I'm aware of what the bound I quoted is, and am just too lazy to type the refinement into Wolfram for a discussion like this. But just knowing the value off the top of my head for 64 bits is 200k for 1e-9 probability of collision, I'm pretty happy with 74 bits.
And although this standard obviously wants to stick within the existing UUID footprint, if you were say doing some IoT software that would run on billions of nodes simultaneously, just add another 32/64/whatever bits of random data and deal with the minor annoyance of longer ids and lack of UUID RFC compatibility. But even then, you can truncate and reformat these these to v4 UUIDs trivially without meaningfully impacting the collision resistance, for unsorted external ids in systems that need the compatability.
The actual big risk with this sort of scheme is vm initialization. You need to be sure the CSPRNG you're using is initialized, which can be slightly tricky in cloud environments with configuration/control layer stuff that's racy. Mess this up and two nodes hydrated from the same snapshot may overlap in sequence as they start generating ids, and of course the time component cannot be trusted to save you in this instance.