why is the opening in the large size smaller than the opening in medium/wide size?

I am just guessing: because you did not get a wide size large.

Are these nasal pillows factory sealed or just zip lock bag?

My nose piece was sealed in plastic.

Is this the nasal cushion or mask frame?

it is just the nasal cushion, for but they sell the frame too. Link for the large size frame, $9.22 - https://www.amazon.com/Philips-Respironics-DreamWear-Nasal-Frame/dp/B01CLEFNWC/ref=pd_bxgy_1/135-4741946-4642053?pd_rd_w=dpOfq&pf_rd_p=c64372fa-c41c-422e-990d-9e034f73989b&pf_rd_r=TTGGF4YC9A0CBZSA20RD&pd_rd_r=d3f42c49-b920-4b7f-a402-ddad2692517e&pd_rd_wg=S0AO2&pd_rd_i=B01CLEFNWC&psc=1

The photo shows a medium but the item description is a large. There isnt a choice to select the size. Do you carry a medium or not?

Yes they have small medium and large but I think medium comes with all of the headgear combo units even if you order the large frame you get a medium pillow. You can order separate but I think it costs a little more

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😌 Sleep smart, breathe easy — upgrade your comfort game tonight!

HYGIENIC WASHABLE - Easy to clean and maintain, keeping your respiratory care routine fresh and safe.
EFFORTLESS COMFORT FIT - Unique under-the-nose design ensures minimal facial contact and maximum comfort throughout the night.
PREMIUM MATERIAL BLEND - Crafted from soft, durable silicone and polycarbonate for long-lasting use and gentle skin feel.
CONFIDENCE BACKED WARRANTY - Enjoy 90 days of service assurance, because your health deserves dependable support.
RELIABLE REPLACEMENT FRAME - Specifically designed as a large replacement frame for DreamWear Gel Pillows Cushion Mask—upgrade your setup without hassle.

The Philips HH1114/00 is a large replacement mask frame designed exclusively for the DreamWear Gel Pillows Cushion Mask. Made from a soft, durable silicone and polycarbonate blend, it features a unique under-the-nose fit that maximizes comfort and minimizes facial contact. Lightweight and washable, this frame comes with a 90-day warranty, ensuring reliable performance and hygiene for your respiratory care needs.

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