I believe an Adsense account is required.
Openx was phpadnews. For me, it was bloated software. Too many features not needed. Made the whole learning process difficult. Updates were also an issue.
With Google Ad Manager there's no need to worry about "updates", security issues, etc. Now, I have just the right amount of features - no clutter.
If you do decide to use Ad Manager take a look at their Getting Started video and help section. Will get you started in no time.
Be advised though...
their is a learning curve.
good luck
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