| 101697-1 | Post traumatic stress disorder checklist - civilian version DSM-5 |
| 101698-9 | PTSD PCL-5 score |
| 101699-7 | Having strong negative beliefs about yourself, others, or the world (qualitative) |
| 101700-3 | Blaming yourself or someone else for the stressful experience or what happened after it (qualitative) |
| 101701-1 | Having strong negative feelings such as fear, horror, anger, guilt, or shame (qualitative) |
| 101702-9 | Taking too many risks or doing things that could cause you harm (qualitative) |
| 101703-7 | Repeated, disturbing, and unwanted memories of the stressful experience (qualitative) |
| 101704-5 | Repeated, disturbing dreams of the stressful experience (qualitative) |
| 101705-2 | Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it) (qualitative) |
| 101706-0 | Feeling very upset when something reminded you of the stressful experience (qualitative) |
| 101707-8 | Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating) (qualitative) |
| 101708-6 | Avoiding memories, thoughts, or feelings related to the stressful experience (qualitative) |
| 101709-4 | Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations) (qualitative) |
| 101710-2 | Trouble remembering important parts of the stressful experience (qualitative) |
| 101711-0 | Loss of interest in activities that you used to enjoy (qualitative) |
| 101712-8 | Feeling distant or cut off from other people (qualitative) |
| 101713-6 | Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you) (qualitative) |
| 101714-4 | Irritable behavior, angry outbursts, or acting aggressively (qualitative) |
| 101715-1 | Being superalert or watchful or on guard (qualitative) |
| 101716-9 | Feeling jumpy or easily startled (qualitative) |
| 101717-7 | Having difficulty concentrating (qualitative) |
| 101718-5 | Trouble falling or staying asleep (qualitative) |
| 102012-2 | Have you had nightmares or thoughts about the event(s) when you did not want to (qualitative) |
| 102013-0 | Have you tried not to think about or avoided situations that reminded you of the event(s) (qualitative) |
| 102014-8 | Have you been constantly on guard, watchful, or easily startled (qualitative) |
| 102015-5 | Have you felt numb or detached from people, activities, or your surroundings (qualitative) |
| 102016-3 | Have you felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused (qualitative) |
| 102017-1 | PC-PTSD-5 score |
| 106860-0 | Perceived stress scale-10 total score |
| 106889-9 | How often have you found yourself thinking about things that you have to accomplish (qualitative) |
| 106890-7 | How often have you been able to control the way you spend your time (qualitative) |
| 106894-9 | How often have you felt that you were effectively coping with important changes that were occurring in your life (qualitative) |
| 106898-0 | How often have you dealt successfully with day to day problems and annoyances (qualitative) |
| 106903-8 | Perceived stress scale-14 Total score |
| 11286-2 | Alcohol binge episodes per month - Reported |
| 54850-3 | Fall one or more times in the last month prior to admission (qualitative) |
| 64653-9 | Are you currently using them - within the last month (qualitative) |
| 66235-3 | In the past Mo, have you had chest pain when you were not doing physical activity (qualitative) |
| 66821-0 | In the last month, how often have you been upset because of something that happened unexpectedly (qualitative) |
| 66822-8 | In the last month, how often have you felt that you were unable to control the important things in your life (qualitative) |
| 66823-6 | In the last month, how often have you felt nervous and stressed (qualitative) |
| 66824-4 | In the last month, how often have you felt confident about your ability to handle your personal problems (qualitative) |
| 66825-1 | In the last month, how often have you felt that things were going your way (qualitative) |
| 66826-9 | In the last month, how often have you found that you could not cope with all the things that you had to do (qualitative) |
| 66827-7 | In the last month, how often have you been able to control irritations in your life (qualitative) |
| 66828-5 | In the last month, how often have you felt that you were on top of things (qualitative) |
| 66829-3 | In the last month, how often have you been angered because of things that were outside of your control (qualitative) |
| 66830-1 | In the last month, how often have you felt difficulties were piling up so high that you could not overcome them (qualitative) |
| 70220-9 | Repeated disturbing memories, thoughts, or images of a stressful experience from the past in the last month (qualitative) |
| 70222-5 | Repeated disturbing dreams of a stressful experience from the past in the last month (qualitative) |
| 70223-3 | Suddenly acting or feeling as if a stressful experience were happening again - as if you were reliving it - in the last month (qualitative) |
| 70224-1 | Feeling very upset when something reminded you of a stressful experience from the past in the last month (qualitative) |
| 70225-8 | Having physical reactions, heart pounding, trouble breathing or sweating, when something reminded you of a stressful experience from the past in the last month (qualitative) |
| 70226-6 | Avoid thinking about or talking about a stressful experience from the past or avoid having feelings related to it in the last month (qualitative) |
| 70227-4 | [PCL-C] (qualitative) |
| 70228-2 | Trouble remembering important parts of a stressful experience from the past in the last month (qualitative) |
| 70229-0 | Loss of interest in things that you used to enjoy in the last month (qualitative) |
| 70230-8 | Feeling distant or cut off from other people in the last month (qualitative) |
| 70231-6 | Feeling emotionally numb or being unable to have loving feelings for those close to you in the last month (qualitative) |
| 70232-4 | Feeling as if your future will somehow be cut short in the last month (qualitative) |
| 70233-2 | Trouble falling or staying asleep in the last month (qualitative) |
| 70234-0 | Feeling irritable or having angry outbursts in the last month (qualitative) |
| 70235-7 | Having difficulty concentrating in the last month (qualitative) |
| 70236-5 | Being super alert or watchful on guard in the last month (qualitative) |
| 70237-3 | Feeling jumpy or easily startled in the last month (qualitative) |
| 71460-0 | Outpatient antibiotics prescribed in past month (qualitative) |
| 72349-4 | Level of fatigue on average over the past month (qualitative) |
| 72350-2 | Severity of pain on average over the past 1 month (qualitative) |
| 72351-0 | Social interaction with other people - family, friends, or others - over the past month (qualitative) |
| 72352-8 | Overall emotional well being over the past month (qualitative) |
| 72353-6 | Overall physical well being over the past month (qualitative) |
| 72354-4 | Overall quality of life over the past month (qualitative) |
| 75333-5 | Within the last month, how often have you experienced cultural factors (qualitative) |
| 75335-0 | Within the last month, how often have you experienced psychosocial factors (qualitative) |
| 75337-6 | Within the last month, how often have you experienced physical factors (qualitative) |
| 80884-0 | How often have you had a sensation of not emptying your bladder completely after you finished urinating over the past month (qualitative) |
| 80885-7 | How often have you had to urinate again less than two hours after you finished urinating over the past month (qualitative) |
| 80886-5 | How often have you found you stopped and started again several times when you urinated over the past month (qualitative) |
| 80887-3 | How often have you found it difficult to postpone urination over the past month (qualitative) |
| 80888-1 | How often have you had a weak urinary stream in the last month (qualitative) |
| 80889-9 | How often have you had to push or strain to begin urination over the past month (qualitative) |
| 80890-7 | How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning over the past month (qualitative) |
| 84932-3 | Friendship Survey - fixed length form - ages 18+ |
| 84933-1 | Friendship Survey - fixed length form - ages 8-17 |
| 84956-2 | Instrumental Support Survey - fixed length form - ages 18+ |
| 84957-0 | Loneliness Survey - fixed length form - ages 18+ |
| 84958-8 | Loneliness Survey - fixed length form - ages 8-17 |
| 85598-1 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, causing swelling in your ankles or legs) |
| 85599-9 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your walking about or climbing stairs difficult) |
| 85600-5 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your working around the house or yard difficult) |
| 85601-3 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your going places away from home difficult) |
| 85602-1 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your sleeping well at night difficult) |
| 85603-9 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your relating to or doing things with your friends or family difficult) |
| 85604-7 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your working to earn a living difficult) |
| 85605-4 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your recreational pastimes, sports or hobbies difficult) |
| 85606-2 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making your sexual activities difficult) |
| 85607-0 | Did your heart failure prevent you from living as you wanted during the past month (4weeks) (qualitative, making you eat less of the foods you like) |
| 85608-8 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making you short of breath) |
| 85610-4 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, making you stay in a hospital) |
| 85611-2 | Did your heart failure prevent you from living as you wanted during the past month (4 weeks) (qualitative, costing you money for medical care) |