Carmela's lawyer is holding a pen with his right hand. From a different angle, the pen is lying on a paper on the desk.
Whenever the mobsters in the Sopranos pay they almost always take a wad of cash out of their pocket and pull off the top 3-4 bills and hand it over. If Tony is paying for a pizza he pulls off 3-4 bills. If he's bribing someone he pulls off 3-4 bills. No matter what the amount is for that particular situation, it's always covered with the top 3-4 bills of the cash wad.