Air Force regulations are really rather simple. There is only one possible configuration for the Medals and the devices are placed vertical on the ribbon. The following will explain in greater detail these general explanations of the regulations.
The following is chart from the Air Force Regulations which explains the configuration options for full sized medals.
You may wear up to three medals per row with no overlapping.
The maximum length of holding bars for medals is 2 3/4 inches. When wearing fewer than 4 regular-size medals, expose all.
Overlap if there are more than three medals in one row.
If wearing more than 3 regular medals on one row, each medal equally overlaps the medal to the left. The overlap does not exceed 50 percent. Expose the medal nearest the lapel.
Hang the top row so the entire medal is exposed on the bottom row.
Stack and center the second or additional row of medals upward. The medal overlaps approximately 50 percent of the ribbon on the row below.
Our rack builder will give Air Force personnel the correct configuration depending on the number of awards. See the examples of Air Force medal mounts below.
There are very few regulations that refer specifically to devices on full size medals. The device precedence can be assumed from the description of how they are worn on ribbons. See the following regulations concerning devices.
On medals, place clusters vertically with silver clusters and stars above similar bronze devices.
Below is a picture of example device configurations on Air Force medals taken from the regulations.
The following regulation seems rather straight forward...
Wear regular devices on regular medals and regular ribbons. Wear all the same size devices.
...But then the following appears later in the regulations.
Oak-leaf clusters are issued in three sizes and two colors. The larger size is worn on the suspension ribbon of the medal, the middle size on the service ribbon, and the smaller size on the miniature medals and ribbons.
Considering that the second is more descriptive we use that in our interpretation.
The previous are the only device regulations that specifically reference full size medals for the rest of the regulations please see the Air Force Ribbon Regulations for further information.
As for the rack builder we interpret the regulations concerning full size medals as follows:
These interpretations are based on physical spacing on the suspension ribbon.