my $VAR1 = {
    '99155' => {
              'PR' => {
                  state_name       => 'Puerto Rico',
                  county_names_all => 'Adjuntas|Utuado',
              },
          },
};

my $v0 = $VAR1;
while ( my ($k1,$v1) = each %$v0 ) {
    while ( my ($k2,$v2) = each %$v1 ) {
        while ( my ($k3,$v3) = each %$v2 ) {
            print "\$VAR1->{$k1}{$k2}{$k3} => '$v3'\n"
        }
    }
}