The achievement of self-actualization was first discussed by Abraham Maslow as part of his hierarchy of needs, and it represents the completition of the highest level of the hierarchy and the emergence of the "fully functional person". Self-actualization is basically the achievement of meaning in one's own life.
Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction. The code will appear as a CO 253 on the RA "Sequestration – reduction in federal payment" as the reason.