The Dish pessary is made from 100% medical grade silicon by Biotique America. Every pessary is shipped in manufacturer’s sealed packing with how to use instructions enclosed. Fitting must be done by a physician, so you must know your proper size AND type.HCPCS Reimbursement Code:For Pessary-A4562……Code for the Office Visit-99214……CPT Procedure Code for Fitting & Insertion-57160 We do not accept returns if item was opened or because youā€™ve chosen the wrong size.Please, know your size! Fitting should be done by a physician. *Discounts are available for returning customers and when BUY 10 or more.