Devices Worn on Military Ribbons
Except for the Medal of Honor, all awards in the Pyramid of Honor can be awarded multiple times for different acts, each successive award noted by a device worn on the ribbon for the first award.
The following are devices that are worn on either or both the ribbon bar and suspension ribbon of Military Decorations. In most cases, the individual services prescribe how the device is displayed with the exception of defense awards which are determined by the assistant secretary of defense. A maximum of four devices may be worn on any single ribbon.