A pill verification system obtains a prescription filled at a pharmacy and gathers information of the pills being dispensed for a remote pharmacist to verify the prescription. As pills are dispensed to a pill vial to fill the prescription, a pill imaging system captures images of the pills, and a pill vial imaging system captures an image of the pill vial. The prescription, pill images, and pill vial image are transmitted to a remote verification system. A pharmacist is presented with the prescription, images of substantially all pills filling the prescription, and the pill vial of the prescription to verify the prescription is correct. The remote verification system may present prescriptions filled from many different pharmacies, permitting increased rate of verification and one pharmacist to support many pharmacies. The pharmacist's verification is transmitted to the pill verification system and displayed for a technician to complete verification of the pills.