Have you checked out course 305 Hierarchy Management?
If you still have questions, please let me know.
It is possible to create a hierarchy with the file you have attached but only thing you need to consider is you have to upload only the required rows into respective hierarchy list. For example,
Region L1 --> Have only first row and do the import by mapping "NA" parent into the name and code
Country L2 --> Have only first row and do the import by mapping NA as a parent and US as name and code
State L3 --> Have only 2nd and 6th row and do the import by mapping parent and child.....
But however this is not a good way to import hierarchy into the system. We need to have a file that shows clear hierarchy ie. Region,Country,State,etc.. in seperate column.