{
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  "system" : "http://terminology.hl7.org/CodeSystem/contributor-summary-source",
  "property" : [ ],
  "codesystem" : "fcc16571-902f-5741-b7ed-dd1adae0d4b6",
  "concept_id" : "088ceda8-2025-53ec-bc5e-d8fd44feba5b",
  "ancestors" : {
    "custom" : 0
  },
  "id" : "77a86316-0783-47c6-af72-5d525297841e",
  "code" : "custom",
  "display" : "custom format",
  "version" : "1.0.0"
}