You can get OpenX enterprise or hosted. Same app, running on "their" servers. Not sure about the 109mil hits though.
But are we talking about your own banners? I you are just interested in creating a few adzones and deliver a RON then there are many options. I like JuicyAds.com very much. Currently also talking to the guys from Ero-Advertising.com. Both cases it's just a matter of including their code into your pages and your done. And you still have the option to add your own banner and url as "filler" for each zone you create. Those will be replaced as soon as you sell your zone for a period of time.
I do however combine OpenX and JuicyAds. See
http://www.pinktraffic.net/advertisement.php. Those ads are running on 8 sites served by OpenX (hosted by myself in this case, but could also have been on a managed site). I dont come even close to the 109mil hits you talk about though ;).