Automatic packager for pharmaceuticals and method of operating the same. The method includes receiving a prescription to be filled by a pharmacy management system and identifying one or more bulk containers that contain medications to fill the prescription. The method also includes counting, using a pre-counter, medications from the one or more bulk containers to fill the prescription and depositing the counted medications in one or more cartridges. The method also includes placing the one or more cartridges including the counted medications at an automatic packager and dispensing the medications in the one or more cartridges. The method also includes packaging medications dispensed from the one or more cartridges into packages and verifying whether the medications are correctly packaged.