharmacy Team

Language Line Services: Provides information about our
Telephonic translation service of approximately 150 languages
which is offered to patients that do not speak or understand
English
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Activity #9
Ask a Team Member to help you access RxNet from the Pharmacy
Computer System.
Explore the following:
1. Inventory Management Reference Guide
2. Pharmacy Operations Manual
3. Your state-specific reference page
Record your notes in the space below.
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V-NET (Voice Networking) and Contact
Information
Calls can be made between stores or to the Support Center by using
the CVS calling plan system, better known as V-Net. Calls are
dialed as follows:
Contact
Calling other stores
Calling individual extensions at the
Contact Support Center
Helpdesk for all technical support,
human resource support or program
support. (For example, RxConnect
problems, printer repairs, Third Party
issues, Human Resource issues)
Telephone Number
1-700-600-XXXX (XXXX = store #)
1-700-602-XXXX
(770-XXXX = extension #)
Calling the FIXX line for repairs
1-866-349-9287
1-866-528-7272
NOTE: In most stores, you will first need to dial ‘9’ to obtain an outside line.
Red Bag
Red Bags are an interoffice mail system. Hard copy communications and other items
that need to be delivered to the stores are delivered via Red Bag. For example,
Connections is a CVS newsletter that keeps all CVS colleagues informed about
changes, initiatives, and important news within the company.
CVS.com
CVS.com is an extension of our CVS/pharmacy stores with 24/7 convenience. It
contains industry leading online tools and services that complement the CVS Health
Vision, Mission, and Values. The site provides health and drug information to
empower the CVS customer to take charge of their health, improving the quality of
their lives.
The key prescription management services available on CVS.com include:
• View your CVS prescription profile online
• View/print your CVS prescription history
• Submit prescription refills online for pick-up at any CVS/pharmacy location
• Check the status of prescriptions online
• Set up email refill reminders
• Request prescriptions to be transferred from competitor pharmacies and filled
at any CVS/pharmacy location
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Activity #10
To take advantage of the advanced prescription management features
offered online, visit CVS.com, create an account (if not already a
registered user), and become familiar with the site and the features
available.
1. Create a CVS.com account by providing an email address
and password
2. Sign-up for prescription management by providing the store
and prescription number from a CVS prescription and
answering a few questions to ensure the prescription history
is accessible only to you
Explore the site and list the benefits that you think the Pharmacy Team
will see by patients using the site.
Record your notes in the space below and discuss the Pharmacy
Teams benefits with a Team Member.
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Pharmacy Basics: Workbook
Course Completion
Congratulations! You have completed the Pharmacy Basics workbook. You should
now be able to:

Describe key information included on the stock bottle

Identify the various types of medication dosage forms

Recognize the elements of prescription labels

Recognize medication schedules

Identify and communicate Action and Patient Care Notes correctly

Identify the different communication vehicles used in the pharmacy
Next Steps
In order to receive credit for the completion of this workbook, you need to complete
an on-line assessment to test your understanding of what you have learned. This
assessment is available from the Pharmacy Basics Workbook course description
page on LEARNet. Please contact your Trainer with any questions/concerns.
Once you have completed the assessment, you will attend the Foundations of
Pharmacy class.
Remember to bring your completed workbook to the Foundations of
Pharmacy class. Your Trainer will review the activities during class.
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Appendix #1: Knowledge Check Answer Key
The following provide answers to the knowledge check questions from this course.
The Activities will be reviewed during the Foundations of Pharmacy class.
Pharmacy Settings
Question
Your Answer
1. Which type of pharmacy setting do you work in if
you work at a pharmacy CVS retail store?
Community Retail Pharmacy
2. Which other types of pharmacy settings do you
think there are there at CVS Health? As you
answer this question, think about our services such
as Omnicare and other ways that our patients
receive their filled prescriptions from CVS Health.
Compounding Community
Pharmacy (Specialty
Services), Long-term Care
Pharmacy (Omnicare), and
Mail-Order Pharmacy
The Pharmacy Workflow
Workstation
Roles and Responsibilities
Quality
This workstation, which is staffed by a Pharmacist, is where final
Assurance
accuracy checks are completed prior to dispensing a prescription
to the patient.
Production
The Team Member assigned to this workstation fills prescriptions
to keep the process flowing and to ensure that the patient
receives the correct medication(s) when promised.
Drive-thru
At this station the Team Member is responsible for both
Drop-off and Pick-up tasks.
Drop-off
This is a critical piece of the prescription fulfillment process.
When a customer brings a prescription to the pharmacy, the
interaction at this workstation is the customer’s first indication of
the service level that will be provided by the pharmacy team.
Pick-up
Team Members serve customers picking up their prescription(s)
in the store.
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Appendix #1: Knowledge Check Answer Key Continued
Regulation Scenarios
Regulation
or Agency
Scenario
1. A patient gives you her medication vial. She explains that she would
like to exchange the safety cap for a non-safety cap because she is
unable to open the vial.
CPSC
2. A license for each Pharmacist that works in the store is displayed on
the wall.
State Board
3. You make the Offer to Counsel (per state regulations) to ensure the
patient is fully informed about his/her prescriptions.
OBRA ‘90
4. You read about a new medication that has recently been approved
and ask your Pharmacist when your store might get the medication.
Your Pharmacist tells you it will be available in a few weeks.
FDA
5. You place Blue Trash Bags at all pharmacy workstations to ensure all HIPAA
Confidential Pharmacy trash (excluding food & beverage), Pharmacy
records, Front Store confidential materials, and MinuteClinic trash
(where applicable) are disposed of properly.
Medication Identification
Item
Answer
Product name
Plavix
Medication Strength
Storage Requirement
Package Quantity
Medication Dosage Form
Manufacturer’s Name
Controlled Substance Mark
Lot Number
Expiration Date
National Drug Code (NDC) Number
75 mg
25o C (77o F)
90
Tablets
Bristol-Myers Squibb
N/A
F6843
08 - 2009
63653-1171-1
Controlled Substances
1. Controlled substances are medications that:
a.
Cannot be refilled
b.
Are not available at CVS/pharmacy
c.
Have potential for abuse
d.
Are usually over-the-counter medications
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Appendix #1: Knowledge Check Answer Key Continued
2. If the prescription was written for a legitimate medical purpose, it must
contain:
a.
Patient’s full name and address
b.
Prescriber’s full name, address and DEA Registration
number
c.
Drug name, strength, dosage form, quantity and
directions
d.
Number of authorized refills, if any
e.
Signature of the prescriber and the date issued
Page 52 of 58
Appendix #2: Reporting Thefts or Losses of Controlled
Substances
Colleague Responsibility
Federal regulations require that thefts and significant losses of controlled substances be
reported to the DEA. The DEA must receive initial notification of the theft or loss of controlled
substances within 24 hours of discovery of the theft or loss. Therefore, it is important
that all CVS/pharmacy colleagues immediately report any suspected theft or loss of a
controlled substance to the Pharmacist on duty, who is responsible for executing their
due diligence to confirm the loss within 72 hours and filing the Initial Notification with
24 hours of confirmed loss.
CVS/pharmacy wants to ensure the security of controlled substances and prevent the
possible diversion of prescription drugs to addicts or criminals. We also must prevent
diversion of drugs by CVS/pharmacy colleagues.
Pharmacy colleagues must immediately report an incident to the Pharmacist on duty so that
the appropriate investigation and notifications can take place. The incident should also be
reported to the Ethics Line by calling 877-CVS-2040 or online at www.cvscaremarkethicsline.ethicspoint.com.
If a colleague is not comfortable reporting an incident to the Pharmacist on duty, then the
incident must immediately be reported to the Ethics Line by calling 877-CVS-2040 or online
at www.cvscaremark-ethicsline.ethicspoint.com.
Incidents to be reported:
•
•
•
You suspect that there may have been a theft of controlled substances
You suspect unauthorized access to or any breach of security regarding controlled
substances
You believe that there has been an unexplained loss of controlled substances, which
might include:
o a loss of a significant amount of a controlled substance
o a pattern of losses
o any other suspicious circumstances regarding the loss of controlled substances
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Appendix #2: Reporting Thefts or Losses of Controlled
Substances, continued
The Reporting Process
The Pharmacist on duty must report the loss or theft of controlled substances immediately
upon discovery.

The Initial Notification of Suspected Controlled Substance Theft or Potential
Significant Loss Form must be filled by using the electronic Initial Notification of
Suspected Controlled Substance Theft or Potential Significant Loss Form
(available in Spark under the “Applications” tab) and notify his/her District
Leader or Target Pharmacy Supervisor of the situation within 24 hours of
discovery of theft or loss.

The Pharmacist on Duty must complete the electronic Initial Notification form located
within Spark in full, listing the correct fax numbers for the nearest DEA Field Office,
State Board of Pharmacy (where applicable) and/or State Controlled Substance
Authority (where applicable.) The Spark application will automatically send a copy of
the form to CVS Drug Loss Program team at Drug_Loss_Program@CVSHealth.com.

The information from the Initial Notification Form and the Mandatory Internal
Coversheet will be entered into the Archer Drug Loss Program Database (“Archer
DLP”) by a member of the Drug Loss Program team.

Upon completion, the Drug Loss Program team will distribute a copy of the Initial
Notification form identifying theft or significant loss to the store via fax, which needs to
be stored in the correct folder in the Regulatory Records Box.

The Pharmacist must also notify his or her District Leader or Target Pharmacy
Supervisor within 24 hours of any theft or potential loss involving controlled
substances.

At the conclusion of a case involving a loss, a Drug Loss Program team member will
submit the closing documentation (DEA 106 form or Letter of Conclusion) to the
applicable regulatory agencies. Once the DEA 106 form or Letter of Conclusion has
been completed, the Pharmacy will receive and must retain a copy of all paperwork
including the Initial Notification form (if received from the Drug Loss Program team),
completed DEA 106 form or letter of conclusion in the Regulatory Records Box.

Before filing submitted 106 forms in your Regulatory Records box, please ensure that
your store is following the security measures that are documented on section 17 of the
form.
• All thefts, regardless of the quantity involved, must be reported. This includes if the
Pharmacy is the victim of colleague theft, armed robbery, burglary, “snatch and grab”
or other similar incidents where controlled substances or listed chemicals are taken.
All “significant losses” of controlled substances must be reported. The DEA has not
defined “significant,” so the Drug Loss Program will make the determination, with the
assistance of Legal, as to whether a loss qualifies as “significant.”
 NOTE: For controlled substance liquids, particularly Schedule II liquids,
accurate dispensing is important as even small amounts of overdispensing or
small quantities remaining in dispensing vessles can add up to a signficant loss
over time.
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
If you have any legal questions regarding theft/loss reporting, you may send your
question to Drug_Loss_Program@CVSHealth.com.
Appendix #2: Reporting Thefts or Losses of Controlled
Substances, continued
In some cases, the state agency may have different time requirements for the filing of theft/loss
notifications or reports, may require that events other than theft or “significant loss” be reported and
may require the use of a specific state reporting form.

Some states have their own theft/loss reporting requirements, and it is the responsibility of any
Pharmacist working in those states to be aware of the specific state requirements.
All colleagues handling controlled substances should be thoroughly familiar with CVS/pharmacy
policies and procedures on reporting of thefts/losses of controlled substances.
The critical role of each CVS/pharmacy colleague is as follows:
Colleague
Responsibility
All CVS Colleagues
•
Pharmacist on duty
•
•
•
•
•
District Leader or
Target Pharmacy
Supervisor
•
•
The colleague discovering the theft or loss of a controlled
substance should report the matter to the Pharmacist on duty.
If the colleague is not comfortable reporting to the Pharmacist
on duty, he/she may notify the Ethics Line by calling 1-877CVS-2040.
The Pharmacist on duty must report the suspected loss or
theft of controlled substances within immediately upon
discovery by electronically submitting an Initial Notification of
Suspected Controlled Substance Theft or Significant Loss
Form.
The Pharmacist on duty must complete the electronic Initial
Notification of Suspected Controlled Substance Theft or
Significant Loss Form which is available in RADAR, under the
“Applications” tab and be sure to
o Complete it in full
o List the correct fax numbers for the nearest DEA Field
Office and State Board of Pharmacy (where applicable)
The Spark application will automatically send a copy of the
form to the CVS Drug Loss Program team at
Drug_Loss_Program@CVSHealth.com.
Police must also be notified of all thefts.
The Pharmacist must also notify his or her District Leader or
Target Pharmacy Supervisor within 24 hours of any theft or
loss involving controlled substances.
The District Leader or Target Pharmacy Supervisor will
coordinate the investigation with Loss Prevention and is
responsible for filling in the 106 fields in the Archer DLP.
Note: If you are not familiar with the Archer DLP please refer
to course # 820001.
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Appendix #2: Reporting Thefts or Losses of Controlled
Substances, continued
Once reported to the District Leader or Target Pharmacy Supervisor, the District Leader or
Target Pharmacy Supervisor must:
• Confirm that the Initial Notification form was submitted to the appropriate regulatory
agencies
• Coordinate with Loss Prevention to initiate an investigation of the incident
• If the incident is a theft, it must also be reported to local law enforcement
• Upon completion of the investigation, complete the 106 fields in the Archer DLP so
that Rx Regulatory can submit the DEA 106 Form
• If the investigation remains ongoing for more than 30 days, update DEA (and state
authorities, if applicable) with a letter of continuation every 30 days until the
investigation is complete
What must be reported?
If questionable or suspicious activity is observed you must report these activities.
Furthermore, all violations of company policy or procedure must be addressed individually
and the appropriate field management notified.
To report this activity, you may provide the information to:
 District Leader or Target Pharmacy Supervisor
 RLPM
 Regional Director or HR Business Partner
 The Ethics Line at 1-877-CVS-2040
Failure to timely report a potential violation of the law or company policy related to
controlled substances can lead to action up to and including termination.
The information on suspicious activity you are expected to provide does not have to be a
result of witnessing diversion. You are expected to report on suspicions or indications that
diversion may be occurring. The Loss Prevention department’s role is to validate concerns
and report findings to the appropriate parties. All information is handled discreetly and
confidentially.
Similarly, there are times that you as a Pharmacist may be asked for information or
participate in an investigation. All LP investigations are confidential. Please do not discuss
actions or details with anyone other than the LP department. This will jeopardize the
investigation and prolong a loss.
Additionally, questions or concerns about diversion or potential diversion can be directed to
Drug Loss Program team at Drug_Loss_Program@CVSHealth.com.
Page 56 of 58
Appendix #2: Reporting Thefts or Losses of Controlled
Substances, continued
In-Transit Losses
“In-transit” losses are those losses that occur while controlled substances or listed
chemicals are en route from one facility to another (e.g., from a wholesaler to a
distribution center, or from a distribution center to a retail store). All in-transit losses must
be reported to the DEA, regardless of the quantity of controlled substances involved.
Pharmacists and Pharmacy colleagues must notify the Pharmacy Team Leader or the
Pharmacist on duty immediately of any shortages in shipments of controlled substances
received in the Pharmacy.
The Pharmacy Manager or Pharmacist must refuse any shipment from an outside vendor
if any shortage or discrepancy is identified.
The Pharmacy Manager or Pharmacist on duty must immediately notify their District
Leader or Target Pharmacy Supervisor, Loss Prevention and Distribution Services (if the
order is being received from a distribution center) upon discovery of an in-transit loss.
• Penalties for Violations
• Consequences:
•
Failure to report thefts or losses in a timely manner can result in serious consequences
for the company, including monetary penalties and other sanctions.
•
Failure by a colleague to immediately report a potential theft or loss of a controlled
substance or a security breach regarding controlled substances can result in
disciplinary action, up to and including termination.
•
We will promptly investigate any incident involving the theft or loss of controlled
substances or listed chemicals.
•
Any colleague involved in stealing or diverting controlled substances, listed chemicals
or other drugs will be terminated. Information about the incident also will be turned over
to law enforcement and state authorities, including state Boards of Pharmacy.
Page 57 of 58
Payroll Slip for Pharmacy Basics Self-paced Workbook
In order to be paid properly for completing this workbook and assessment, you must then
complete this form and give it to your Home Store Manager who will record the appropriate
number of hours under the payroll code indicated.
Employee Name: ___________________________
Day: __________________________________
Start Time*:
_______________
End Time*:
________________
EMP ID: _______________
Date: ______ / ______ / ______
Total Hours to be charged to TR7 Payroll*: __________
*Include time spent reading the workbook and completing the on-line assessment.
Employee Signature: ________________________________________________
Home Store Manager – Retain this form with your payroll records for the appropriate time
period.
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