A system and processes for automating and verifying medication order fulfillment and medication administration compliance. A medication package is formed from a package back pane and blister housing, and filled in accordance to a prescription order. The package back pane has a medication housing color pattern that contrasts medication colorings of a prescribed medication, such that a number of empty medication blisters can be determined from a package image matrix generated by analyzing the medication housing color pattern, the medication colorings, and a plurality of reference marks on the package back pane from a captured image of the medication package. The package image matrix is compared to a previous package image matrix in order to determine if the prescribed medication has been administered properly. A unique prescription code of the medication package can program a processor with a scheduling profile, medication order information, and the package image matrix.