A pharmaceutical order filling system receives pharmaceutical orders and uses an accumulation device to accumulate bottles of pharmaceuticals corresponding to the pharmaceutical orders. The accumulation device is configured with a table assembly that includes a plurality of holding tubes configured to accumulate multiple bottles corresponding to pharmaceutical orders. The accumulation device also includes a bottle pick and place assembly configured to place bottles into holding tubes and an unload assembly configured to empty accumulated bottles from holding tubes into an unload assembly tube. The accumulation device may be further configured to receive and temporarily store a single bottle of a prescription order. The accumulation device may be configured to release accumulated bottles onto a conveyor in an upright position.