Post on 21-Apr-2015
Global leaders in sleep and respiratory medicine
• Swift FX Nasal Pillows System and Accessories..............................2
• Swift FX for Her and Swift FX Bella Nasal Pillows Systems.............3
• Swift LT and Swift LT for Her Nasal Pillows Systems.....................4,5
• Mirage Swift II Nasal Pillows System and Accessories.....................6
• Mirage FX and Mirage FX for Her Nasal Mask Systems..................7
• Mirage SoftGel Nasal Mask System and Accessories..................8,9
• Mirage Activa LT Nasal Mask System and Accessories.............10,11
• Mirage SoftGel/Activa LT ConvertAble Pack..................................12
• Mirage Activa Nasal Mask System and Accessories......................13
• Mirage Micro and Mirage Micro for Kids Nasal Mask Systems.......14
• Ultra Mirage II Nasal Mask System and Accessories.....................15
• Pixi Pediatric Nasal Mask System..................................................16
• Mirage Vista and Mirage Kidsta Nasal Mask Systems...................17
• Quattro FX and Quattro FX for Her Full Face Mask Systems....18,19
• Mirage Quattro Full Face Mask System and Accessories.........20,21
• Ultra Mirage Full Face Mask System and Accessories..............22,23
• Mirage Liberty Full Face Mask System and Accessories..........24,25
• Mask Spares and Accessories.......................................................26
• S9 APAP and CPAP Flow Generators.......................................27,28
• S9 VPAP Bilevel Flow Generators.................................................29
• S9 Humidifiers and Accessories.....................................................30
• Ventilation Products.......................................................................31
• C-Series Flow Generator................................................................32
• Software, Modules and Accessories.........................................33,34
• ApneaLink/ApneaLink Plus and Accessories............................35,36
• Flow Generator Accessories and Filters...............................37,38,39
• Heated Humidification Systems and Accessories..........................40
Lasting Results
QUALITY SYSTEMS
COMPLETE SOLUTIONS
RELIABLE PRODUCTS
ResMed CorpProduct List
Effective: January 2012Contents
2Confidential Home Care Provider Product List
Swift™ FX NasalPillows System
Item # Description HCPCS
61500 Swift™ FX nasal pillows systemIncludes small, medium, and large size dual-wall pillows, and headgear
A7034,+A7035
PILLOWS
61520615216152261523
Extra small dual-wall pillow Small dual-wall pillow Medium dual-wall pillow Large dual-wall pillow
A7033
FRAME
61510615116151261513
Swift FX frame system with extra small dual-wall pillows - no headgearSwift FX frame system with small dual-wall pillows - no headgearSwift FX frame system with medium dual-wall pillows - no headgearSwift FX frame system with large dual-wall pillows - no headgear
A7034
61528 Swift FX frame assembly - no dual-wall pillows, no headgear N/A
HEADGEAR
61529 Headgear assembly A7035
ACCESSORIES
6152861530611216054960550
Short tube assembly - refer to Swift FX frame assembly (Item #61528) Soft wraps - 2 packDistal pressure port attachmentPressure port plug - 1 packPressure port plug - 10 pack
N/AN/AN/AN/AN/A
3Confidential Home Care Provider Product List
Swift™ FX for Her Swift™ FX Bella
Nasal Pillows Systems
Item # Description HCPCS
61540
61560
Swift™ FX for Her nasal pillows systemIncludes extra small, small, and medium size dual-wall pillows, and headgear
Swift™ FX Bella nasal pillows systemIncludes extra small, small, and medium size dual-wall pillows, Bella Loops accessory and Swift FX forHer headgear with soft wraps
A7034,+A7035
PILLOWS
61520615216152261523
Extra small dual-wall pillow Small dual-wall pillow Medium dual-wall pillow Large dual-wall pillow
A7033
FRAME
61510615116151261513
Swift FX frame system with extra small dual-wall pillows - no headgearSwift FX frame system with small dual-wall pillows - no headgearSwift FX frame system with medium dual-wall pillows - no headgearSwift FX frame system with large dual-wall pillows - no headgear
A7034
61528 Swift FX frame assembly - no dual-wall pillows, no headgear N/A
HEADGEAR
61543
61580
Swift FX for Her headgear assembly (headgear, pink and light blue back straps, pink andgray soft wraps)
Swift FX for Her headgear assembly with Bella Loops accessory (headgear, pink andlight blue back straps, pink and gray soft wraps, Bella Loops)
A7035
ACCESSORIES
61528615306154461121605496055061581
Short tube assembly - refer to Swift FX frame assembly (Item #61528) Soft wraps - 2 pack (gray)Soft wraps - 2 pack (pink)Distal pressure port attachmentPressure port plug - 1 packPressure port plug - 10 packSwift FX Bella Loops
N/AN/AN/AN/AN/AN/AN/A
4Confidential Home Care Provider Product List
Swift™ LT NasalPillows System
Item # Description HCPCS
60560 Swift™ LT nasal pillows systemIncludes small, medium, and large size dual-wall pillows, and headgear
A7034,+A7035
PILLOWS
60574605716057260573
Extra small dual-wall pillow Small dual-wall pillow Medium dual-wall pillow Large dual-wall pillow
A7033
FRAME
60585605826058360584
Swift LT frame system with extra small dual-wall pillows - no headgearSwift LT frame system with small dual-wall pillows - no headgearSwift LT frame system with medium dual-wall pillows - no headgearSwift LT frame system with large dual-wall pillows - no headgear
A7034
60581 Swift LT frame assembly - no dual-wall pillows, no headgear N/A
60575 Frame only N/A
HEADGEAR
60578 Headgear assembly A7035
ACCESSORIES
611216055860559605796058060577607426058660557605496055060599
Distal pressure port attachmentHeadgear buckle (back) - 1 packHeadgear buckle (back) - 10 packHeadgear buckle (top) - 1 packHeadgear buckle (top) - 10 packShort tube assembly, includes elbow, short tube and swivel - 1 packShort tube assembly, includes elbow, short tube and swivel - 10 packTube retainer (plastic)Tube retainer (velcro)Pressure port plug - 1 packPressure port plug - 10 packSoft wraps - 2 pack
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
5Confidential Home Care Provider Product List
Swift™ LT for Her NasalPillows System
Item # Description HCPCS
60588 Swift™ LT for Her nasal pillows systemIncludes extra small, small and medium size dual-wall pillows, and headgear
A7034,+A7035
PILLOWS
60574605716057260573
Extra small dual-wall pillow Small dual-wall pillow Medium dual-wall pillow Large dual-wall pillow
A7033
FRAME
60585605826058360584
Swift LT frame system with extra small dual-wall pillows - no headgearSwift LT frame system with small dual-wall pillows - no headgearSwift LT frame system with medium dual-wall pillows - no headgearSwift LT frame system with large dual-wall pillows - no headgear
A7034
60581 Swift LT frame assembly - no dual-wall pillows, no headgear N/A
60575 Frame only N/A
HEADGEAR
60595 Headgear assembly - light blue A7035
ACCESSORIES
6112160740607416059760596605776074260598605496055060599
Distal pressure port attachmentHeadgear buckle (back) - 1 pack - light blueHeadgear buckle (back) - 10 pack - light blueHeadgear buckle (top) - 1 pack - light blueHeadgear buckle (top) - 10 pack - light blueShort tube assembly, includes elbow, short tube and swivel - 1 packShort tube assembly, includes elbow, short tube and swivel - 10 packTube retainer (plastic) - light bluePressure port plug - 1 packPressure port plug - 10 packSoft wraps - 2 pack
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
6Confidential Home Care Provider Product List
Mirage Swift™ II NasalPillows System
Item # Description HCPCS
60512 Mirage Swift™ II nasal pillows systemIncludes small, medium, and large size pillow sleeves, and headgear
A7034,+A7035
PILLOW SLEEVES
605416054260543
Small pillow sleeveMedium pillow sleeveLarge pillow sleeve
A7033
FRAME
605376053860539
Mirage Swift II frame system with small pillows - no headgearMirage Swift II frame system with medium pillows - no headgearMirage Swift II frame system with large pillows - no headgear
A7034
60544 Mirage Swift II frame assembly - no pillows, no headgear N/A
60536 Frame with clip and cap only N/A
HEADGEAR
60526 Headgear A7035
ACCESSORIES
61121605236054060524605256052860529605306054960550
Distal pressure port attachmentHeadgear buckleFrame clipSeal ring - 10 packSeal capShort tube assembly, includes elbow, short tube and swivel - 1 packShort tube assembly, includes elbow, short tube and swivel - 10 packTube retainer - 3 packPressure port plug - 1 packPressure port plug - 10 pack
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
7Confidential Home Care Provider Product List
Mirage™ FX and Mirage™ FX forHer Nasal Mask Systems
Item # Description HCPCS
62103
62118
62128
Mirage™ FX nasal mask complete system Includes cushion and headgearMirage FX nasal mask complete system - wideIncludes cushion and headgearMirage™ FX for Her nasal mask complete system Includes cushion and headgear
A7034,+A7035
CUSHIONS
6211162125
Mirage FX and Mirage FX for Her cushion - standardMirage FX cushion - wide A7032
FRAME SYSTEM
6211262126
Mirage FX and Mirage FX for Her frame system with cushion - standardMirage FX frame system with cushion - wide
A7034
HEADGEAR
6211062129
Mirage FX headgear Mirage FX for Her headgear A7035
8Confidential Home Care Provider Product List
Mirage™ SoftGel Nasal Mask Systems
Item # Description HCPCS
61600
61601
61602
61603
Mirage™ SoftGel nasal mask complete system - smallIncludes cushion and headgearMirage SoftGel nasal mask complete system - mediumIncludes cushion and headgearMirage SoftGel nasal mask complete system - largeIncludes cushion and headgearMirage SoftGel nasal mask complete system - large wideIncludes cushion and headgear
A7034,+A7035
CUSHIONS
61631616326163361634
Small cushion and clipMedium cushion and clipLarge cushion and clipLarge wide cushion and clip
A7032
FRAME
61626
61627
61628
61629
Mirage SoftGel nasal mask frame system with small cushion - no headgear *Mirage SoftGel nasal mask frame system with medium cushion - no headgear *Mirage SoftGel nasal mask frame system with large cushion - no headgear *Mirage SoftGel nasal mask frame system with large wide cushion - no headgear ** includes headgear clips
A7034
60196
60175
Mirage Activa LT/SoftGel nasal mask complete frame assembly - small, no cushion, no headgear, includes headgear clipsMirage Activa LT/SoftGel nasal mask complete frame assembly - standard,no cushion, no headgear, includes headgear clips
N/A
60180 Mask frame only - standard N/A
9Confidential Home Care Provider Product List
Mirage SoftGelNasal Mask Systems (cont.)
Item # HEADGEAR HCPCS
16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, and Quattro -medium
A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT, SoftGel,Ultra Mirage Full Face Mask and Quattro - small
Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra Mirage FullFace Mask and Quattro- large
A7035
ACCESSORIES
16399601766019760123601241639316569167341657016571165656128916387
Elbow assembly - includes elbow and swivelCushion clip - standardCushion clip - smallForehead pad - 1 pack Forehead pad - 10 pack Forehead supportHeadgear clip - 2 packHeadgear clip - 10 packPort cap - 2 pack Port cap - 10 pack Quick release swivelForehead DialElbow
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
10Confidential Home Care Provider Product List
Mirage Activa™ LTNasal Mask Systems
Item # Description HCPCS
60182
60148
60149
60150
Mirage Activa™ LT nasal mask complete system - smallIncludes cushion and headgearMirage Activa LT nasal mask complete system - mediumIncludes cushion and headgearMirage Activa LT nasal mask complete system - largeIncludes cushion and headgearMirage Activa LT nasal mask complete system - large wide Includes cushion and headgear
A7034,+A7035
CUSHIONS
60198601776017860179
Small cushion and clipMedium cushion and clipLarge cushion and clipLarge wide cushion and clip
A7032
FRAME
60195
60172
60173
60174
Mirage Activa LT nasal mask frame system with small cushion - no headgear *Mirage Activa LT nasal mask frame system with medium cushion - no headgear *Mirage Activa LT nasal mask frame system with large cushion - no headgear *Mirage Activa LT nasal mask frame system with large wide cushion - no headgear *
* includes headgear clips
A7034
60196
60175
Mirage Activa LT/SoftGel nasal mask complete frame assembly - small, no cushion, no headgear, includes headgear clipsMirage Activa LT/SoftGel nasal mask complete frame assembly - standard,no cushion, no headgear, includes headgear clips
N/A
6019360180
Mask frame only - smallMask frame only - standard N/A
11Confidential Home Care Provider Product List
Mirage Activa LTNasal Mask Systems (cont.)
Item # HEADGEAR HCPCS
16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, and Quattro -medium
A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT, SoftGel,Ultra Mirage Full Face Mask and Quattro - small
Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra Mirage FullFace Mask and Quattro- large
A7035
ACCESSORIES
16399601766019760123601241639316569167341657016571165656128916387
Elbow assembly - includes elbow and swivelCushion clip - standardCushion clip - smallForehead pad - 1 pack Forehead pad - 10 pack Forehead supportHeadgear clip - 2 packHeadgear clip - 10 packPort cap - 2 pack Port cap - 10 pack Quick release swivelForehead DialElbow
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
12Confidential Home Care Provider Product List
Mirage SoftGel/Activa LTConvertAble™ Packs
Item # Description HCPCS
61604
61609
61615
61620
Mirage SoftGel/Activa LT ConvertAble™ Pack - smallIncludes one SoftGel mask, one Activa LT cushion and headgear
Mirage SoftGel/Activa LT ConvertAble Pack - mediumIncludes one SoftGel mask, one Activa LT cushion and headgear
Mirage SoftGel/Activa LT ConvertAble Pack - largeIncludes one SoftGel mask, one Activa LT cushion and headgear
Mirage SoftGel/Activa LT ConvertAble Pack - large wide Includes one SoftGel mask, one Activa LT cushion and headgear
A7032,+A7034,+A7035
13Confidential Home Care Provider Product List
Mirage Activa™Nasal Mask Systems
Item # Description HCPCS
60100
60101
60102
Mirage Activa™ nasal mask complete system - standardIncludes cushion and headgearMirage Activa nasal mask complete system - largeIncludes cushion and headgearMirage Activa nasal mask complete system - shallowIncludes cushion and headgear
A7034,+A7035
CUSHIONS601176011860119
Standard cushionLarge cushionShallow cushion
A7032
FRAME
601116011260113
Mirage Activa nasal mask frame system with standard cushion - no headgear *Mirage Activa nasal mask frame system with large cushion - no headgear *Mirage Activa nasal mask frame system with shallow cushion - no headgear ** includes headgear clips
A7034
60144 Mirage Activa nasal mask complete frame assembly - no cushion, no headgear,includes headgear clips
N/A
60121 Mask frame - one size fits all, mask frame only N/A
HEADGEAR
16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, and Quattro- medium A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT,SoftGel, Ultra Mirage Full Face Mask and Quattro - smallUniversal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra MirageFull Face Mask and Quattro - large
A7035
ACCESSORIES
6012660120601256012360124601226011560116609266092716570165716001461905
Carry bagCushion clipElbow assembly - includes exhaust ventForehead pad - 1 pack Forehead pad - 10 pack Forehead supportHeadgear clips - 2 packHeadgear clips - 10 packInlet tube with swivel assembly - 1 packInlet tube with swivel assembly - 10 packPort cap - 2 pack Port cap - 10 pack Swivel assembly - 10 packMask fitting template
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
14Confidential Home Care Provider Product List
Mirage Micro™ and Micro for KidsNasal Mask Systems
Item # Description HCPCS
61013
16333
16334
16335
Mirage Micro™ for Kids nasal mask complete system - smallIncludes small cushion and small headgearMirage Micro™ nasal mask complete system - smallIncludes small cushion and medium headgearMirage Micro nasal mask complete system - medium and largeIncludes two cushions (medium and large) and medium headgearMirage Micro nasal mask complete system - large wide and x-largeIncludes two cushions (large wide and x-large) and medium headgear
A7034,A7035
CUSHIONS1638816389163901639116392
Small cushionMedium cushionLarge cushionLarge wide cushionX-large cushion
A7032
FRAME16378
16379163801638116382
Mirage Micro and Mirage Micro for Kids nasal mask frame system with smallcushion - no headgearMirage Micro nasal mask frame system with medium cushion - no headgearMirage Micro nasal mask frame system with large cushion - no headgearMirage Micro nasal mask frame system with large wide cushion - no headgearMirage Micro nasal mask frame system with x-large cushion - no headgear
A7034
16383
16384
Mirage Micro and Mirage Micro for Kids nasal mask complete frame assembly,small - no cushion, no headgearMirage Micro nasal mask complete frame assembly,standard - no cushion, no headgear
N/A
1639416395
Mask frame only, standardMask frame only, small N/A
HEADGEAR16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, and
Quattro - mediumA7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT,SoftGel, Ultra Mirage Full Face Mask and Quattro - smallUniversal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, UltraMirage Full Face Mask and Quattro - large
A7035
ACCESSORIES
1639960123601241639316569167341657016571165656128916387
Elbow assembly - includes elbow and swivelForehead pad - 1 pack Forehead pad - 10 pack Forehead supportHeadgear clip - 2 packHeadgear clip - 10 packPort cap - 2 pack Port cap - 10 pack Quick release swivelForehead DialElbow
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
15Confidential Home Care Provider Product List
Ultra Mirage™ II Nasal Mask Systems
Item # Description HCPCS
16548
16549
16550
16577
Ultra MirageTM II nasal mask complete system – standardIncludes cushion and headgearUltra Mirage II nasal mask complete system – largeIncludes cushion and headgearUltra Mirage II nasal mask complete system – shallowIncludes cushion and headgearUltra Mirage II nasal mask complete system – shallow wideIncludes cushion and headgear
A7034,+A7035
CUSHIONS
16556165571655816735
Standard cushionLarge cushionShallow cushionShallow wide cushion
A7032
FRAME
16726167271672816736
Ultra Mirage II nasal mask frame system with standard cushion - no headgearUltra Mirage II nasal mask frame system with shallow cushion - no headgearUltra Mirage II nasal mask frame system with large cushion - no headgearUltra Mirage II nasal mask frame system with shallow wide cushion - no headgear
A7034
16594 Ultra Mirage II nasal mask complete frame assembly -no cushion, no headgear N/A
HEADGEAR
16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, and Quattro -medium
A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT,SoftGel, Ultra Mirage Full Face Mask and Quattro - small
Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra MirageFull Face Mask and Quattro - large
A7035
ACCESSORIES
1656316566165721657360123601241659016569167341657016571165651657561905
Cushion clipElbow assembly - includes elbow, quick release swivel and vent coverElbow clip - 1 packElbow clip - 10 packForehead pad - 1 pack Forehead pad - 10 pack Forehead support with padsHeadgear release clip - 2 packHeadgear release clip - 10 packPort cap - 2 pack Port cap - 10 pack Quick release swivelVent coverMask fitting template
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
16Confidential Home Care Provider Product List
Pixi™ Pediatric Nasal Mask System
Item # Description HCPCS
61030 Pixi™ Pediatric nasal mask complete system Includes cushion and headgear
A7034,+A7035
CUSHIONS
61033 Pixi Pediatric cushion A7032
FRAME SYSTEM
61035 Pixi Pediatric frame system - no headgear A7034
HEADGEAR
61034 Pixi Pediatric headgear A7035
17Confidential Home Care Provider Product List
Mirage Vista™ and Mirage Kidsta™Nasal Mask Systems
Item # Description HCPCS
60000
60001
61010
Mirage Vista™ nasal mask complete system - standardIncludes cushion and headgearMirage Vista nasal mask complete system - deepIncludes cushion and headgear
Mirage Kidsta™ nasal mask complete system - smallIncludes cushion and headgear
A7034,+A7035
CUSHIONS
609216092260013
Mirage Vista Standard cushionMirage Vista Deep cushionMirage Kidsta Small Cushion
A7032
FRAME
6092960930
Mirage Vista nasal mask frame system with standard cushion - no headgearMirage Vista nasal mask frame system with deep cushion - no headgear A7034
60928 Mirage Vista nasal mask complete frame assembly-no cushion, no headgear N/A
60924 Mirage Vista and Mirage Kidsta Mask frame - one size fits all, mask frame only N/A
HEADGEAR
6091861020
Mirage Vista Headgear assemblyMirage Kidsta Headgear assembly A7035
ACCESSORIES
60919609206102561026609266092716570165716001460940
Mirage Vista Headgear clips - 2 packMirage Vista Headgear clips - 10 packMirage Kidsta Headgear clips - 2 packMirage Kidsta Headgear clips - 10 packInlet tube with swivel assembly - 1 packInlet tube with swivel assembly - 10 packPort caps - 2 packPort caps - 10 pack Swivel assembly - 10 pack2D fitting template
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
The Mirage Kidsta™ nasal mask is intended for multi-patient use for children aged seven and older orweighing more than 40 lbs, prescribed continuous positive airway pressure (CPAP) or bilevel therapyin hospital, clinic and/or home environments. The Mirage Kidsta nasal mask is intended to be usedwith ResMed’s VPAP™ III ST-A.
18Confidential Home Care Provider Product List
Quattro™ FXFull Face Mask Systems
Item # Description HCPCS
61700
61701
61702
Quattro™ FX full face mask complete system - smallIncludes cushion and medium/standard headgearQuattro™ FX full face mask complete system - mediumIncludes cushion and medium/standard headgearQuattro™ FX full face mask complete system - largeIncludes cushion and medium/standard headgear
A7030,+A7035
CUSHIONS
617216172261723
Small cushionMedium cushionLarge cushion A7031
FRAME SYSTEM
617246172561726
Quattro FX full face mask frame system with small cushion - no headgearQuattro FX full face mask frame system with medium cushion - no headgearQuattro FX full face mask frame system with large cushion - no headgear A7030
HEADGEAR
617336173461738
Quattro FX full face mask headgear - medium/standardQuattro FX full face mask headgear - smallQuattro FX full face mask headgear - large A7035
19Confidential Home Care Provider Product List
Quattro™ FX for HerFull Face Mask Systems
Item # Description HCPCS
62501
62502
Quattro™ FX for Her full face mask complete system - smallIncludes cushion and medium/standard headgearQuattro™ FX for Her full face mask complete system - mediumIncludes cushion and medium/standard headgear
A7030,+A7035
CUSHIONS
617216172261723
Small cushionMedium cushionLarge cushion A7031
FRAME SYSTEM
62513
62514
Quattro FX for Her full face mask frame system with small cushion - no headgearQuattro FX for Her full face mask frame system with medium cushion - no headgear
A7030
HEADGEAR
6250662507
Quattro FX for Her full face mask headgear (light pink) - smallQuattro FX for Her full face mask headgear (light pink) - standard A7035
20Confidential Home Care Provider Product List
Mirage Quattro™ Full FaceMask Systems
Item # Description HCPCS
61200
61201
61202
61203
Mirage QuattroTM full face mask complete system - x-smallIncludes cushion and medium headgearMirage Quattro full face mask complete system - smallIncludes cushion and medium headgearMirage Quattro full face mask complete system - mediumIncludes cushion and medium headgearMirage Quattro full face mask complete system - largeIncludes cushion and medium headgear
A7030,+A7035
CUSHIONS
61290612916129261293
X-small cushion with clipSmall cushion with clipMedium cushion with clipLarge cushion with clip
A7031
FRAME
61260612616126261263
Mirage Quattro full face mask frame system with x-small cushion - no headgearMirage Quattro full face mask frame system with small cushion - no headgearMirage Quattro full face mask frame system with medium cushion - no headgearMirage Quattro full face mask frame system with large cushion - no headgear
A7030
61264
61265
61266
61267
Mirage Quattro full face mask complete frame assembly, x-small - no cushion, no headgearMirage Quattro full face mask complete frame assembly, small - no cushion, no headgearMirage Quattro full face mask complete frame assembly, medium - no cushion, no headgearMirage Quattro full face mask complete frame assembly, large - no cushion, no headgear
N/A
61270612716127261273
Mask frame only, x-smallMask frame only, smallMask frame only, mediumMask frame only, large
N/A
21Confidential Home Care Provider Product List
Mirage Quattro Full FaceMask Systems (cont.)
Item # HEADGEAR HCPCS
16117 Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel,and Quattro -medium A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT,SoftGel, Ultra Mirage Full Face Mask and Quattro - small
Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra MirageFull Face Mask and Quattro - large
A7035
ACCESSORIES612866128761274612756127661277612946128260123601246128861289165656011560116612956129661858
Valve and clip assembly - 1 packValve and clip assembly - 10 packCushion clip, x-smallCushion clip, smallCushion clip, mediumCushion clip, largeElbow assembly - includes elbow, valve, clip and swivelElbowForehead pad - 1 pack Forehead pad - 10 pack Forehead supportForehead dialQuick release swivelHeadgear clips - 2 packHeadgear clips - 10 packPorts cap - 2 packPorts cap - 10 packFitting template
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
22Confidential Home Care Provider Product List
Ultra Mirage™ Full FaceMask Systems
Item # Description HCPCS
60600
60601
60602
60603
60604
60605
Ultra Mirage™ full face mask complete system - small standardIncludes cushion and headgearUltra Mirage full face mask complete system - small shallowIncludes cushion and headgearUltra Mirage full face mask complete system - medium standardIncludes cushion and headgearUltra Mirage full face mask complete system - medium shallowIncludes cushion and headgearUltra Mirage full face mask complete system - large standardIncludes cushion and headgearUltra Mirage full face mask complete system - large shallowIncludes cushion and headgear
A7030,+A7035
CUSHIONS
166041667116605166721660616673
Small standard cushionSmall shallow cushionMedium standard cushionMedium shallow cushionLarge standard cushionLarge shallow cushion
A7031
FRAME
606206062160622606236062460625
Ultra Mirage full face mask frame system with small standard cushion - no headgearUltra Mirage full face mask frame system with small shallow cushion - no headgearUltra Mirage full face mask frame system with medium standard cushion - no headgearUltra Mirage full face mask frame system with medium shallow cushion - no headgearUltra Mirage full face mask frame system with large standard cushion - no headgearUltra Mirage full face mask frame system with large shallow cushion - no headgear
A7030
60666
60667
60668
Ultra Mirage full face mask complete frame assembly, small - no cushion, no headgearUltra Mirage full face mask complete frame assembly, medium - no cushion, no headgearUltra Mirage full face mask complete frame assembly, large - no cushion, no headgear
N/A
606706067160672
Mask frame only, smallMask frame only, mediumMask frame only, large
N/A
23Confidential Home Care Provider Product List
Ultra Mirage Full FaceMask Systems (cont.)
Item # HEADGEAR HCPCS
60674 Headgear - includes headgear clips, one size fits all A7035
16118
16119
Universal headgear for Ultra Mirage II, Micro, Micro for Kids, Activa, Activa LT,SoftGel, Ultra Mirage Full Face Mask and Quattro - small
Universal headgear for Ultra Mirage II, Micro, Activa, Activa LT, SoftGel, Ultra MirageFull Face Mask and Quattro - large
A7035
ACCESSORIES
16613
166171661816674166751667616637606836012360124606736011560116606816068216689606801662416981
Anti-asphyxia valve - includes elbow retainer, valve frame, valve membrane, valveelbow, swivel clip and swivelAnti-asphyxia valve membrane - 1 packAnti-asphyxia valve membrane - 10 packCushion clip, smallCushion clip, mediumCushion clip, largeElbow and swivel clip kit - includes five elbow clips and five quick release clipsElbow clipForehead pad - 1 pack Forehead pad - 10 pack Forehead support - 1 packHeadgear clips - 2 packHeadgear clips - 10 packLuer locks - 2 packLuer locks - 10 packSwivel onlySwivel clipValve elbow3D fitting template
N/A
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
24Confidential Home Care Provider Product List 24
Mirage Liberty™ Full FaceMask Systems
Item # Description HCPCS
61300
61301
Mirage LibertyTM full face mask complete system - smallIncludes cushion, pillows and headgearMirage Liberty full face mask complete system - largeIncludes cushion, pillows and headgear
A7027,+A7035
CUSHIONS
6133061331
Small mouth cushionLarge mouth cushion A7028
PILLOW SLEEVES
613336133461335
Dual-wall nasal pillows - smallDual-wall nasal pillows - mediumDual-wall nasal pillows - large
A7029
FRAME
61318
61319
61320
61321
61322
61323
Mirage Liberty full face mask frame system with smallcushion and small pillows - no headgearMirage Liberty full face mask frame system with smallcushion and medium pillows - no headgearMirage Liberty full face mask frame system with smallcushion and large pillows - no headgearMirage Liberty full face mask frame system with largecushion and small pillows - no headgearMirage Liberty full face mask frame system with largecushion and medium pillows - no headgearMirage Liberty full face mask frame system with largecushion and large pillows - no headgear
A7027
61325
61326
Mirage Liberty full face mask complete frame assembly, small -no cushion, no pillows, no headgearMirage Liberty full face mask complete frame assembly, large -no cushion, no pillows, no headgear
N/A
6133761338
Mask frame only, smallMask frame only, large N/A
25Confidential Home Care Provider Product List 25
Mirage Liberty Full FaceMask Systems (cont.)
Item # HEADGEAR HCPCS
6134861349
Headgear - smallHeadgear - standard A7035
ACCESSORIES
6134261343613406135261353165701657160926609276190060014
Valve and clip assemby - 1 packValve and clip assemby - 10 packElbow assembly - includes elbow, valve, clip and swivelUpper clips (left & right)Lower clips - 2 packPorts cap - 2 pack Ports cap - 10 pack Inlet tube with swivel assembly - 1 packInlet tube with swivel assembly - 10 packFitting templateSwivel assembly - 10 pack
N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A
26Confidential Home Care Provider Product List
Mask Spares andAccessories
Item # Description HCPCS
16015 Chin Restraint A7036
6191461915
Gecko™ Nasal Pad: Small - 10 pack (case)Gecko™ Nasal Pad: Large - 10 pack (case)
Note: The Gecko Nasal Pad is reimbursed on the individual units: PN 61911 (small) andPN 61910 (large). The Gecko Nasal Pad can only be ordered and shipped by 10 pack(case). The individual item numbers cannot be ordered.
A7032
16120
16121
16122
16123
Camouflage Headgear - Medium - Universal Headgear for Ultra Mirage II, Micro, Activa,Activa LT, SoftGel and Quattro masks
Light Blue Headgear - Medium - Universal Headgear for Ultra Mirage II, Micro, Activa,Activa LT, SoftGel and Quattro masks
Pink Headgear - Medium - Universal Headgear for Ultra Mirage II, Micro, Activa, ActivaLT, SoftGel and Quattro masks
Leopard Headgear - Medium - Universal Headgear for Ultra Mirage II, Micro, Activa,Activa LT, SoftGel and Quattro masks
A7035
27Confidential Home Care Provider Product List
S9™ APAP and CPAP SeriesFlow Generators
Item # Description HCPCS
36005 S9 AutoSet™Features include the new Enhanced AutoSet algorithm with central sleep apnea detection.Superior APAP comfort with whisper quiet operation and dramatically reduced conductednoise levels. Also includes EPR with Easy-Breathe technology; available in AutoSet mode aswell as CPAP mode. Includes usage-based compliance and efficacy downloads for accuratepatient monitoring and a standard data card for easy two-way data transfer. Optional acces-sories support wired and wireless compliance data transfer and integrated pulse oximetrymonitoring.
E0601
36015 S9 AutoSet & H5i™ S9 AutoSet packaged with the H5i humidifier (Item #36900).
E0601,+E0562
36075 S9 AutoSet & H5i for Her (light pink)S9 AutoSet for Her packaged with the H5i for Her humidifier.
E0601,+E0562
36025 S9 AutoSet & Climate Control KitS9 AutoSet packaged with the H5i humidifier and the ClimateLine™ Tubing (Item #36995)
E0601,+E0562,+A4604
36003 S9 Elite™Features include new central sleep apnea detection, whisper quiet operation and dramatical-ly reduced conducted noise levels. Also includes EPR with Easy-Breathe technology;Includes usage-based compliance and efficacy downloads for accurate patient monitoringand a standard data card for easy two-way data transfer. Optional accessories support wiredand wireless compliance data transfer and integrated pulse oximetry monitoring.
E0601
36013 S9 Elite & H5i S9 Elite packaged with the H5i humidifier (Item #36900).
E0601,+E0562
36023 S9 Elite & Climate Control Kit S9 Elite packaged with the H5i humidifier and the ClimateLine Tubing (Item #36995) E0601,
+E0562,+A4604
The S9™ system sets the new industry standard for comfortable sleep apnea treatment. Equipped with sophisticated new fea-tures that showcase ResMed's innovation and dedication to patient compliance, the stylish S9 system delivers everything you andyour patients need - and more.
28Confidential Home Care Provider Product List
S9™ APAP and CPAP SeriesFlow Generators, continued
Item # Description HCPCS
36002 S9 Escape Auto™Features include superior APAP mode based upon the gold-standard AutoSet Algorithm pro-viding comfort with whisper quiet operation and dramatically reduced conducted noise levels.Also includes EPR with Easy-Breathe technology; available in AutoSet mode as well asCPAP mode. Includes usage-based compliance and AHI data for accurate patient monitoring,along with a standard data card for easy two-way data transfer. Optional accessories supportwired and wireless compliance data transfer.
E0601
36012 S9 Escape Auto & H5iS9 Escape Auto packaged with the H5i humidifier (Item #36900).
E0601,+E0562
36022 S9 Escape Auto & Climate Control KitS9 Escape Auto packaged with the H5i humidifier and the ClimateLine Tubing (Item #36995)
E0601,+E0562,+A4604
36001 S9 Escape™Features include whisper quiet operation and dramatically reduced conducted noise levels.Also includes EPR with Easy-Breathe technology; Includes usage-based compliance down-loads for accurate patient monitoring along with a standard data card for easy two-way datatransfer. Optional accessories support wired and wireless compliance data transfer.
E0601
36011 S9 Escape & H5i S9 Escape packaged with the H5i humidifier (Item #36900).
E0601,+E0562
36021 S9 Escape & Climate Control Kit S9 Escape packaged with the H5i humidifier and the ClimateLine Tubing (Item #36995) E0601,
+E0562,+A4604
The S9™ system sets the new industry standard for comfortable sleep apnea treatment. Equipped with sophisticated new fea-tures that showcase ResMed's innovation and dedication to patient compliance, the stylish S9 system delivers everything youand your patients need - and more.
29Confidential Home Care Provider Product List
S9 VPAP™ Series Flow Generators
Item # Description HCPCS
36004 S9 VPAP™ SA fully-integrated bilevel device, including EPR with Easy-Breathe technology, simple menusettings and color LCD. Features whisper quiet operation and dramatically reduced noiselevels. AHI with Central sleep apnea (CSA) detection. Optional oximetry monitoring, wirelessdata compliance transfer.
E0470
36014 S9 VPAP S & H5iS9 VPAP S packaged with the H5i humidifier (Item #36900).
E0470,+E0562
36024 S9 VPAP S & Climate Control KitS9 VPAP S with the H5i humidifier and the ClimateLine tubing (Item #36995).
E0470,+E0562+A4604
36006 S9 VPAP™ AutoA fully-integrated auto-adjusting bilevel device with enhanced AutoSet algorithm continuallymonitors breathing. Simple menu settings and color LCD display. It also features a sleepquality indicator, which allows patients to view their therapy progress. Enhanced Vsync™technology compensates for leak and provides superior patient-ventilator synchrony.TiControl™ (Ti Max/Min) feature accommodates individual respiratory conditions. AHI withcentral sleep apnea (CSA) detection. Optional oximetry monitoring and wireless compliancedata transfer.
E0470
36016 S9 VPAP Auto & H5iS9 VPAP Auto packaged with the H5i humidifier (Item #36900).
E0470,+E0562
36026 S9 VPAP Auto & Climate Control Kit S9 VPAP Auto with the H5i humidifier and the ClimateLine Tubing (Item #36995)
E0470,+E0562+A4604
36008 S9 VPAP™ STA full-integrated bilevel device that delivers comfortable and effective therapy with exceptionalpatient-ventilator synchrony to patients requiring backup rate. It also features optional inte-grated oximetry and a sleep quality indicator, which allows patients to view their therapyprogress on a daily basis.
E0471
36018 S9 VPAP ST & H5iS9 VPAP ST packaged with the H5i humidifier (Item #36900).
E0471+E0562
36028 S9 VPAP ST & Climate Control KitS9 VPAP ST with the H5i humidifier and the ClimateLine tubing (Item #36995).
E0471+E0562+A4604
36007 VPAP™ AdaptAn adaptive servo-ventilator specifically designed to treat central sleep apnea (CSA) in all itsforms, including mixed events. It also features optional integrated oximetry and a sleep quali-ty indicator, which allows patients to view their therapy progress on a daily basis.
E0471
36017 VPAP Adapt & H5i™VPAP Adapt packaged with the H5i humidifier (Item #36900).
E0471+E0562
36027 VPAP Adapt & Climate Control KitVPAP Adapt with the H5i humidifier and the ClimateLine tubing (Item#36995).
E0471+E0562+A4604
30Confidential Home Care Provider Product List
S9 Humidifiers and Accessories
Item # HUMIDIFIERS HCPCS
3690036901
H5i - for use with S9 Flow GeneratorsH5i with cleanable water tub - for use with S9 Flow Generators
E0562E0562
H5i HUMIDIFIER ACCESSORIES
3699536997368023680036891368953689236894
H5i ClimateLine Tubing - 1 packH5i ClimateLineMAX™ Tubing - 1 packH5i Water TubH5i Cleanable Water TubH5i Flip LidH5i for Her Flip LidH5i Flip Lid SealH5i Air Outlet and Outlet Clip
A4604A4604A7046A7046
N/AN/AN/AN/A
S9 FLOW GENERATOR ACCESSORIES
36810368112494736821
369203686036861368593697036955
SlimLine™ TubingSlimLine Tubing WrapResMed Power Station II Battery - requires S9 90W Power Supply to chargeS9 90W Power Supply Unit Plus Power Cord - can be used with or withouthumidifier - for use with S9 and ResMed Power Station Station II BatteryS9 30W Power Supply UnitS9 Travel BagS9 for Her Travel BagS9 Filter CoverDC/DC Converter - 24V/90W outputS9 Embletta Adapter
A7037N/AN/AN/AN/AN/AN/AN/AN/AN/A
S9 FILTERS
36850368513685236853
36855368563685736858
S9 Standard Filter - 1 packS9 Standard Filter - 2 packS9 Standard Filter - 12 packS9 Standard Filter - 50 pack
S9 Hypo-allergenic Filter - 1 packS9 Hypo-allergenic Filter - 2 packS9 Hypo-allergenic Filter - 12 packS9 Hypo-allergenic Filter - 50 pack
A7038A7038A7038A7038
A7038A7038A7038A7038
31Confidential Home Care Provider Product List
Ventilation Products
Item # Description HCPCS
24157 Stellar™ 100 Adult and Pediatric VentilatorUltra-premium non-invasive ventilator with invasive option for adult and pediatric (13 kg)ventilation. Pressure from 3–40 cm H2O, PS to 37 cm H2O, andinternal battery. FiO2 and SpO2 monitoring (optional)
E0471
Item # Stellar Humidifier and Accessories HCPCS
24927 H4i Heated Humidifier for Stellar E0562
36810 SlimLine tube - for use with S9 and Stellar A7037
24977 Stellar Mobility bag N/A
22305 XPOD Oximeter N/A
16936 Oximeter Sensor Cable N/A
24955 FiO2 Monitoring Kit N/A
CAP008617 FiO2 Monitoring Sensor N/A
24976 ResMed Leak Port N/A
24934 Stellar Filter - hypoallergen - 12 pack A7038
2490524913249172491924920
Standard stand (without top plate)VPAP Series top platePremium circuit support armTube clip–doubleTube clip–single
N/AN/AN/AN/AN/A
Item # Description HCPCS
24116 S7 VPAP™ III ST-APremium non-invasive ventilator with expanded pressure range from 3–30 cm H2O and acomprehensive suite of alarms.
E0471
36008 S9 VPAP™ STA full-integrated bilevel device that delivers comfortable and effective therapy with excep-tional patient-ventilator synchrony to patients requiring backup rate. It also featuresoptional integrated oximetry and a sleep quality indicator, which allows patients to viewtheir therapy progress on a daily basis.
E0471
36018 S9 VPAP ST & H5iS9 VPAP ST packaged with the H5i humidifier (Item #36900).
E0471+E0562
36028 S9 VPAP ST & Climate Control KitS9 VPAP ST with the H5i humidifier and the ClimateLine tubing (Item #36995).
E0471+E0562+A4604
32Confidential Home Care Provider Product List
C-Series Flow Generator
Item # C-SERIES FLOW GENERATOR HCPCS
34000 C-Series Tango™Features include classic CPAP functionality with ResMed superior quality and reliability.Optional humidification and disposable water chamber.
E0601
33Confidential Home Care Provider Product List
Software, Modules andAccessories
Item # COMPLIANCE SOFTWARE HCPCS
31313 ResScan software - clinical management software for use with all ResMed flow generatorproducts.
N/A
S9 DATA ACCESSORIES
368403684536931
Protective Folder with SD card - 10 pack Protective Folder without SD card - 10 packSD Card Reader
A9279N/AN/A
S8 DATA ACCESSORIES
22903229062220722212309423094722201222032291517952
ResScan data cards with protective folder - 10 packProtective Folder (no data card) - 10 packResScan card readerSmartMedia card reader II - USBSmartMedia card - 2 packSmartMedia card spare labels - 10 packSerial port adapterResScan USB serial adapterData module coverNull modem cable - for use with VPAP III, AutoSet Spirit™, AutoSet RespondTM, S7TM
Elite CPAP, S8 CPAP and AutoSet T flow generators
A9279N/AN/AN/A
A9279N/AN/AN/AN/AN/A
S9 MODULE AND OXIMETRY
369303695036940
369100
S9 Wireless ModuleS9 USB AdapterS9 Oximeter AdapterS9 Complete Oximetry Kit (includes Item #36940 and Item #36942)
A9279N/AN/AN/A
S8 MODULE AND OXIMETRY
22206
22230
222102
S8 ResLink™Includes 32 MB SmartMedia card, user’s manual and mailing bag.
S8 ResTraxx GSM device - Includes a carry bag and Quick Reference Guide Card. A pro-prietary system comprised of both hardware and software that facilitates the wireless trans-fer of patient compliance data via cellular technology to an internet-accessed portal knownas ResTraxx™ Online. There is also a monthly subscription fee.
S8 Complete Oximetry Kit (includes Item #22206 and Item #1430050)
A9279
A9279
A9279
S7 MODULE AND OXIMETRY
30924
309100
S7 ResLink PMM - patient management module Includes 32 MB SmartMedia card, user’s manual and mailing bag.
S7 Complete Oximetry Kit (includes Item #30924 and Item #1430050)
A9279
A9279
34Confidential Home Care Provider Product List
Software, Modulesand Accessories, continued
Item # OXIMETRY ACCESSORIES HCPCS
1430050 Oximeter Spirit PMM kitResLink cable and XPod for S7& S8
N/A
36942 S9 Oximetry Accessory Kit (includes reusable soft sensor, 3M cable, sensor clip, Xpod) N/A
7075601431002
Reusable soft sensor - 3MDisposable flex sensor - 3M - includes sensor and item #70276 (adhesive strips, single use -25 pk)
N/AN/A
22961 ResLink converter cable - This converter cable is for use with ApneaLink™ XPOD to connectthe oximeter port for either the S7 ResLink or S8 ResLink modules.
N/A
36941 S9 Oximeter converter cable - This converter cable is for use with existing ResLink XPOD toconnect with the S9 Oximeter module.
N/A
35Confidential Home Care Provider Product List
ApneaLink™ApneaLink™ Plus
Item # Description HCPCS
22328 ApneaLink™ Plus Complete Kit A portable home sleep test diagnostic device that records up to four channels of informa-tion: respiratory effort, pulse, oxygen saturation and nasal flow. Kit includes ApneaLink Plusrecorder, software CD, quick software setup guide, carry bag, EasySense respiratory effortsensor, 2 reusable belts, USB download cable, 2 AA batteries, 3 nasal cannulas, XPODoximeter, 3 single use oximetry sensors and sensor clip.
N/A
22319 ApneaLink Plus Basic Kit A portable home sleep test diagnostic device that records up to four channels of informa-tion: respiratory effort, pulse, oxygen saturation and nasal flow. Kit includes ApneaLink Plusrecorder, software CD, quick software setup guide, carry bag, EasySense respiratory effortsensor, 2 reusable belts, USB download cable, 2 AA batteries and 1 nasal cannula.
N/A
22302 ApneaLink™A sleep screening device withi up to three channels (with oximetry) used to objectivelyassist in identifying the risk for sleep-disordered breathing. Includes ApneaLink softwareCD, operating instructions, carry bag, 3 nasal cannulas, single use belt, USB downloadcable and 2 AA batteries.
N/A
22304 ApneaLink Oximetry KitProvides oximetry and pulse information to the ApneaLink/ApneaLink Plus recorderdevices. Uses single-use or reusable probes. Must be used in conjunction with ApneaLinkand ApneaLink Plus only. Kit includes oximeter (XPOD), oximeter sensor clip and 3 singleuse sensors.
N/A
36Confidential Home Care Provider Product List
ApneaLink/ApneaLink PlusAccessories
Item # ACCESSORIES AND CONSUMMABLES HCPCS
2233622333
ApneaLink Plus and ApneaLink Software CD 9.2 (compatible with all devices)ApneaLink Plus EasySense Respiratory Effort Sensor (for use with ApneaLink Plus ONLY)
N/AN/A
NASAL CANNULAS
7038870319
ApneaLink standard cannula - 25 packApneaLink nasal/oxygen cannula - 25 pack
N/AN/A
BELTS
62905270406
Reusable belt - for use with ApneaLink and ApneaLink PlusSingle use belt - 10 pack (for use with ApneaLink ONLY)
N/AN/A
MISCELLANEOUS
62905122309
USB download cableRechargeable battery kit - includes battery charger and 4 AA rechargeable batteries
N/AN/A
OXIMETRY COMPONENTS
223067041370567707267027622338
22337
Oximeter sensor clipReusable soft sensor - largeReusable soft sensor - smallReusable flex sensor kit, 36” includes sensor and Item #70276 Adhesive strips, single use - for use with Item #1431002 or Item #70726 - 25 packSingle use sensor, adult, 36” (1 meter) (ResMed Standard) - 24 pack. Replaces Item#22316Single use sensor, 36” (1 meter) (value line) - 24 pack. Replaces Item #70412
N/AN/AN/AN/AN/AN/A
N/A
37Confidential Home Care Provider Product List
Flow Generator Accessories andReplacement Parts
Item # POWER SUPPLIES HCPCS
70253701992693222015339423393814951
2690533948
110V inverter for SullivanTM CPAP and VPAP systemsBattery adapter, 12 voltDC converter - for VPAP ST, VPAP Auto 25 and VPAP SDC converter - for VPAP III ST-ADC-12 converter - for S8 CPAP unit and VPAP AutoPower cord - for S8 CPAP and C-Series Tango unitsPower cord - for Sullivan V and ResMed S6 CPAP units, S7 Elite CPAP, VPAP, AutoSet T,AutoSet Spirit and AutoSet Respond unitsPower cord - for VPAP Adapt SV and VPAP III ST-AS8 connector plug - 10 pack
N/AN/AN/AN/AN/AN/AN/A
N/AN/A
Item # RESMED POWER STATION II HCPCS
2494724923249592498124961249602494636821
24964249652495224943
ResMed Power Station II Battery - requires S9 90W Power Supply to chargeResMed Power Station II - Battery and bagDC cable, StellarDC cable, Stellar, 0.5mDC cable, S9 SeriesDC cable, S8 VPAPPSU adaptor, ResMed Power Station II90W Power Supply Unit Plus Power Cord - can be used with or withouthumidifier - for use with S9 and ResMed Power Station II BatteryBattery coupler kit, ResMed Power Station IIBattery coupler, ResMed Power Station IICarry bag, ResMed Power Station IIVelcro strap, ResMed Power Station II
N/AN/AN/AN/AN/AN/AN/AN/A
N/AN/AN/AN/A
TUBINGS AND AIR DELIVERY SYSTEMS
26923
149111499414999
1498614922149872696014915269312692426925
Air delivery system - for VPAP Adapt SVIncludes sensor tubing, tube clips, proximal cuff and standard 2 meter air hoseAir tubing connector - 5 packAir tubing, standard - light gray, ribbed (6’)Air tubing, clear gray ribbed (9’, 2.75 meter)- for use with all S7, S8 products and S9VPAP onlyAir tubing, autoclave - dark gray (6’6”, 2 meter)Air tubing, gray (9’9”, 3 meter)Air tubing, standard - light gray, cuffed (6’6”, 2 meter)Oxygen adapter port - for VPAP ST, VPAP Auto 25 and VPAP SOxygen sideport connectorProximal cuff - for VPAP Adapt SVSensor tubing with Luer lock - for VPAP Adapt SVTube clips - 9 pack - for VPAP Adapt SV
N/A
N/AA7037A7037
A7037A7037A7037
N/AN/AN/AN/AN/A
CARRY / TRAVEL BAGS
3392534902339723395630923
Carry pouch for S8C-Series Tango carry bagS8 Series II premium travel bag (black)S8 standard travel bag (blue)VPAP Adapt SV carry bag
N/AN/AN/AN/AN/A
38Confidential Home Care Provider Product List
Flow Generator Accessories andReplacement Parts, continued
AIR FILTER COVERS
21937309093392333959
ResMed S6 air filter coverS7 Series and VPAP III air filter coverFilter cover for S8Blue filter cover for S8
N/AN/AN/AN/A
MANOMETERS AND PRESSURE SENSOR ADAPTERS
14535
30901
1794730916
Manometer, gauge type and portable kitIncludes carrying case, tubing and stand. Range: 0–25 cm H2O, 0.5 incrementsPressure sensor adapter - clear plastic adapter for external humidifier connec-tion with the AutoSet Spirit, AutoSet Respond and S7 ElitePressure sensor adapter - for use with AutoSet TPressure sensor adapter - rubber adapter for AutoSet Spirit, AutoSet Respondand S7 Elite CPAP
N/A
N/A
N/AN/A
39Confidential Home Care Provider Product List
Flow Generator Filters
Item # Description HCPCS
33915339733397433918
33919339753397633922
309193090730908
219442193521936
2194621926219471795717937179381498514907149081490914910
2692626927
S8, S8 II and C-Series Tango filters - 1 packS8, S8 II and C-Series Tango filters - 2 packS8, S8 II and C-Series Tango filters - 12 packS8, S8 II and C-Series Tango filters - 50 pack
S8, S8 II and C-Series Tango hypo filters - 1 packS8, S8 II and C-Series Tango hypo filters - 2 packS8, S8 II and C-Series Tango hypo filters - 12 packS8, S8 II and C-Series Tango hypo filters - 50 pack
S7 Series and VPAP III filters - 1 packS7 Series and VPAP III filters - 3 packS7 Series and VPAP III filters - 50 pack
ResMed S6 air filter strips - 1 packResMed S6 air filter strips - 3 packResMed S6 air filter strips - 50 pack
Air filter strips - fine, hypoallergenic - 1 packAir filter strips - fine, hypoallergenic, fits all Sullivan V CPAP and VPAP III units - 5 packAir filter strips - fine, hypoallergenic, fits all ResMed S6 units - 10 packAutoSet T filter - 1 packAutoSet T filter - 3 packAutoSet T filter - 50 packAir filter strips fits all Sullivan V, CPAP and VPAP II units - 1 packAir filter strips fits all Sullivan V, CPAP and VPAP II units - 50 packAir filter strips fits all Sullivan V, CPAP and VPAP II units - 3 packAir filter assembly - fits all Sullivan V, CPAP and VPAP II unitsAir filter assembly - fine, hypoallergenic, fits all Sullivan V, CPAP and VPAP II units - 1packVPAP Adapt SV air inlet filter, standard - 3 packVPAP Adapt SV air inlet filter, hypoallergenic - 3 pack
A7038A7038A7038A7038
A7038A7038A7038A7038
A7038A7038A7038
A7038A7038A7038
A7038A7038A7038A7038A7038A7038A7038A7038A7038
N/AN/A
N/AN/A
40Confidential Home Care Provider Product List
Heated HumidificationSystems and Accessories
Item # Description HCPCS
26940 H4i - for use with all S8, S8 II and VPAP bilevel products. E0562
26950 H4i with optional cleanable water chamber - for use with all S8, S8 II and VPAP bilevelproducts.
E0562
30902 HumidAire 2i™ - for use with S7™ Lightweight CPAP, S7 Elite CPAP, AutoSet Spirit, AutoSetRespond, VPAP III and VPAP Adapt SV E0562
34900 C-Series heated humidifierFeatures disposable water chamber E0562
Item # Description HCPCS
26952269582695926953269542695526963
33926339273393533947
309513091530914309383096130939309553095630912
3490134903
1892018913189111891218910
189193396318916
H4i water chamber (standard) H4i water chamber (cleanable)H4i water chamber upgrade kitH4i top cover and sealH4i tub plate sealH4i cleaning plugH4i spill guard
HumidAire 3i top cover and sealHumidAire 3i top cover sealHumidAire 3i carry pouchHumidAire 3i cleaning plug pack
HumidAire 2i tub assemblyHumidAire 2i water chamber o-ringHumidAire 2i water chamber tub plateHumidAire 2i water chamber cross member, PCHumidAire 2i base PC-side catchHumidAire 2i latch, PCHumidAire 2i side catches, PCHumidAire 2iC tub assemblyHumidAire 2i and 2iC water chamber seal
C-Series water chamberC-Series adapter seal - 10 pack
HumidAire water chamberHumidAire water chamber baseHumidAire water chamber lidHumidAire water chamber sealPassover humidifier connector
Short air tubing - 19 cm/7.5 inch and white adapterTubing wrap (6’ 6”) - reduces rainout in tubing caused by heated humidificationTubing (20 inch) - use with HumidAire humidifier
A7046A7046A7046
N/AN/AN/AN/A
N/AN/AN/AN/A
A7046N/AN/AN/AN/AN/AN/A
A7046N/A
A7046N/A
A7046N/AN/AN/AN/A
N/AN/A
A7037
41
This Home Care Provider Product List has been prepared solely for the use of ResMed’scustomers.
ResMed reserves the right to modify any of the information contained herein at any time withoutnotice, including pricing, product descriptions and configurations, and warranty terms.
All information contained in this Product List is confidential. You agree not to disclose suchinformation to any third party without the prior written approval of ResMed. While ResMed hastaken reasonable precautions to ensure the accuracy of the pricing and information presented inthis document as of the date of publication, ResMed strongly recommends that you contactcustomer service and/or a sales representative to confirm the accuracy of the information or to seeif other discounts, promotions, or specials may apply.
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Activa, AutoScan, AutoSet, AutoSet Respond, AutoSet Spirit, ClimateLine, ConvertAble, EPR, Gecko, H4i, HumidAire, Kidsta, Liberty, Mirage, Mirage Activa, Mirage FX, MirageKidsta, Mirage Liberty, Mirage Micro, Mirage Quattro, Mirage Swift, Mirage Vista, Pixi, Quattro, Rescontrol, ResLink, ResScan, ResTraxx, SmartStart, S7 Elite, S7 Lightweight, S8,S8 Compact, S8 Elite, S8 Escape, S9, S9 AutoSet, S9 Elite, S9 Escape, S9 Escape Auto, SlimLine, Stellar, Sullivan, Swift, Tango, Ultra Mirage, Vista, VPAP, VPAP Adapt SV, VPAPAuto, VPAP Malibu and VSet are trademarks of ResMed Ltd.
Activa, ApneaLink, AutoSet, Escape, HumidAire, Kidsta, Mirage, Mirage Quattro, SmartStart, Sullivan, Vista and VPAP are registered in U.S. Patent and Trademark Office.
ApneaLink is a trademark of MAP Medizin Technologie GmbH and Breath-O-Prene™ is a trademark of AccuMed. ©2007 ResMed Ltd.